Marketing Healthcare

[+ Lucky]

This time of presidential selection seems as good as any to discuss the sorry state of medication marketing in this country. Today the New York Times has articles revealing that the flu vaccine doesn't work so well for people over 70 in most cases, (or even those with impaired immune systems) yet is still heavily marketed to them. Talk about money, money,money.

 

Additionally, for years now we have been told that the drug Zetia, especially when marketed with another cholesterol drug in a tablet called Vytorin, was an advance in protection against heart attacks.

 

But now we find that Zetia doesn't work...at all. Yet today's Times also reveals that many doctors are still prescribing it. Even worse, some studies are suggesting that the chemical in the drug that blocks the absorption of cholesterol in the stomach also blocks chemicals that prevent cancer. So, in other words, Zetia may lead to an increase in cancer!

 

We all know that doctors take kickbacks for prescribing certain drugs, especially the newer expensive ones. Who hasn't gone to a doctor's office and seen all the note pads and pencils and even the paper on the table plastered with sponsors? How many times do you have to sit and wait until the drug reps talk to the doc before he can find time to see you? Everytime I go to one office there is a huge spread of free food for the staff. (But it is nice that the drug companies send cute guys to the gay ones and cute girls to the straight ones)

 

One doc I know in New York goes to a fancy restaurant for dinner EVERY night he wants, for free.

 

Even I have given up on fighting Lipitor since docs seem determined to have us all on it. There is no evidence yet that Lipitor prevents any heart disease, but because it does lower cholesterol numbers the docs push it for lack of nothing else. Yet many suffer severe side effects.

 

I remember telling a doc about the leg pain I got from Zetia. He insisted that it couldn't be true since Zetia had no side effects. "How could it," he asked. "It's absorbed in the stomach and doesn't even get into the bloodstream?" Well, maybe it also absorbed chemicals I needed to prevent leg pain, I don't know. I'm not a doctor!

[seaboy4hire]

Lucky thanks for mentioning this article. When I get home from work tonight I'll see if I can find it online. I've been screaming to my friends about this for the last seven years. But since I'm not a fancy reporter and just a dumb hooker no one really pays much attention to me. My uneducted guess is that this goes much much deeper and it's much more then free meals and pens and notepads that the Drs. and staff of the offices are receiving. The drug companies pockets are as deep as the river is wide.

 

Hugs,

Greg

seaboy4hire@yahoo.com

http://seaboy4hire.tripod.com http://www.daddysreviews.com/newest.php?who=greg_seattle

http://img182.imageshack.us/img182/6707/lebec084a9ad147f620acd5ps8.jpg

I need a holiday!

[+ Lucky]

Even the Wall Street Journal will defy the drug companies...albeit at the bottom of page D2:

 

Studies have been released showing that fish oil is a slightly treatment for people with chronic heart conditions. Better than anticholesterol drugs? No, better than placebo!

 

One study:

3500 on fish oil= 1981 dead over 4 years

3500 on placebo = 2053 dead over 4 year

 

Another study:

 

2285 people on Crestor over 4 years

2289 people on placebo over 4 years

No significant difference in the death rate

 

Which brings in more money? Which does your doc recommend? Which is most likely to help you?

[+ purplekow]

>>We all know that doctors take kickbacks for prescribing

>certain drugs, especially the newer expensive ones. Who hasn't

>gone to a doctor's office and seen all the note pads and

>pencils and even the paper on the table plastered with

>sponsors? How many times do you have to sit and wait until the

>drug reps talk to the doc before he can find time to see you?

>Everytime I go to one office there is a huge spread of free

>food for the staff. (But it is nice that the drug companies

>send cute guys to the gay ones and cute girls to the straight

>ones)

>

Are you really of the belief that notepads and pens or even a free lunch is the determining factor in presciption writing?

And if all pharmaceautical houses are buying physician's souls with table paper and paper bags, are there really enough souls to go around?

I have eaten one or two of those huge spreads you mention. It seems to me that they consisted of pizza and soda or some sandwiches. For this, the doctor was asked to spend some time talking with the representative about the drug. Many physicians opt not to bother but some find the information on new drugs to be helpful and find lunch is the only time that will allow any discussion.

But don't concern yourself about the doctors selling out for stationery, as of January 1, most of the larger American pharmaceautical houses will stop distribution of such items voluntarily. One suspects that they are doing so not out of altruism, but rather because they will save some money and just as likely, that they have found that kind of advertising is not working. They will likely spend that money on blimps and radio and tv spots or perhaps getting a stadium name.

I wonder if you are just a sure the pharmaceutical houses are pushing poisons when it comes to drugs to treat AIDS and diabetes and hypertension and dare I ask, erectile dysfunction as you are about lipid lowering agents. One can certainly make the case that the cost for the drug to an individual may be a hardship when compared to the relative lowering of risk of coronary disease. My personal belief is that these drugs are overprescribed. I don't believe they are overprescribed because the doctor got a free personalized pen, pepperoni pizza or purple pill pocket protector.

 

Your thread makes it seem as though you spend a great deal of times at doctors offices. Perhaps you should check your stock of pens and find if you have an advertising pen from a drug company and if you do, mail it back to them with a note explaining that you don't need their stinking bad pens.

[+ Lucky]

I can't afford the stamp after all the medical bills! SO, KMEM, you think medical care is just great and that the pharmaceutical companies are America's saviors? That about sums up your position as well as you summed up mine!

[+ deej]

Over-prescribing is a general problem. The only defense against it is being an informed patient.

 

My former doctor had me on Lipitor. I repeatedly questioned the need, based on personal research, and he refused to discuss it and kept demanding I continue taking it. I complained about the cost and he handed me a month's worth of free samples. Eventually I stopped taking it without telling him and over the next 2 months the monthly blood test numbers didn't budge.

 

(For the uninformed, a monthly blood test is recommended to detect potential liver damage from Lipitor. I'm perfectly capable of damaging my own damn liver! ;-))

 

When I confronted him with this, we had a rather excited discussion.

 

I have a new doctor now. I explained to him that I had a communication issue with my previous doctor: I wanted some and he didn't. New Dr's opinion is that while my cholesterol is slightly elevated it certainly isn't worth worrying about or medicating, particularly since the "good" cholesterol is quite high. (I like this guy a LOT! He's GREAT about laying out options and what each means.)

 

Fran "The Nanny" Drescher's book is called "Open a Mouth" and it's all about speaking up and becoming an active part of your own medical care. We all really have to do it.

 

(And don't get me started on costs! I just got the memo today about the increase in my per-month costs because my birthday tomorrow has a zero in it. Hmph!)

[seeker630]

In the past year, I've started taking my father to all of his medical appointments (GP, dermatologist, ophthalmologist & cardiologist). (He's developed memory problems and this is the only way to be certain we know what the doctors tell him.)

 

I've only seen drug company reps at one practice - and they were sitting in the waiting room with the patients, a couple of times. *We saw the doctor before they did, so I have no idea how when or how long the interaction occurred.

 

If you think your doctor is over-prescribing because of pens & notepads - or even a free lunch - you need to find another doctor! (which seems pretty obvious - NO drug is totally lacking in side effects; the nest you can hope for is that they're minor and infrequent or rare.)

 

What I *do have an issue with, to some extent, is direct-to-consumer marketing. That takes big bucks, and I'm not sure the 'informing the public' aspect of advertising is worth it!

[+ ArVaGuy]

The pharmaceutical companies now spend more dollars marketing direct to the consumer than they do to the medical profession. Seems like every third commercial on network and cable is for some particular drug or another. Who the hell ever heard of “restless leg syndrome” before the advent of pharmaceutical advertising? Be it Lipitor, Crestor, Byetta, Viagra, Cialis or whatever they all end with “ask your doctor if (insert drug name here) is right for you.”

 

Thanks to all this advertising we’re rapidly becoming a nation of hypochondriacs. Deej speaks of communications with one’s physician and that’s critically important. However, there’s many a patient who visits their doctor demanding prescriptions for drugs they don’t need because they've seen some stupid commercial that tells them they may have some godawful condition that requires XYZ company’s new drug. People have changed doctors because they’ve refused to prescribe a drug so this problem of over prescribing goes both ways.

 

As for all those give away items and free meals that the pharmaceutical companies hand out that’s a bogus issue as far as I’m concerned. There’s not an industry that does not engage in this kind of practice in one way or another. Jeesh if all a pharmaceutical representative has to do is bring a tray of sandwiches or some Danish to a medical office to meet the doctor then they are getting off cheap.

 

Every single day I get sales calls from hotels offering me breakfast, lunch, dinner and all kinds of stuff just to meet them. I’ve notepads, pens, rulers, paperweights, stuffed animals, mouse pads, and squeeze toys to overflowing all given to me by Marriott, Hyatt, Hilton, Starwood and chains you’ve never knew existed. Oh I forgot to mention bathrobes, bubble bath, incense and a whole lot of other crap too. I’ve stayed in hotel suites with not one but two baby grand pianos and bathrooms the size of my apartment. If I played golf, I’d never have to spend a weekend at home due to some hotel tournament or another.

 

And none of it has any effect whatsoever on which hotel I choose for a conference. The same can be said for most physicians who get these alleged freebies from pharmaceutical representatives. The vast majority are not going to be influenced by some tchotsky made in China by some drug company. Most of that stuff is for the patients anyway and obviously it works Lucky because you’re the one paying attention to the pens, pads, and posters they unloaded on these offices. BTW, can I interest you in some pads and pens?

[+ Lucky]

What crap! Really. American healthcare is slave to the pharmaceutical companies and their lobbyists. Doctors are on the take in just about every serious medical study that comes out recommending one of their new pills. The FDA has sold out to them and you have the nerve to post dribble like that. As if we all stay in hotel rooms with huge pianos. It matters or they wouldn't be putting you in them.

[+ purplekow]

>What crap! Really. American healthcare is slave to the

>pharmaceutical companies and their lobbyists. Doctors are on

>the take in just about every serious medical study that comes

>out recommending one of their new pills. The FDA has sold out

>to them and you have the nerve to post dribble like that. As

>if we all stay in hotel rooms with huge pianos.

Obviously you haven't been placed on the newest antipsychotic medication. Guess your doctor is waiting for his check.

Reading time for you post 30 seconds. Time well spent considering it 30 nanoseconds. Hyperbole infinite.

 

You might also consider the role of insurance companies in prescribing not only medications but tests. Many insurance companies decide which drugs they will cover and which they won't based on which ones make the most profit for them. If they get a better deal somewhere else, they change their preferred drug. I think the many millions of dollars these companies are making regarding otherwise arbitrary or even worse, detrimental drug selection might be worth your wrath Lucky. As for me, I have to gather some chocolate and silk stockings for the copay for my yearly physical. For some reason my doctor stopped accepting pens and pads for payments.

 

It matters or

>they wouldn't be putting you in them.

 

I suppose this statement then is in agreement with my statement that the drug companies voluntarily stopping all logo directed advertising to doctors, such as pens and pads, as of Jan 2009, is indicative that it doesn't work.

[+ ArVaGuy]

Obviously you’ve bought the “big pharma is evil” propaganda hook line and sinker. I certainly don’t believe that every single doctor and health care professional in this country is on “the take” as you put it. These studies you cite have just as big an agenda as the pharmaceutical manufacturers, insurance companies, and other allied industries that make up the health care component of our system.

 

Clearly that agenda includes the alleged improvement that universal healthcare would put an end to these supposed abuses you cite. Point of fact, I do think we need reform in our healthcare system but I’m not about to agree with the notion that complete overhaul and conversion to universal single-payer system will vastly improve what we have now.

 

Why such a cynical outlook on the medical profession Lucky? Have you mentioned to your physician that you think he’s “on the take” to the pharmaceutical companies? Have you told him you think he can be bought off for a stack of notepads and box of ink pens along with a tray of muffins and bagels?

 

Excuse me now while I jet off to my next site inspection. The deciding factor will be if Hyatt has four shower heads in the VIP suite versus three at the Marriott. That seems like a fair criteria to base a multimillion dollar decision after all it’s not a matter of life and death but the hotel has gone all out for my business with the absurdly appointed suite. The offer for hotel pads and pens still stands I’ve got boxes of them. I’ll even throw in a couple of mouse pads.

[+ Lucky]

Read what I said. I didn't say every doctor was on the take. I said every doctor who put out a study for a major drug company was on the take. That means we aren't getting objective info on new meds, especially since the FDA sold out.

 

The average doctor is struggling to make ends meet, so he takes what he can get, whether it's a free meal or a blow job from a med rep. The pharmy companies keep stats on which drugs he writes, so he has to answer to them or no more goodies. Most docs can resist the blow jobs, thankfully, but they all wish they had gone into dermatology.

 

Only Unicorn remains immune to these pressures and stands up to big pharma!

[EXPAT]

Most doctors aren't great business people and don't fully get the power of commercial persuasion. I had the same conversation with my doctor that Deej had regarding Lipitor and I suggested that I didn't need it and she kept going on and on about all of the reports she has read. I reminded her that most of the reports were created by doctors hired by the company that makes Lipitor. I told her that she needs to take those with a grain of salt and that she should try to realize that they are pushing a $9 billion a year business for statins alone !!!! She was really offended by my suggesting that she would be taken by stuff like that. I said the power of marketing is very strong especially when drug company profits are at hand. She said that she has never taken anything from these companies. I said that I have seen drug reps in her office on 3 different occasions (now how often do I go to the doctor?? and yet I saw one three different times?) and in each case they were making luncheon arrangements for the entire staff etc. etc.

 

I really believe that some doctors believe that they are doing the right thing and may not even realize they are being unduly influenced by the drug companies who have learned how to influence doctors with psuedo facts and figures.

 

I believe that the idea of being as informed as possible and questioning your doctor is CRITICAL.

[Luv2play]

If you think it's bad in the USA, I remember talking to a doctor friend in Switzerland, which is the home to many pharmaceutical giants and he thought nothing of accepting all-expense paid trips by these companies to exotic locales to attend conventions. Such places as Hawaii in winter, San Francisco in summer, well you get it.

 

A few months ago, I was sitting in my GP's office and saw a pharm rep with his briefcase talking to the receptionist. Seems he wanted to take the doc to lunch. Didn't hear what happened. Pharm companies can be truly sleezy, yet they do produce life saving drugs we need and couldn't do without! What a conundrum! :-(

[+ purplekow]

>Most doctors aren't great business people and don't fully get

>the power of commercial persuasion. I had the same

>conversation with my doctor that Deej had regarding Lipitor

>and I suggested that I didn't need it and she kept going on

>and on about all of the reports she has read. I reminded her

>that most of the reports were created by doctors hired by the

>company that makes Lipitor. I told her that she needs to take

>those with a grain of salt and that she should try to realize

>that they are pushing a $9 billion a year business for statins

>alone !!!! She was really offended by my suggesting that she

>would be taken by stuff like that. I said the power of

>marketing is very strong especially when drug company profits

>are at hand. She said that she has never taken anything from

>these companies. I said that I have seen drug reps in her

>office on 3 different occasions (now how often do I go to the

>doctor?? and yet I saw one three different times?) and in each

>case they were making luncheon arrangements for the entire

>staff etc. etc.

>

>I really believe that some doctors believe that they are doing

>the right thing and may not even realize they are being unduly

>influenced by the drug companies who have learned how to

>influence doctors with psuedo facts and figures.

>

>I believe that the idea of being as informed as possible and

>questioning your doctor is CRITICAL.

 

 

Well thank god you were there to educate this doctor in a matter of minutes as to the proper approach to critical evaluation of medical articles. Perhaps you should set up some seminars for other doctors.

I am also sure she was pleased to hear of your eavesdropping on the arrangements being made by her staff and the fact that you were keeping track of these conversations on each of your visits when most people would have forgotten about it as just part of the noise of the day.

 

If you were as demeaning in person as you come off in your account it is a wonder that the doctor did not suggest you finding a different physician.

 

The doctor is offering advice. She isn't taking you at gun point to the pharmacy and forcing you to ingest large quantities of statins. If. after due diligence and with consideration of your doctor's advice, you decided that a statin was not right for you, then a simple, "Dr. X, I know you have suggested Lipitor, but I have decided I do not want to use that drug, have you any other suggestions?" might have opened a discussion rather than the confrontation you describe. If she insisted on the Lipitor with no other recommendations, then it was time for you to move on to another doctor.

 

This thread has help clarify why it can take days to get an appointment with a doctor. It is not that in order for most primary care physicians to meet expenses and make a salary equivalent to the store manager at Home Depot that he/she has to see 4 to 6 patients an hour. No the real reason is sumptuous feasts of cold sandwiches and overly mayonaissed salads supplied by sex starved drug representatives who perform lascivious acts and lavish the doctor with several dollars worth of stationery, have left the doctors, who are fairly stupid, easily swayed sheep, too weak to see patients who in any case, would be better off dismissing the doctors advice and educating them on the basics of critical reading.

 

This thread also cleared up another mystery. At a graduation party recently, as I walked around the pool and the strains of Simon and Garfunkle wafted over the scene, the local physician, walked up to the new graduate and I overheard him say: "I have just one word for you Benjamin.....stationery"

 

I wonder are you taking a statin now? My cholesterol has been about 220 for years my HDL is about 35 which is low and my LDL 140 which is a bit high but because I have no other risk factors for coronary artery disease, I have not taken a statin. Dietary changes have made little impact and as far as I know, my coronaries are still patent. Considering my age, and using a tool developed from the Framingham study to assess cardiac risk, by accepting the higher level of cholesterol, I have an increased risk of about 16% over my baseline risk of 12% of having a cardiac event in the next 7 years. Each time my physician suggests a statin, I respond that I understand that my choice is not one which optimally limits coronary risk but it is my considered choice.

[+ Lucky]

Dude, no one is saying that you don't need drugs. A little lithium could be real handy for a guy like you. And, it's so old, your doc didn't get any kickbacks on it, so you know you really need it. C'mon now, open wide!

[KMEM]

I have been out of town and have not posted on health care as far as I remember. I think you mean PurpleKow.

 

Best regards,

KMEM

[+ Lucky]

My apologies KMEM. That is not the first senior moment I have had this week.

[+ Lucky]

Lucky is off today to have arthroscopic knee surgery.

[foxy]

A few weeks ago I listened to an interview with Melody Petersen who has written a book called "Our Daily Meds". I haven't read the book but in the interview she said there are only two countries in the world that have television commercials for drugs. The US and New Zealand. She went on to say how Americans are the most over-medicated people in the world and not any healthier because of it.

 

A few weeks ago I met with a woman from a hospice since I thought my mother was about to die and wanted to learn more about hospice care. The woman said my mother wasn't at that stage yet.

 

She went on to tell me about a 92 year old woman who was on over 20 medications. She was in bad shape. She was admitted into hopsice. They took her off all drugs at her request. No doctors were to be brought in to care for her. 6 months later she was released from the hospice. She went on to live for 2 more years. No drugs, no doctors, no more medical tests.

[Luv2play]

Good luck with your surgery. You may be interested to know that the New England Journal of Medicine has just released a study saying your type of surgery is useless. But the doctors love to do it cuz it makes them lots of money. There is a thread here if you care to reflect.

[+ Lucky]

Almost a million of the surgeries have been done at an average cost of $7000 each, not to mention lost time at work, pain and suffering, etc.

 

You have to love our healthcare system. In case you didn't get it, I was kidding about having the surgery.

[Guest zipperzone]

I can't remember who made the comment and I'm too lazy to go back and find the post - but - the comment about most doctors struggling to make ends meet, was a hoot.

 

Any doctor I know (and I know many personally) makes a very good living. What planet were you referring to?

[KMEM]

Zip,

 

Glad you are back among at least the walking wounded which simply means that being out of the hospital doesn't make you completely well. Best wishes on that.

 

As far as medico's making or not making a lot of money, and I know you don't have this in Canada, try talking to a hired hand in a Doc in the Box which is a throw away term for stand alone emergency medical outlets.

 

Best regards,

KMEM

[Lookin]

> In case you didn't get it, I was kidding about having the surgery.

 

I didn't get it, and here I was all day wishing you a speedy recovery!

 

Oh well, prayers already skyward. Please pay attention tomorrow - you'll be recovering from something!