Physicians need to understand subtle marketing manipulation

[Guest guest]

http://www.kevinmd.com/blog/2011/08/physicians-understand-subtle-marketing-manip\

ulation.html

Physicians need to understand subtle marketing manipulation

by Toni Brayer, MDâ  | in Medsâ  | 6 responsesâ â 

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There is do doubt that the way pharmaceutical companies market drugs to both

doctors and consumers sways prescribing and drives up health costs. 

Prescription drug costs have outpaced other health care spending and are

predicted to exceed the growth rates for hospital care and physician services

going forward from 2010-2019.

Two researchers ( Brody, MD, PHD, University of Texas Medical Galveston

and , PhD,  University of Medicine and Dentistry of New Jersey)

have outlined 6 things that have a large effect on physicians and lead us into

prescribing drugs that may not be needed.   It’s not just the pharmaceutical

marketing that has led us to this place … it is also how journals publish

literature that physicians rely on for changing medical practice.

Here are the 6 strategies that influence us:

 Reducing thresholds for diagnosing disease.  For example, a diabetes

diagnosis used to be fasting blood sugar above 130.  Now it is glucose above

100.  There is no evidence that tight control leads to improved outcomes in

preventing stroke, total mortality, blindness or renal failure.  Early

detection  is a good thing if it helps with diet and exercise but recent data

shows that the intensive therapy (HbA 1c-<6%) group did worse.

Relying on surrogate endpoints rather than outcomes as goals.  We know that

Statins lower cholesterol.  From 1994-2006 the use of Statin drugs by adults 45

and older increased 10 fold.  In a meta-analysis of 11 clinical trials

involving 65,229 participants of high-risk patients without prior cardiovascular

disease, the Statin use did not lower all- cause mortality.  Surrogate

endpoints make it easier for marketers to make claims that the drug will benefit

the patient.

Exaggerating safety claims.  When drugs are initially tested, the test

population is usually homogeneous and small.  As a larger number of patients

take the drugs, the potential for adverse effects increases.  We need to always

be aware of this.

Exaggerating efficacy claims.  Marketers often emphasis that a new drug is

better than an established (lower cost) drug when actually the drug performs no

better than the old one.  New drugs might have an advantage for a smaller

subset of patients but marketers emphasize the benefit for everyone.

Creating “newâ€Â  diseases.  Social anxiety disorder (aka: shyness), 

Erectile Dysfunction (aka: aging men), Pre-diabetes etc. creates millions of new

customers who might benefit, but will also be exposed to high cost and potential

side effects.

Encouraging unapproved uses.  It is illegal for a pharmaceutical company to

market a drug for a non-indicated condition, but that doesn’t stop physicians

who are on the honorarium payroll from shilling for dollars.  This has been a

common practice that has just lately had a light shown on it.

I am not bashing Big Pharma here.  They have a product to sell and patients and

physicians are the customer.  It is up to physicians to understand the subtle

marketing manipulation and published research.  We need to remember that

epidemiological data linking a risk factor to a bad outcome does not prove that

changing the risk factor by taking a drug will reduce the risk for an

individual  patient.

Modern pharmaceuticals are lifesavers and have increased longevity and good

health for millions.  But we should always stop and think before we start a

patient on a “lifetime†drug if they have no complaints and make sure we are

really preventing an outcome, not just a lab test.

Toni Brayer is an internal medicine physician who blogs at EverythingHealth.

Submit a guest post and be heard on social media’s leading physician voice.

Sent via BlackBerry by AT & T

[Guest guest]

http://www.kevinmd.com/blog/2011/08/physicians-understand-subtle-marketing-manip\

ulation.html

Physicians need to understand subtle marketing manipulation

by Toni Brayer, MDâ  | in Medsâ  | 6 responsesâ â 

Tweet

There is do doubt that the way pharmaceutical companies market drugs to both

doctors and consumers sways prescribing and drives up health costs. 

Prescription drug costs have outpaced other health care spending and are

predicted to exceed the growth rates for hospital care and physician services

going forward from 2010-2019.

Two researchers ( Brody, MD, PHD, University of Texas Medical Galveston

and , PhD,  University of Medicine and Dentistry of New Jersey)

have outlined 6 things that have a large effect on physicians and lead us into

prescribing drugs that may not be needed.   It’s not just the pharmaceutical

marketing that has led us to this place … it is also how journals publish

literature that physicians rely on for changing medical practice.

Here are the 6 strategies that influence us:

 Reducing thresholds for diagnosing disease.  For example, a diabetes

diagnosis used to be fasting blood sugar above 130.  Now it is glucose above

100.  There is no evidence that tight control leads to improved outcomes in

preventing stroke, total mortality, blindness or renal failure.  Early

detection  is a good thing if it helps with diet and exercise but recent data

shows that the intensive therapy (HbA 1c-<6%) group did worse.

Relying on surrogate endpoints rather than outcomes as goals.  We know that

Statins lower cholesterol.  From 1994-2006 the use of Statin drugs by adults 45

and older increased 10 fold.  In a meta-analysis of 11 clinical trials

involving 65,229 participants of high-risk patients without prior cardiovascular

disease, the Statin use did not lower all- cause mortality.  Surrogate

endpoints make it easier for marketers to make claims that the drug will benefit

the patient.

Exaggerating safety claims.  When drugs are initially tested, the test

population is usually homogeneous and small.  As a larger number of patients

take the drugs, the potential for adverse effects increases.  We need to always

be aware of this.

Exaggerating efficacy claims.  Marketers often emphasis that a new drug is

better than an established (lower cost) drug when actually the drug performs no

better than the old one.  New drugs might have an advantage for a smaller

subset of patients but marketers emphasize the benefit for everyone.

Creating “newâ€Â  diseases.  Social anxiety disorder (aka: shyness), 

Erectile Dysfunction (aka: aging men), Pre-diabetes etc. creates millions of new

customers who might benefit, but will also be exposed to high cost and potential

side effects.

Encouraging unapproved uses.  It is illegal for a pharmaceutical company to

market a drug for a non-indicated condition, but that doesn’t stop physicians

who are on the honorarium payroll from shilling for dollars.  This has been a

common practice that has just lately had a light shown on it.

I am not bashing Big Pharma here.  They have a product to sell and patients and

physicians are the customer.  It is up to physicians to understand the subtle

marketing manipulation and published research.  We need to remember that

epidemiological data linking a risk factor to a bad outcome does not prove that

changing the risk factor by taking a drug will reduce the risk for an

individual  patient.

Modern pharmaceuticals are lifesavers and have increased longevity and good

health for millions.  But we should always stop and think before we start a

patient on a “lifetime†drug if they have no complaints and make sure we are

really preventing an outcome, not just a lab test.

Toni Brayer is an internal medicine physician who blogs at EverythingHealth.

Submit a guest post and be heard on social media’s leading physician voice.

Sent via BlackBerry by AT & T

[Guest guest]

http://www.kevinmd.com/blog/2011/08/physicians-understand-subtle-marketing-manip\

ulation.html

Physicians need to understand subtle marketing manipulation

by Toni Brayer, MDâ  | in Medsâ  | 6 responsesâ â 

Tweet

There is do doubt that the way pharmaceutical companies market drugs to both

doctors and consumers sways prescribing and drives up health costs. 

Prescription drug costs have outpaced other health care spending and are

predicted to exceed the growth rates for hospital care and physician services

going forward from 2010-2019.

Two researchers ( Brody, MD, PHD, University of Texas Medical Galveston

and , PhD,  University of Medicine and Dentistry of New Jersey)

have outlined 6 things that have a large effect on physicians and lead us into

prescribing drugs that may not be needed.   It’s not just the pharmaceutical

marketing that has led us to this place … it is also how journals publish

literature that physicians rely on for changing medical practice.

Here are the 6 strategies that influence us:

 Reducing thresholds for diagnosing disease.  For example, a diabetes

diagnosis used to be fasting blood sugar above 130.  Now it is glucose above

100.  There is no evidence that tight control leads to improved outcomes in

preventing stroke, total mortality, blindness or renal failure.  Early

detection  is a good thing if it helps with diet and exercise but recent data

shows that the intensive therapy (HbA 1c-<6%) group did worse.

Relying on surrogate endpoints rather than outcomes as goals.  We know that

Statins lower cholesterol.  From 1994-2006 the use of Statin drugs by adults 45

and older increased 10 fold.  In a meta-analysis of 11 clinical trials

involving 65,229 participants of high-risk patients without prior cardiovascular

disease, the Statin use did not lower all- cause mortality.  Surrogate

endpoints make it easier for marketers to make claims that the drug will benefit

the patient.

Exaggerating safety claims.  When drugs are initially tested, the test

population is usually homogeneous and small.  As a larger number of patients

take the drugs, the potential for adverse effects increases.  We need to always

be aware of this.

Exaggerating efficacy claims.  Marketers often emphasis that a new drug is

better than an established (lower cost) drug when actually the drug performs no

better than the old one.  New drugs might have an advantage for a smaller

subset of patients but marketers emphasize the benefit for everyone.

Creating “newâ€Â  diseases.  Social anxiety disorder (aka: shyness), 

Erectile Dysfunction (aka: aging men), Pre-diabetes etc. creates millions of new

customers who might benefit, but will also be exposed to high cost and potential

side effects.

Encouraging unapproved uses.  It is illegal for a pharmaceutical company to

market a drug for a non-indicated condition, but that doesn’t stop physicians

who are on the honorarium payroll from shilling for dollars.  This has been a

common practice that has just lately had a light shown on it.

I am not bashing Big Pharma here.  They have a product to sell and patients and

physicians are the customer.  It is up to physicians to understand the subtle

marketing manipulation and published research.  We need to remember that

epidemiological data linking a risk factor to a bad outcome does not prove that

changing the risk factor by taking a drug will reduce the risk for an

individual  patient.

Modern pharmaceuticals are lifesavers and have increased longevity and good

health for millions.  But we should always stop and think before we start a

patient on a “lifetime†drug if they have no complaints and make sure we are

really preventing an outcome, not just a lab test.

Toni Brayer is an internal medicine physician who blogs at EverythingHealth.

Submit a guest post and be heard on social media’s leading physician voice.

Sent via BlackBerry by AT & T

[Guest guest]

http://www.kevinmd.com/blog/2011/08/physicians-understand-subtle-marketing-manip\

ulation.html

Physicians need to understand subtle marketing manipulation

by Toni Brayer, MDâ  | in Medsâ  | 6 responsesâ â 

Tweet

There is do doubt that the way pharmaceutical companies market drugs to both

doctors and consumers sways prescribing and drives up health costs. 

Prescription drug costs have outpaced other health care spending and are

predicted to exceed the growth rates for hospital care and physician services

going forward from 2010-2019.

Two researchers ( Brody, MD, PHD, University of Texas Medical Galveston

and , PhD,  University of Medicine and Dentistry of New Jersey)

have outlined 6 things that have a large effect on physicians and lead us into

prescribing drugs that may not be needed.   It’s not just the pharmaceutical

marketing that has led us to this place … it is also how journals publish

literature that physicians rely on for changing medical practice.

Here are the 6 strategies that influence us:

 Reducing thresholds for diagnosing disease.  For example, a diabetes

diagnosis used to be fasting blood sugar above 130.  Now it is glucose above

100.  There is no evidence that tight control leads to improved outcomes in

preventing stroke, total mortality, blindness or renal failure.  Early

detection  is a good thing if it helps with diet and exercise but recent data

shows that the intensive therapy (HbA 1c-<6%) group did worse.

Relying on surrogate endpoints rather than outcomes as goals.  We know that

Statins lower cholesterol.  From 1994-2006 the use of Statin drugs by adults 45

and older increased 10 fold.  In a meta-analysis of 11 clinical trials

involving 65,229 participants of high-risk patients without prior cardiovascular

disease, the Statin use did not lower all- cause mortality.  Surrogate

endpoints make it easier for marketers to make claims that the drug will benefit

the patient.

Exaggerating safety claims.  When drugs are initially tested, the test

population is usually homogeneous and small.  As a larger number of patients

take the drugs, the potential for adverse effects increases.  We need to always

be aware of this.

Exaggerating efficacy claims.  Marketers often emphasis that a new drug is

better than an established (lower cost) drug when actually the drug performs no

better than the old one.  New drugs might have an advantage for a smaller

subset of patients but marketers emphasize the benefit for everyone.

Creating “newâ€Â  diseases.  Social anxiety disorder (aka: shyness), 

Erectile Dysfunction (aka: aging men), Pre-diabetes etc. creates millions of new

customers who might benefit, but will also be exposed to high cost and potential

side effects.

Encouraging unapproved uses.  It is illegal for a pharmaceutical company to

market a drug for a non-indicated condition, but that doesn’t stop physicians

who are on the honorarium payroll from shilling for dollars.  This has been a

common practice that has just lately had a light shown on it.

I am not bashing Big Pharma here.  They have a product to sell and patients and

physicians are the customer.  It is up to physicians to understand the subtle

marketing manipulation and published research.  We need to remember that

epidemiological data linking a risk factor to a bad outcome does not prove that

changing the risk factor by taking a drug will reduce the risk for an

individual  patient.

Modern pharmaceuticals are lifesavers and have increased longevity and good

health for millions.  But we should always stop and think before we start a

patient on a “lifetime†drug if they have no complaints and make sure we are

really preventing an outcome, not just a lab test.

Toni Brayer is an internal medicine physician who blogs at EverythingHealth.

Submit a guest post and be heard on social media’s leading physician voice.

Sent via BlackBerry by AT & T