“A Pill For Every Ill”: Consumer Drug Advertising Should Be Banned
Consumer advertising of prescription drugs is a massive public health experiment in which billions of dollars are spent each year. But this advertising is a blunt instrument where a sharp edge is needed.
Drugs have harms as well as benefits, and the harms are greater when drugs are indiscriminately prescribed. Consumer advertising, delivered to the masses as a shotgun blast, rather than as specific information to concerned patients or caregivers, results in more prescriptions and less appropriate prescribing.
There is no evidence that consumer ads improve treatment quality or result in earlier provision of needed care. Research has shown that the ads convey an unbalanced picture, with benefits and emotional appeals given far greater weight than risks. Clinicians can work to override these miscues, but this steals precious time from activities that can provide real benefit to patients. In the packed agenda of the patient visit, in which so many real concerns and evidence-based care are available to make a difference in people’s lives, the intrusion of marketing risks harm.
Advertising also provokes a subtle shift in our culture — toward seeking a pill for every ill. While there are many for whom stimulants and other medications can be a godsend, the case of attention deficit hyperactivity disorder is a prime example of how, too often, a pill substitutes for more human responses to distress. U.S. clinicians prescribe stimulant medication for A.D.H.D. at a rate 25 times that of their European counterparts. The complex decision to start a long-term medication should be motivated by the observations of teachers and parents and children, in the context of a relationship with a caring clinician − not stimulated by rosy ads.
Consumer drug advertising is banned in most of the world, although pharmaceutical companies are making a full-court press on the European Union, even while violating the limited guidelines for that advertising in the United States.
In the information age, in which more balanced sources of information on drugs should be widely available, biased pill-pushing messages are a public health menace. To advance the health of the public, the United States should follow the lead of the vast majority of countries, and ban direct-to-consumer pharmaceutical advertising.
By: Kurt C. Strange, Room for Debate, The New York Times, December 15, 2013
Affordable Care Act Delivers Big Savings For Seniors
Most of the Affordable Care Act won’t take effect for a few years — and if court rulings and the 2012 elections go a certain way, it may not take effect at all — but there’s already evidence that the reform law is working.
It’s making a big difference in providing coverage for young adults; it’s providing treatment options for women like Spike Dolomite Ward; and it’s slowing the growth in Medicare spending.
It’s also, as Jonathan Cohn explained, saving seniors quite a bit of money on prescription medication.
Under the terms of the Affordable Care Act — yes, Obamacare — pharmaceutical companies provide a 50 percent discount on name-brand drugs for seniors who hit the “donut hole.” The donut hole is the gap in coverage that begins once an individual Medicare beneficiary has purchased $2,840 in drugs over the course of a year. At that point, the beneficiary becomes completely responsible for prescription costs — in other words, he or she has to pay for them out of his pocket — until he or she has spent another $3,600.
It may not sound like a lot of money. But the seniors who hit the donut hole are, by definition, the ones with the most medical problems. Saving a few hundred dollars, on average, makes a real difference. And that’s precisely what’s happening, according to data the administration released today. According to its calculations, 2.65 million seniors hit the donut hole — and then saved an average of $569 each. The data runs through October. More seniors will hit the donut hole through year’s end, so the total number of beneficiaries who take advantage of the discount in 2012 should end up higher.
In an interview with USA Today, Jonathan Blum, director of the Center for Medicare, added, “We’re very pleased with the numbers. We found the Part D premiums have also stayed constant, despite predictions that they would go up in 2012.”
Seniors have been some of the biggest skeptics of the Affordable Care Act, but they’ve also seen some of the most direct benefits. Indeed, USAT’s report went on to note that as of the end of November, “more than 24 million people, or about half of those with traditional Medicare, have gone in for a free annual physical or other screening exam since the rules changed this year because of the health care law.”
If Republicans repeal the law, all of these benefits will simply disappear. It’s something voters may want to keep in mind.
By: Steve Benen, Contributing Writer, Washington Monthly Political Animal, December 7, 2011
Eric Cantor Loves Government Spending…On The Drug Industry
Republicans would like you to believe that our deficit problem is primarily a spending problem and that responsibility for that problematic spending is primarily a Democratic responsibility. But the second claim is as misleading as the first. Republicans have also been known to promote wasteful government spending, particularly when it goes towards an industry with which they happen to be cozy. For a vivid illustration of this, look no further than a new Politico article about House Majority Leader Eric Cantor and his position on a key deficit reduction proposal.
The proposal in question would lower the cost of what the federal government currently pays to provide low-income seniors with prescription drugs. For years, the government purchased drugs for these seniors directly through Medicaid, taking advantage of the low prices drug companies must, by law, provide when selling drugs for the people in that program. But that changed in 2006, with the creation of Medicare drug benefit. At that point, the government delegated the purchasing of drugs for low-income seniors to private firms. And the firms haven’t been able to negotiate equally deep discounts, partly because of restrictions on their ability to limit drug availability.
According to the Congressional Budget Office, restoring the “Medicaid discount” for low-income seniors could save more than $100 billion over the course of a decade, depending on the structure of the proposal. And, at one point, many health care reformers had hoped to include that proposal as part of what became the Affordable Care Act. The administration and leaders of the Senate Finance Committee agreed not to include the proposal in the final legislation, as part of their infamous deal with the drug industry lobby. But that was a one-time deal, at least in theory, and congressional negotiators are looking seriously at enacting the proposal now.
The problem is lawmakers like Cantor, who oppose the idea. According to the Politico story, written by Matt Dobias, Cantor is making the same argument that the drug industry lobby does: That the proposal would amount to a form of government price controls, retarding economic growth and discouraging innovation.
The latter point is highly dubious: The reduction would bring reimbursement levels for these drugs very close to what they were a few years ago. Many experts, including the CBO, think the likely impact on research and development would be negligible. (Harvard economists Richard Frank and Joseph Newhouse addressed this issue at some length in Health Affairs a few years ago.)
As for the former suggestion, it’s true that any net reduction in government spending could reduce economic growth, at least at this particular moment. That’s why it’s not a good idea to be madly slashing government spending right now — and why, perhaps, congressional negotiators should delay implementation of this cut, like the others, so that it would take effect after the economy has more fully recovered.
But Cantor’s anxiety over the economic ramifications of spending cuts seems strangely selective. He hasn’t raised similar concerns about cuts to food stamps, Medicaid, and similar programs that would likely have a more devastating impact, both on the economy as a whole and the people who depend upon them for support.
Then again, food stamp recipients didn’t donate $168,000 to Cantor’s reelection campaign in the last cycle. The drug industry did.
By: Jonathan Cohn, The New Republic, July 15, 2011
Drug Marketing and Free Speech: U. S. Supreme Court Says Data Mining Trumps Your Medical Privacy
Pharmaceutical companies, which spend billions of dollars a year promoting their products to doctors, have found that it is very useful to know what drugs a doctor has prescribed in the past. Many use data collected from prescriptionsprocessed by pharmacies — a doctor’s name, the drugs and the dosage — to refine their marketing practices and increase sales.
The Supreme Court on Thursday made it harder for states to protect medical privacy with laws that regulate such practices. In 2007, Vermont passed a law that forbade the sale of such records by pharmacies and their use for marketing purposes. The ruling upheld a lower court decision that struck down the law as unconstitutional.
Justice Anthony Kennedy, writing for the 6-to-3 majority, said the law violates First Amendment rights by imposing a “burden on protected expression” on specific speakers (drug marketers) and specific speech (information about the doctors and what they prescribed). It is unconstitutional because it restricts the transfer of that information and what the marketers have to say.
In dissent, Justice Stephen Breyer explains that the law’s only restriction is on access to data “that could help pharmaceutical companies create better sales messages.” He notes that any speech-related effects are “indirect, incidental, and entirely commercial.” By applying strict First Amendment scrutiny to this ordinary economic regulation, he warns, the court threatens to substitute “judicial for democratic decision-making.”
The law would have been upheld, Justice Breyer says, if the court had treated it as a restriction on commercial speech, which is less robustly protected than political speech. The court’s majority unwisely narrows the gap between commercial and political speech, and makes it harder to protect consumers.
By: Editorial, The New York Times, June 23, 2011
Share This Blog
Unknown Feed- An error has occurred; the feed is probably down. Try again later.
mykeystrokes.com 