Dr. Ken Carter

From The New York Times:

PRESCRIPTIONS BLOG: Despite Generic Rivals, Branded Drugs Still Sell Well

Drug companies are finding lucrative foreign markets for their brand-name drugs after patents expire in the United States and unleash generic competition.

http://nyti.ms/xhkjTZ

February 2, 2012, 6:27 PM

Drug Makers Dial Down TV Advertising

By BRUCE JAPSEN

Spending on the advertising of brand-name prescription drugs on television  — which not long ago was a fast-growing marketing venue for the pharmaceutical industry in the United States — has dropped more than 20 percent in the last five years.

According to new figures from Nielsen, spending on television advertising fell 23 percent to $2.4 billion from the beginning of 2007 to the end of last year. Spending in 2011 dropped 2 percent from 2010, and last year was the fourth consecutive year that such spending fell. Drug companies in the United States spent more than $3.1 billion on advertising pharmaceuticals on television in 2007, Nielsen said.

The decline is in sharp contrast to the decade-long drug-industry advertising spree that began in 1997, when the Food and Drug Administration loosened its regulations and allowed direct-to-consumer advertising of prescription drugs on TV.

Some industry analysts attribute part of the decline to controversy over such ads. Employers and health insurance companies have long complained that TV ads drive consumers to the latest, often most expensive, pills. And doctors complain that their patients often pressure them into prescribing these heavily advertised drugs.

Perhaps the most well-known criticism of  TV advertising of pharmaceuticals arose in 2004 when Merck withdrew the once heavily advertised painkiller Vioxx after studies showed it increased the risk of heart attacks and strokes.

Such controversies have led to greater scrutiny of drug ads by the F.D.A. as well as by doctor groups like the American Medical Association.

Analysts say spending on brand-name drug ads on television could deteriorate further because of generic competition to some top-selling drugs that have been widely advertised, like Pfizer’s Lipitor for cholesterol.

From 2011 to the end of 2015, more than $100 billion of brand-name drug sales will be exposed to generic competition, IMS Health said.

Pharmacies and health insurance companies offer incentives to patients with drug coverage to choose cheaper generics over brand-name drugs, limiting the power of television advertising.

This week, Pfizer said fourth-quarter sales of its Lipitor fell more than 40 percent in the United States, where the drug lost patent protection in late November.

Though Nielsen said the $156 million Pfizer spent on TV ads for Lipitor last year was more than the amount spent on any other branded prescription drug, the figure was down 14 percent from the Lipitor advertising in 2010.

Pfizer just entered the third month of a 180-day period of market exclusivity in which Lipitor is competing against just two generic versions, so it has continued to advertise on TV. But the company said it has not yet decided to make a long-term commitment to advertising Lipitor on television after that.

“We will continue to listen to patients over time and adjust our plans for Lipitor, including advertising, as needed to determine how we can continue to best meet the needs of patients,” said a Pfizer spokesman, MacKay Jimeson.

via Drug Makers Dial Down TV Advertising – NYTimes.com.

From The New York Times:

DOCTOR AND PATIENT: Have These Symptoms? Buy This Drug

Checklists of symptoms have become a critical part of every major pharmaceutical marketing campaign, making it easy for patients to diagnose their own ailments — and making it easy for drug makers to sell drugs.

http://nyti.ms/xNjLwa

Dr. Ken Carter
Associate Professor of Psychology
Oxford College of Emory University

Depression’s Criteria May Be Changed to Include Grieving – NYTimes.com.

35% of Canadian psychiatrists intentionally underprescribe recommended dosages of pharmaceuticals: McGill study
May.12, 2011 in Health Care: Ethics, Mental Health, Mental Health: Depression, Pharmaceuticals
They may be uncomfortable talking about it, but it’s definitely going on.
A recent survey, led by McGill Psychiatry Professor and Senior Lady Davis Institute Researcher Amir Raz, reports that one in five respondents – physicians and psychiatrists in Canadian medical schools – have administered or prescribed a placebo. Moreover, an even higher proportion of psychiatrists (more than 35 per cent) reported prescribing subtherapeutic doses of medication (that is, doses that are below, sometimes considerably below, the minimal recommended therapeutic level) to treat their patients.
Prescribing pseudoplacebos – that is treatments that are active in principle, but that are unlikely to be effective for the condition being treated, e.g., using vitamins to treat chronic insomnia – is more widespread than we may have thought according to the survey. Dr. Raz and his colleagues suggest that this may be because physicians have shown themselves to be more prepared to prescribe biochemically active materials even though at lower doses than might be effective.
The survey, which was also designed to explore attitudes toward placebo use, found that the majority of responding psychiatrists (more than 60 per cent) believe that placebos can have therapeutic effects. This is a significantly higher proportion than for other medical practitioners. “Psychiatrists seem to place more value in the influence placebos wield on the mind and body,” says Raz. Only 2 per cent of those psychiatrists believe that placebos have no clinical benefit at all.
Raz’s own interest in placebos grew out of his work in three very different areas: his explorations into how people’s physiology is influenced by their expectations of what is about to happen, his work on deception; and the time he spent as a former magician. Together, these three separate areas of experience have led Raz to explore what remains an uncomfortable hinterland of medical practice for many practitioners – the use of placebos in medicine.
”While most physicians probably appreciate the clinical merits of placebos, limited guidelines and scientific knowledge, as well as ethical considerations, impede open discussion about the best way we may want re-introduce placebos into the medical milieu,” says Raz. He adds, “This survey provides a valuable starting point for further investigations into Canadian physicians’ attitudes towards and use of placebos.”
The research was funded by the Canadian Institute of Health Research, the Natural Sciences and Engineering Research Council of Canada, and the Oxford-McGill Neuroscience Collaboration.
Source for 35% of Canadian psychiatrists intentionally underprescribe recommended dosages of pharmaceuticals: http://www.stonehearthnewsletters.com/35-of-canadian-psychiatrists-intentionally-underprescribe-recommended-dosages-of-pharmaceuticals-mcgill-study/mental-health/

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