We have all seen advertisements for drugs followed by the admonition, "Ask your doctor." This is called 'direct to the patient ' advertising. This is just one of the questionable tactics used by the pharmaceutical industry. In the last couple of years, they have paid over $2 billion dollars in fines for illegal promotion and marketing.
Last year, prescription drug sales rose 11.5% and had a profit margin of 14% -- among the highest for US companies, according to Time magazine. The pharmaceutical industry also has 526 lobbyists in Washington (almost one for every representative).
The latest problem in the drug industry is Vioxx. Merck has withdrawn Vioxx from the market after it was revealed that it can bring on heart attacks and strokes. It belongs to a group of drugs known as Cox-2 inhibitors. They are used because they appear to have less risk of gastrointestinal side effects. They are not necessarily better at treating the arthritis.
While Merck took this drug off the market voluntarily, it did not do so without considerable prodding. The Cleveland Clinic published a paper in 2001 showing a significant risk of heart attack. At the time, Merck dismissed these and other studies as 'flawed.'
We, as consumers, should be very skeptical of all drug advertising and very angry at the drug companies for illegal and unethical behavior.
Time and time again, it has been shown that pharmaceutical companies promote their newest, more expensive drugs when an older drug may be at least as effective and much less expensive than the older one. A case in point was a study last year that clearly showed an older drug, a diuretic, treated high blood pressure more effectively than the newer and much more costly drugs being heavily promoted by drug companies.
Thomas Scully with the Centers for Medicare and Medicaid Services told doctors that they should be ashamed if they prescribe Nexium for patients with heartburn because it has no benefits over older and cheaper heartburn drugs.
When the patent on a drug is about to expire and, with it, high profits, drug companies heavily promote the drug and also develop "new" drugs to take their place. These are usually just different enough to get a new patent but really not a new development or treatment. Nexium is such a drug.
Drug companies also encourage physicians to prescribe certain drugs under the guise of education. While it is illegal for pharmaceutical companies to advise use for "off label" reasons, Pfizer recently paid a fine of almost a half a billion dollars and pleaded guilty to encouraging doctors to prescribe Neurontin for off label uses. Neurontin is a good drug to treat epilepsy but 90% of the prescriptions written for Neurontin are for things other than epilepsy.
Many people are now calling for legislation to require pharmaceutical companies to do proper research into the comparative effectiveness of drugs, to stop advertising directly to consumers, to stop promoting off label uses of drugs, and to clean up their promotional activities with physicians and the public.