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    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

    ''Once you tell people there's a cure for something, the more likely they are to pressure doctors to prescribe it.''
    -Robert Ehrlich, drug advertising executive.

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    Wednesday, December 29, 2004

    Crusading Cardiologist: Dr. Eric Topol of the Cleveland Clinic has come out against direct to consumer drug advertising - at least when it comes to arthritis drugs. He appears to make exceptions for cholesterol lowering drugs:

    Rather than a sufficient waiting period after approval to firmly establish safety in the large, representative 'real world' population, the unbridled promotion exacerbated the public health problem. This is so poignantly clear for an indication such as arthritis, which is one of the most common conditions requiring medication. Furthermore, one has to question the wisdom of allowing direct-to-consumer advertising for lifestyle medications that have no capability of preserving life or preventing major events such as MI or stroke. Here the paradox of actually promoting these events is all the more difficult to accept. (emphasis mine)

    It's true that direct to consumer advertising of prescription drugs increases the demand for drugs. The biggest problem with advertising, though, is that the target audience doesn't actually pay for the product, at least not directly. But if Dr. Topol could lay aside his cardiovascular bias for a moment, he would recognize that cardiovascular drug makers are just as guilty of overmarketing their product as any other drug maker. Cholesterol lowering drugs are advertised just as aggressively as arthritis drugs, with commercials that make it seem as if taking them will keep people safe from heart attacks and strokes. In fact, taking them will only reduce the risk from about 15% to 12% for each individual, and there have been studies that suggest they may increase the risk of cancer in the elderly. ( Dr. John Abramson's Overdosed America is an excellent source for the details of the various statin studies and what they do and don't say about the benefits and risks of the drugs.)

    It's also wrong to assume that for every individual patient, preventing future heart disease is more desirable than alleviating the suffering of pain. Ask an 80 year old woman which she would opt for - a cholesterol medicine that lowers her risk of heart disease by three percent over ten years or an arthritis medicine that makes it possible for her to visit her grandchildren but increases that risk by 3%. More than likely, she'll choose the latter.

    posted by Sydney on 12/29/2004 08:45:00 AM 0 comments


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