As patients, we all know that millions (billions?) of dollars get thrown around in the Pharma and healthcare industries that may not ever touch us directly. Are all those dollars spent on marketing and research really providing the value they propose? Two related posts/discussions by industry insiders caught my eye lately:
The Downside (and Upside) of Drug Ads
In this piece from the Wall St. Journal Health Blog, Novartis CEO Dan Vasella admits that TV and magazine drug ads may be creating unreasonable expectations. Ya think?
"As a seller, you want to promote the benefit and not so much the potential downside... (the pharmaceutical industry doesn't) show advertisements where drugs are being portrayed as serious, potentially dangerous interventions. Instead, it's all with the people happy and healthy and hugging each other, and it's the sun and flowers."
Still, Vasella claims the ads "serve an important public health function, by getting people to go see the doctor about serious health risks, such as high blood pressure and high cholesterol, that often go undiagnosed and untreated."
I don't know about you, but no rosy, happy people touting drugs on TV ever got me to think seriously about going to the doctor. What got me to the doctor was SYMPTOMS. Admittedly, it would be great if we could motivate people to practice better preventative measures, but I must take issue with the notion that upwards of $58 billion per year in promotions for specific drugs are the right tools here. What say you?
Will Comparative Effectiveness Research Help Patients?
Legendary medblogger Kevin Pho penned this op-ed article for USA Today, in which he takes a doctor's view of studies designed to compare and contrast the effectiveness of similar drugs, medical devices and procedures. The Obama administration has set aside $1.1 billion for this kind of research (still a droplet compared to the money spent on promotions - see above).
Here's how this research could help, according to The American College of Physicians: by potentially "reducing unwarranted variations in treatment among providers, increasing patient accuracy in expected treatment outcomes, and providing patients with greater comfort in the treatment choice made."
Good. I get that. BUT some groups are worried that this research could provide fodder for insurance companies looking to ration coverage by denying patients access to certain treatments or drugs. Also, research itself is imperfect. Minorities tend to be underrepresented in these studies, and large-scale trials take forever ... um, years to complete, so the issue could become irrelevant before the study's even complete.
And the bigger problem is an even more basic one: Will doctors be willing to incorporate this new research in their daily practice? There's no law that says they have to. There's only a U.S. Preventive Services Task Force made up of primary-care physicians -- "an independent, government-sponsored body that provides preventive care recommendations based on rigorous assessments of the available evidence." But its recommendations are not binding.
Still, Kevin MD believes that this research will help doctors sort through the "increasing array of diagnostic and treatment options" and ultimately make better choices for their patients.
Thinking it over, this kind of research seems to have far more value to patients than the typical one-sided drug studies usually conducted, in which Pharma companies simply test their own drugs on a bunch of patients and report the (typically glowing) results. With comparative studies, we can at least get some sense of drugs and treatments stack up against each other. Which is patient-critical info that's been sorely missing in the past. What say you there, Patient Friends?