It's time to ban DTC ads for medications in the US

An excellent thread KrazyshOt!

Prior to the Clinton administration, DTC ads for prescriptions drugs were forbidden. Prescription drugs were advertised only in professional publications, not available to the general public.

Bill Clinton caved in to Big Pharma and got this done about the same time he caved in to Wall Street interests and had the Glass Steagall Act repealed.

I suspect DTC ads have much to do with the level of hypochondria in this country, and with the profit margins of Big Pharma.

Ridiculous. Don't care too much for druggies, but prohibition of any item/substance is a failed proposition. Withholding pain medication from patients who require it is also not the solution, as it forces them to turn to the black market.

Would be nice to see someone in government get smart for a change.

Time to stop legislating morality and let people make their own choices. They don't need the state holding their hands. If they want to make idiotic decisions and get hooked on narcotics then that is their prerogative. As long as they don't expect anyone to bail them out when it goes wrong, which it eventually will.

Putting people in prison or denying them medical treatment to prevent them from *potentially* harming themselves is the absolute wrong answer

a reply to: JBurns

If they want to make idiotic decisions and get hooked on narcotics then that is their prerogative. As long as they don't expect anyone to bail them out when it goes wrong, which it eventually will.

This is the problem... they will always expect someone to bail them out and there will be some bedwetting do gooder lobbying for government to do so. For the children...

a reply to: Boadicea

I'll give you that WebMD is a good idea in concept, but in practice it can do more harm than good. Here's a good discussion talking about their flaws. The problem is that at NO point should these websites be used as a substitute for your doctor and even after consulting them you should still probably speak with your doctor to verify your suspicions. Every article on WebMD finishes with "consult your doctor"

a reply to: Metallicus

Satan must be chilly today huh?

originally posted by: Krazysh0t
I was reading this article on WaPo talking about this massive class action lawsuit in Cleveland, Ohio against the pharmaceutical companies that sell opiates. Part of the lawsuit is addressing the deceptive methods used to advertise these products. Even one of the defendants of the case agrees there is a problem (keep in mind the other two are denying the allegations altogether):

Purdue Pharma, one of more than a dozen defendants in the case, has said it is “deeply troubled” by the crisis and “dedicated to being part of the solution.”

Most people watching the case have determined that a settlement WILL happen. It just remains to be seen if this will go to trial and jury and how much the settlement will be. Granted, the pharma companies want to "be part of the solution but not pay." Lol. Yeah right. Now there are a great many other factors are work leading to the opiate epidemic, but the heart of it all is the way the drug was advertised. Even the pharma companies are admitting that advertising tactics need to be changed (though I doubt any are calling for my change or would support it). Now, a caveat here, one of the chief problems with the advertising with opiates has more to do with their marketing towards doctors, but this issue got me thinking about drug marketing altogether and it seems like now would be a good time to address this awful awful practice.

DTC ads (or direct-to-consumer ads) are ads that sell you (the consumer) medication that jumps the doctor approach. Basically your tv is being your doctor instead of your actual doctor. This makes people go to their doctor and specifically ask for these medications even if you don't specifically need it. For those not in the know, DTC ads are illegal in all but 2 countries. BTW, you'll notice (if you click on my link) that the article I just linked here is talking about the FDA making DTC ads even more problematic.

That alone should be more than enough to tell you that these things should be banned, but the simple fact is that non-medical people aren't knowledgeable enough about diseases and medications to make these kinds of judgements. Marketing directly to them is straight up unethical.

It really surprises me that this isn't talked about more thoroughly on ATS. Do many not know about this practice? The pharma companies say that drug prices have to be high due to R&D research, but there are fully functioning R&D research labs in other countries with low costs. Let's be real here. One of the real reasons that drugs are at such a high cost in the States has to do with artificial demand created by marketing directly to consumers. Economics 101: as demand rises, price rises, while supply drops.

I have never.. EVER seen on TV or heard on radio... anywhere... ads for any narcotics.. Opioids nor any other schedule narcotics. Ever.. No voiceovers, no billboards, no t.v.

And we once owned a neighborhood pharmacy... and I've been in the Medi-Cal profession since 1985.

Never seen an ad for "Got pain? Try FENTANYL! ". "Kids got you frazzled? Ask your doctor for VALIUM. Calms you right down! "

Univ. of Mich. Medical Center 20yr. Retiree
EMT/1St Responder-Currently.

Show one and prove me wrong... I'll stand corrected...

PS to add.. Thank you!

originally posted by: Krazysh0t
a reply to: bigfatfurrytexan

Yeah the whole situation is F'd. Another good indicator are the Super Bugs out there appearing in hospitals. Because of over prescribed antibiotics, diseases that we had under control are coming back stronger than ever. It doesn't take a large leap in logic to come to the conclusion that this is due to DTC ads and people asking to be prescribed antibiotics just because they are sick.

I disagree. In our country DtC advertissing for prescription meds are not allowed. Yet we still have super resistant bugs. The people at the prescribing end (doctors) are responsible for overprescribing antibiotics.

a reply to: mysterioustranger

Since you deemed to quote my whole OP, I assumed you read it all it all, but I guess not...

From the OP:

Now, a caveat here, one of the chief problems with the advertising with opiates has more to do with their marketing towards doctors

The opiate issue only got me thinking about this issue in general.

originally posted by: Krazysh0t
a reply to: Boadicea

I'll give you that WebMD is a good idea in concept, but in practice it can do more harm than good. Here's a good discussion talking about their flaws. The problem is that at NO point should these websites be used as a substitute for your doctor and even after consulting them you should still probably speak with your doctor to verify your suspicions. Every article on WebMD finishes with "consult your doctor"

And yet isn't that exactly what these commercials are telling their patients to do? Consult their doctors...

And isn't that exactly what those folks demanding antibiotics for viral infections did? Consult their doctors... who knew an antibiotic wouldn't help but gave it to them anyway...

And isn't that exactly what those folks addicted to fentanyl did? Consult their doctors who prescribed them a powerful and addictive drug for pain that could have been handled with far less dangerous drugs and substances...

And isn't that exactly what everyone with hospital-acquired MRSA and other antibiotic resistant infectious diseases did? They consulted their doctors...

Who had all the power? The doctors. Who screwed it up royally? The doctors.

Now imagine if folks actually knew that their viral flu could not be treated with antibiotics so they never demanded those antibiotics and just took care of themselves... or if folks could obtain a natural plant with no lethal properties for their pain... or if they knew how to otherwise take care of themselves and could simply avoid a medical setting absolutely seething with germs -- including antibiotic resistant germs -- by taking care of themselves at home...

There is most definitely a place for doctors and other healthcare professionals. But it's not everywhere for everything for everyone. There is plenty that folks can and should do for themselves.

originally posted by: Boadicea
And yet isn't that exactly what these commercials are telling their patients to do? Consult their doctors...

And isn't that exactly what those folks demanding antibiotics for viral infections did? Consult their doctors... who knew an antibiotic wouldn't help but gave it to them anyway...

And isn't that exactly what those folks addicted to fentanyl did? Consult their doctors who prescribed them a powerful and addictive drug for pain that could have been handled with far less dangerous drugs and substances...

And isn't that exactly what everyone with hospital-acquired MRSA and other antibiotic resistant infectious diseases did? They consulted their doctors...

Who had all the power? The doctors. Who screwed it up royally? The doctors.

Doctors may hold a lot of the blame, but that doesn't excuse things like DTC ads from making the situation worse. It sounds like you hold doctors to blame and don't consider pharmaceutical companies culpable for their shady advertising schemes. Do you not believe that advertising works with medication or something?

Now imagine if folks actually knew that their viral flu could not be treated with antibiotics so they never demanded those antibiotics and just took care of themselves... or if folks could obtain a natural plant with no lethal properties for their pain... or if they knew how to otherwise take care of themselves and could simply avoid a medical setting absolutely seething with germs -- including antibiotic resistant germs -- by taking care of themselves at home...

Speaking of which, the ACA wanted to increase primary care access to people in the country so that less people would get sick and therefore require less expensive procedures down the line, but the right didn't like any of that.

There is most definitely a place for doctors and other healthcare professionals. But it's not everywhere for everything for everyone. There is plenty that folks can and should do for themselves.

And then you read stories about people deciding that doctors don't know what they are talking about and pursue hokum like homeopathics which are pretty much placebos with how diluted the manufacturers of them make their products. Or the anti-vaxxer group who has convinced themselves that vaccines cause autism. I was reading a story on Reddit the other day about a lady who was in Africa complaining about getting malaria over and over again yet said she didn't get vaccines. I mean how dumb can you get? So don't pretend like humans have a good grasp on how to take care of themselves.

a reply to: Boadicea

Doctors are not superhumans. Even though they think they are not bought by Pharma companies, actual studies showed the opposite (although carefully worded as to not suggest a causal relationship between pharma payments and prescribing habbits).
The mass amount of money spent on drug advertissements (not only DtC, but to the medical community too) is unbelievable. All that money could have been used to actually find a cure for some of the top 5 diseases the kill a massive amount of people

a reply to: Krazysh0t

Doctors may hold a lot of the blame, but that doesn't excuse things like DTC ads from making the situation worse. It sounds like you hold doctors to blame and don't consider pharmaceutical companies culpable for their shady advertising schemes.

Please. As if I don't have a record right here on ATS of bitching about Big Pharma ad nauseum infinitum!

Patients don't get their drugs directly from Big Pharma... we are forced to go through (and pay) the middleman: the doctor. Big Pharma could say and do whatever they choose, and it wouldn't matter one whit if doctors weren't ready, willing and able to sell out their patients' best interests for whatever goodies Big Pharma is doling out. And/or covering up their gross negligence and malpractice, such as antibiotic resistant infections, which are killing folks left and right but are seldom properly attributed to the true cause: the antibiotic resistant infections.

So don't pretend like humans have a good grasp on how to take care of themselves.

LOL!!! I never "pretended" anything of the kind -- I'm saying exactly the opposite!!! People have been made so dependent upon others that we don't know how to take care of ourselves and are too often actually afraid of our own bodies. I'm saying that has to change through education and information... NOT MAKE US MORE DEPENDENT ON THOSE WHO SCREWED US IN THE FIRST PLACE.

a reply to: Boadicea

It just seems like you are trying to excuse the pharmaceutical companies' behavior and blame the doctors for prescribing the drugs.

originally posted by: whismermill
a reply to: Boadicea

Doctors are not superhumans.

Exactly!!! Doctors have a very valuable place in society. But they are not gods. They are not perfect. They are not infallible. And they are NOT incorruptible.

Dependency equals weakness. Independence equals strength and power. The more dependent one is upon others -- especially for their most fundamental needs -- the more vulnerable one is to being victimized by the one with the power. Power corrupts and absolute power corrupts absolutely.

And that necessarily includes Big Pharma and the FDA.

originally posted by: Krazysh0t
a reply to: Boadicea

It just seems like you are trying to excuse the pharmaceutical companies' behavior and blame the doctors for prescribing the drugs.

Then you need to consider why you feel that why -- because I sure don't. This isn't an either/or situation. There's plenty of blame to go around. Big Pharma plays their part and doctors play their part.

And we get screwed because we don't know any better and have no other options.

a reply to: Boadicea

Ok. That's fair. I'm willing to blame both parties. Though fixing the doctor issue is a tougher dilemma than banning DTC ads.

originally posted by: Krazysh0t
a reply to: Boadicea

Ok. That's fair. I'm willing to blame both parties. Though fixing the doctor issue is a tougher dilemma than banning DTC ads.

And that's fair too -- more than fair.

I would expect that many doctors, nurses, etc., would also appreciate an end to these ads. I'm sure it puts more pressure on them while trying to treat patients in the safest and most effective way possible. Doctors who are familiar with their patients' specific condition and circumstances, and understand their specific needs much better than a one-size-fits-all type commercial just trying to sell a product.

I have chronic pain from fibromyalgia/small fiber polyneuropathy.

I was told of two different classes of drugs i could take opiates or anti depressants.

I tried the anti depressants and they did not work for the pain and the side effects were hell.

I will not take opiates for over one month. plus i found i would have to jump through hoops and go in monthly for drug testing just to get opiates

I had to do research on the internet till i found Gabapentin, a cheap generic drug my doctor never told me about.

I told my doctor i wanted to try it and brought in the research i had done on the internet about Gabapentin and how it worked for people with fibromyalgia/small fiber polyneuropathy.

My doctor had no problem prescribing it and said it was a low danger drug and if it worked great.

I was on it for 9 years before my pain levels dropped to a level i could do without it daily and i still take it once in a while for breakout nerve pain.

The VA now prescribes it to other veterans with neurological pain.

originally posted by: ANNED
I have chronic pain from fibromyalgia/small fiber polyneuropathy.

I was told of two different classes of drugs i could take opiates or anti depressants.

I tried the anti depressants and they did not work for the pain and the side effects were hell.

I will not take opiates for over one month. plus i found i would have to jump through hoops and go in monthly for drug testing just to get opiates

I had to do research on the internet till i found Gabapentin, a cheap generic drug my doctor never told me about.

I told my doctor i wanted to try it and brought in the research i had done on the internet about Gabapentin and how it worked for people with fibromyalgia/small fiber polyneuropathy.

My doctor had no problem prescribing it and said it was a low danger drug and if it worked great.

I was on it for 9 years before my pain levels dropped to a level i could do without it daily and i still take it once in a while for breakout nerve pain.

The VA now prescribes it to other veterans with neurological pain.

www.healthline.com...


It’s not an opioid, but a popular pain medication is increasingly showing up in drug overdoses, worrying doctors and lawmakers. Gabapentin is a prescription medication primarily used to treat seizures and neuropathic pain associated with herpes zoster, otherwise known as shingles. Since the drug was first approved for use in the United States in 1993, it’s largely been considered safe with little or no potential for misuse.
But the opioid epidemic could be changing that.
Gabapentin is now so common among overdose deaths in Kentucky that lawmakers have included it as a controlled substance.
According to data from the coroner’s office in Louisville, gabapentin was found in nearly one-fourth of all overdoses. Across the state, the drug is now showing up in about 1 in every 3 overdose deaths.

The drug has been dubbed an “emerging threat” in the opioid epidemic by officials there.

It’s sold under the brand names Neurontin, Gralise, and Horizant. It’s been available as a generic in the United States since 2004.

Despite turning up in a significant number of fatal overdoses, officials say gabapentin is likely not the cause of the deaths.
Gabapentin can cause effects on the central nervous system, including drowsiness and low-level euphoria, but nowhere near the extent of opioid painkillers.

It’s far more likely for potent drugs such as fentanyl and heroin to result in death. But combining these with gabapentin can result in an even more dangerous high.
“Gabapentin is not a very potent drug, needing high doses to produce its effects,” Edward Bilsky, PhD, provost and chief academic officer at Pacific Northwest University of Health Sciences in Washington and an expert in opioid pharmacology, told Healthline.
“There has been an increase in the mentions of gabapentin toxicity in emergency rooms, including overdose deaths. These are likely due to a combination of gabapentin with another central nervous system depressant,” he said.

Gabapentin’s reputation
Even before gaining recent attention for its role in the opioid epidemic, gabapentin had acquired something of a dubious reputation. While initially only approved for seizures and neuropathic pain, it was widely prescribed and marketed for other conditions and symptoms. Those include bipolar disorder, migraines, insomnia, and anxiety.
It’s also sometimes prescribed for chronic pain.
Pfizer, the developer of gabapentin, was involved in a lawsuit over their marketing of the drug for these off-label treatments. The company eventually paid out more than $400 million in 2004 to settle fraudulent claims it made about the drug’s uses.
It’s common and legal for some drugs to be prescribed off-label. However, it’s illegal for drug companies to market drugs to treat unapproved conditions.
Gabapentin is a commonly used drug

Gabapentin remains a widespread and popular drug.
In 2016, it was the 10th most prescribed medication in the United States, with 64 million prescriptions.
As use of a drug grows, so does the unpredictability of side effects and potential for misuse.
“Once released as an approved drug, the number of people being prescribed the drug jumps substantially (tens of thousands to millions), and there is much more variability in the patient population and less control on how the drug is actually being taken,” said Bilsky.
A study from 2016 found that gabapentin misuse was low among the general population at just 1 percent. But that jumped to between 15 and 22 percent among people who misuse opioids.

“With decreasing availability of commonly abused prescription opioids, it has been suggested that nonmedical users of prescription opioids are substituting other licit and illicit drugs for abuse,” wrote the authors of a 2015 study on gabapentin misuse.
Gabapentin isn’t the only “safe” painkiller to show up on the radar of doctors and lawmakers in recent months, either.
As Healthline previously reported, Imodium — an over-the-counter anti-diarrheal drug — has also seen a surge in misuse. So much so that the U.S. Food and Drug Administration announced a plan to help cut down on its misuse potential.

Neither gabapentin nor Imodium is particularly good at getting you high, so reasons for misuse are likely associated with cost and availability.
“It is hard to say what drives the person who suffers from a substance use disorder to switch between drugs and drug classes,” said Bilsky. “The current misuse of gabapentin may be another version of combining drugs to try and maximize the high."

originally posted by: Krazysh0t
a reply to: mysterioustranger

Since you deemed to quote my whole OP, I assumed you read it all it all, but I guess not...

From the OP:

Now, a caveat here, one of the chief problems with the advertising with opiates has more to do with their marketing towards doctors

The opiate issue only got me thinking about this issue in general.

I did read it. Dr.s are more than up on the old and newer narcotics. There are several kinds:
1.Those would prescribe them normally.
2. Those who will with limits.
3. Those who refuse to prescibe them at all.
4. Those who defer patient to a management clinic for diversity of treatment options.

To imply Dr.s are solicited more than they know right out the gate about long established opioids etc... just isn't happening. They've been aware.

Companies don't need to push said mmeds when in every case/system... these drugs are established and come with a lot of patient medication documentation and filing.

To say the pharm. comps. actively visit docs to push sales.. that is simply not true. In fact.. Dr.s are more hesitant to prescribe these long established narcotics as opposed to selling more.

It's the opposite. They wish..