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HEALTH CARE Doctor: Ads lead patients to take unneeded meds



Published: Thu, February 3, 2005 @ 12:00 a.m.



Pharmaceutical companies argue advertising leads patients to ask their doctors questions.

CLEVELAND (AP) -- It's not just the ever-present erectile disfunction ads that make a prominent Cleveland Clinic cardiologist uncomfortable.

Dr. Eric Topol is troubled by sales pitches for any drug that isn't essential to a patient's survival.

The chief academic officer of the prestigious clinic says that drug ads are leading too many people to seek medication. He's calling for restrictions that would require drugs to be on the market for a while before they are advertised.

"These drugs have to go through a period of at least a year after they're commercially available to make sure in the real world population there are no problems that weren't anticipated," he said.

Dr. Topol wrote an editorial in the Journal of the American Medical Association last month in which he blamed the heavy promotion of the arthritis drug Vioxx for increasing the number of people who suffered from the health problems that it has caused. Merck & amp; Co. pulled the pain killer from the market in September because it doubled patients' risk of heart attacks and strokes.

"One of the reasons this got as bad as it did is these drugs were the most successful mass marketed drugs in history," Dr. Topol said.

As chief academic officer, Dr. Topol oversees all research performed by the clinic. He is also director of cardiovascular medicine at the clinic's heart center, which has been ranked No. 1 in the United States by U.S. News & amp; World Report for the past 10 years.

He is not alone in his criticism of drug advertising.

"I think we're building a nation of drug takers," said Dr. Jerome Kassirer, former editor-in-chief of the New England Journal of Medicine. "It encourages people to ask, and when people ask doctors give."

FDA advertising approval

The U.S. Food and Drug Administration began allowing direct-to-consumer advertising of drugs in 1997. Drug companies' ad budgets swelled to an estimated $3.7 billion last year promoting drugs that treat ailments such as impotence, arthritis, depression, allergies and asthma.

Topol doesn't take issue with the advertising of statin drugs, which lower cholesterol and reduce the risk of heart attack by limiting the buildup of artery-clogging fat deposits. But he doesn't see the need for any advertising of "lifestyle" drugs like Viagra for erectile dysfunction.

Viagra maker Pfizer Inc. says its ads help people to talk to their doctors about conditions they may be suffering.

"These ads really do prompt that conversation on an appropriate treatment," Pfizer spokeswoman Michal Fishman said.

She also noted that in the case of Viagra that erectile dysfunction is sometimes a symptom of a more serious medical condition that a visit to the doctor could reveal.

Merck believes that drug ads enhance consumer knowledge about diseases and treatment options, said spokeswoman Casey Stavropoulos.

The Washington trade group Pharmaceutical Research and Manufacturers of America cites an independent survey of 3,000 adults by the Institute for Health Policy at Massachusetts General Hospital that found 25 percent of the patients who visited doctors after seeing a drug ad received a new diagnosis, many for significant conditions like high cholesterol and diabetes.

Changing the law on drug ads would take legislation, something that Dr. Catherine D. DeAngelis, editor in chief of the Journal of the American Medical Association, doesn't see drug companies allowing to happen.

"I'm sure that they're making a lot of money selling these medications to patients who don't need these drugs," she said.

Questionable consulting

Dr. Topol made headlines recently when Fortune magazine reported that he was a paid consultant to a hedge fund that was betting against shares of Vioxx, a drug he publicly criticized. He responded by ending his work with the fund as well as consulting work for drug, diagnostic and medical device companies to avoid any potential conflicts of interest.

Dr. Topol said he's taken the public stand on drug ads because as a cardiologist there's only so much that can be done to treat a patient after the damage has been done. He doesn't want to see another case like Vioxx.

"I've spent 20-some years on heart attack research," Dr. Topol said. "We've gotten to the point where we can treat heart attacks pretty well, but we have to try to prevent them.




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