OT - Gimme drugs...

[Honolulu Blue]

One thing I've noticed over the past few years is the steep increase in advertising for prescription drugs. It seems like their ads are just about everywhere these days. It seems as though they use every known marketing method - beautiful people, famous people, humor, catchy music, even useful information.

I have to say they're effective; I don't think I'll ever forget Dan Reeves crediting his heart medicine for helping him win "the biggest game of the year" (what, Dan, can't say "Front Office Bowl" without express written consent?)

The goofiest ads happen to be for Enzyte and Levitra. I'm not sure what they're for; let me think LONG and HARD about that one (get it?).

Anyhow, this is not a knock on the drug companies who sell them, the advertising companies who make the ads, or the consumers who need them (or at least think they do). Just a comment on the times.

[QuikSand]

Originally posted by Honolulu Blue
The goofiest ads happen to be for Enzyte and Levitra. I'm not sure what they're for; let me think LONG and HARD about that one (get it?).

I love the ad on TV now for, I think, Levitra... with the fiftysomething graying guy out in his backyard trying to throw the football through the tire.

Paging Dr Freud!

[bionicgrov03]

Originally posted by Honolulu Blue
The goofiest ads happen to be for Enzyte and Levitra. I'm not sure what they're for; let me think LONG and HARD about that one (get it?).

I work in a restaraunt and last night Glaxxo-SmithKline reserved a room to introduce and provide more information about Levitra to a group of nurses and physicians. Needless to say the first thing I asked the guy was about that damn commmercial with the guy throwing the football through the tire. The Levitra rep started cracking up and said that he thought that was one of the most unsubtle ways to market the drug. He also said that they have been getting a lot of flack from the Jim Rome show. Way to go clones!!!

[cthomer5000]

Originally posted by QuikSand
I love the ad on TV now for, I think, Levitra... with the fiftysomething graying guy out in his backyard trying to throw the football through the tire.

Paging Dr Freud!

Well, at least it beats the "did you get a haircut?" angle of the viagra ads.

"did you lose weight? Oh wait - you're walking around with a giant stiffy! Way to go Bob!"

[Bonegavel]

I think there was some sort of ban lifted on their advertising on TV a few years back. Up until then, they were only allowed to advertise in mags and such.

[Honolulu_Blue]

My twin is right. There has been an amazing proliferation in advertising for prescription drugs over the last, 5 or so years.

They are incredibly effective. Back in the day, you would go to the doctor's office tell her your symptoms, she'd check you over, if there is a problem, she prescribes you a drug. Most likely the drug is either a brand name or a generic. I wont go into the whole "drug companies buying doctors" thing. I am sure it happens, but that's not the point. But now, you see a commercial for some brandname drug that sounds effective against whatever it is that ails you. You do some research on-line maybe. Get an appointment with your doctor and bring it up. I think drug companies have seen this happen more and more. Given the time and money gone into researching and developing new drugs (millions of dollars over years and years, many of which never get to market) and the fact that it is only a matter of time before the patent expires and generics hit the market (crushing your profits) there is a ton of wisdom behind this type of advertising.

I always enjoy the part near the end where everyone in the commercial is so happy and serene (either because they can get a hard-on again, or can breathe again, or are no longer depressed) and they are walkingthrough a sunny park with children and dogs playing, all the while someone in a quiet, subdued voice rambles on about how "Xyoxopan can cause heart failure, kidney damage, heart burn, migrain headaches, shrivel your nuts to the size of raisins, give your first and third children webbed feet, so please consult your doctor before taking Xyoxopan."

[cthomer5000]

Oh - somewhat related question. Has anyone else noticed that there is now hard alcohol being advertised on TV?

I know there was no advertising on TV for the longest time, but I think i don't believe it was ever a law - but more an agreement between alcholol companies and government.

In the last 2 months I've seen ads for Captain Morgan's rum and Bacardi Rum. And for clarification, I'm not talking about beer, wine, or malt beverages - but hard alcohol.


If anyone knows anything about this - why the sudden change in policy?

[B & B]

I also have noticed this about liquor.

The beer revolution a few years back with Smirnoff Ice, Jack Daniels Hard Cola and Captain Morgans Gold - to name a few - was a way around marketing high proof hard liquor with trendy, shitty watered down wine coolers. Therefore, the big company name got televison airtime in exchange for the wallet hit to the corporation for lack of sales because these products werent profitable for the most part.

Due to this loophole, I am now seeing straight up Canadian Mist commercials and so forth. Times have changed. Pretty sure that the advertisments are limited to not expressly showing anyone drinking the products.

[Honolulu Blue]

QS: Yep, that's the Levitra commercial.

My evil twin is absolutely right about the effects of prescription drug advertising. Since drug companies don't sell to consumers directly, they have to get them to request their doctors prescribe it - by name. And I also enjoy the disclaimers. In magazines like TV Guide, there's a very pretty one or two page ad selling the product, and one or two more ugly pages printed in 6-point type describing the side effects they don't really want you to know, but have to tell you.

And in regards to those hard liquor commercials (which I've also noticed)

Originally posted by cthomer5000
If anyone knows anything about this - why the sudden change in policy?

I'm just guessing, but it probably has to do with the green stuff. Times are hard for everyone, and hard liquor companies are willing to put up more and more money to advertise, and the networks find it harder and harder to stick to their principles and refuse.

One product I had expected to be advertised heavily is condoms. Unlike most products that are pushed heavily, they are actually useful, affordable, and have no side effects. I see them VERY seldom, mostly on channels I hardly ever watch at times I'm hardly ever awake. So why can't they market them in the wink-wink, nudge-nudge way that the male "enhancement" pills? Or are they not profitable enough to bother with that treatment?

[Eaglesfan27]

The issue of drug companies advertising is a very interesting issue. Drug companies want people to believe the cost of medication is so high because of research and development costs. It is true that a new drug costs a LOT of money to develop. However, a ridiculously large amount of money is spent on advertising and marketing. Of course, you all see a portion of the advertising and marketing money that is spent - those ads you see on TV and in magazines, etc. What many people don't realize is that a lot of money is spent directly on doctors themselves, starting as early as medical school (but I find drug reps trying to be nicer and nicer to me as I progress in my career.) I know older physicians who have gotten trips to the tropics paid for by drug companies so that they can go hear an "educational conference" during part of their time down there. According to statistics, the drug companies spend an average (many physicians get more, some get less) of 11,000 dollars per year per physician on various physician expenses which all have the subtext of increasing the physician's knowledge and usage of their drug.

I decided midway through my 4th year of med school(after being educated by a very good doctor/mentor) that I won't utilize these various drug company offerings because I'm afraid it might subconsciously alter my practice. There are other doctors out there who feel the same way and have various web addresses such as nofreelunch.org However, there are many more doctors who freely accept these educational offerings (not all doctors get trips, some are just lunches, dinners, good tickets to a ball game, etc.) It disgusts me because I know the cost gets passed onto the consumer and it is directly responsible at least in part for the high cost of prescription drugs in this country.

[QuikSand]

I love the phrase "certain sexual side effects" that seems to pop up in the disclaimer list for all these antidepressant drugs.

[QuikSand]

Advertisng policies have been governed by a weird structure of implicit agreements, some of which have softened over recent years. Hard liquor has been off limits for television advertising, but there have been some faults in that recently - mostly on cable stations, though, I think. (The various liquor-branded cold beverages like Bacardi Siilver and Smirnoff Ice and such are mostly malt-based, meaning that they are technically "beer" for industry purposes)

Another thing that people don't realize (until it's pointed out) is that there has been an ages-old agreement among the beer companies that nobody actually drinks the beer in the advertisements. You see the table full of people, they're all holding their glasses up in joyful expressions of happiness, toasting the good times, watching the berr pour into the glass, pointing out that their glass is empty, and just about anything else you can imagine you might do with or arond a glass of beer - except actually drink it. It's almost weird once you realize this - that you've probably seen 4,000 hours of beer ads in your lifetime, and have never once seen anyone drink beer in them.

[Ksyrup]

Originally posted by QuikSand
I love the phrase "certain sexual side effects" that seems to pop up in the disclaimer list for all these antidepressant drugs.

I like how the damn disclaimers are as long, if not longer, than the "informational" portion of the ad. They should just say,"May ruin your life in a variety of ways" and save the money they spend turning a 15 second commercial into a 30 second commercial with disclaimers.

Honestly, some of them have a list of "not suitable for..." that is so long, it makes me not want to try them.

[Maple Leafs]

Ever see that eTrade ad that ran a few years ago? Starts off as a drug ad, and when they get to the side effects they have a woman running through a field of flowers while they start rhyming off symptoms like Giant Eyeball and The Condition Known as Hotdog Finger. Pan back to a guy watching the ad, logging into eTrade and furiously clicking "sell". Great ad.

[QuikSand]

Originally posted by Ksyrup
I like how the damn disclaimers are as long, if not longer, than the "informational" portion of the ad.

There's no doubt that this is a compulsory disclaimer - whoever is in charge of this sort of thing (the FDA, I guess) must dictate the detail and specificity of the side-effects disclaimer... or else you know they wouldn't offer anything of the sort.

[sabotai]

My favorite thing about drug commercials are the ones for birth control pills. "Do not use while pregnant."

Really?

[QuikSand]

Originally posted by Maple Leafs
The Condition Known as Hotdog Finger

If I wanted to join the troll craze, this would make a great FOFC handle.

[Bonegavel]

IIRC, another compulsory addition for drug ads on t.v. is they must point you to a Magazine ad that lists more completely the side-effects or whatnot.

You always hear, "See our ad in Prevention magazine" or something like that.

[SackAttack]

I heart cthomer.

[Ksyrup]

Originally posted by QuikSand
There's no doubt that this is a compulsory disclaimer - whoever is in charge of this sort of thing (the FDA, I guess) must dictate the detail and specificity of the side-effects disclaimer... or else you know they wouldn't offer anything of the sort.

I'm quite sure that's the fact. I just find it amusing that they proclaim how great the drug is, then have to shoot themselves in the foot by appearing to rule out 91% of the world's population from being able to take the drug without some kind of side-effect.

[judicial clerk]

Fear the Pharmaceutical industry. I have heard things very similar to what Eaglesfan27 reports.

The drug companies emply 70,000 sales reps, which equates to one sales rep for every nine doctors in the U.S.

Also check out the interesting story surrounding the proposed rider to the Homeland Security Bill (SB 2053) shielding Eli Lilly from potential lawsuits by families of autistic children for the use of their drug Thimerosal. For awhile, noone would admit to inserting the provision into the bill. Ultimately, retiring senator Penis Navy (I mean Dick Armee) took responsibility, but conspiracy theorists suspect he took one for the team on his way out the door.

Of course, all this info came from an attorney I know who specializes in pharmaceutical products liability cases. She had even more information but I only heard this much before my eyes glazed over and I slipped into a coma-like state.

[Glengoyne]

The disclaimer part is required by the law that allowed them to start advertising prescription drugs on television eight or so years ago. Someone mentioned drug companies owning doctors, while doctors are given all sorts of perks for prescribing, the people really being bought off now adays are the insurance companies. Have you ever gone to the pharmacy, only to have the pharmacist tell you he has to call your doctor because the drug he prescribed isn't formulary. Formulary is code for saying that your insurance company doesn't receive a financial benefit from the fill of that prescription. They want the doctor to change the prescription to another drug that is formulary. In other words another drug that the drug company will throw a couple of dollars to your insurance company as a kick back.

Oh the original point I was going to make about the prescription ads was that for the most part, they aren't targetting people who actually need the drugs. They in fact, in the case of viagra and Levitra, targetting recreational users.

[Franklinnoble]

Bah. What they need is a drug that puts women in the mood to give head. Imagine the television spots for that sort of medication...

[Bonegavel]

All i know about Levitra from the ad is that it can help me throw a football through a swinging tire. Looks good to me.

[cthomer5000]

Originally posted by Bonegavel
All i know about Levitra from the ad is that it can help me throw a football through a swinging tire. Looks good to me.

Can someone please write Kordell Stewart a prescription?

[QuikSand]

Originally posted by Bonegavel
All i know about Levitra from the ad is that it can help me throw a football through a swinging tire. Looks good to me.

Apparently your still-baggable wife will appreciate this skill, too.

[Maple Leafs]

Originally posted by QuikSand
If I wanted to join the troll craze, this would make a great FOFC handle.

It's really funny until Jim adds it into FOF6 and your star QB comes down with a bad case.

[Franklinnoble]

This thread is pure gold. I heart FOFC.

[cthomer5000]

Did anyone just catch the "sequel" to this ad on MNF?

All it showed was the swinging tire-swing, and the bedroom light going off inside the house...

I'm laughing out loud here...

[Draft Dodger]

Originally posted by Ksyrup
I like how the damn disclaimers are as long, if not longer, than the "informational" portion of the ad. They should just say,"May ruin your life in a variety of ways" and save the money they spend turning a 15 second commercial into a 30 second commercial with disclaimers.

Honestly, some of them have a list of "not suitable for..." that is so long, it makes me not want to try them.

and the thing is, they all have the exact same side-effects:
headaches, naseau, diarhea (and no, I can't spell them).

you'd think they'd be able to solve that somehow.

[RPI-Fan]

FWIW, there was an official law or somesuch passed by the FDA allowing hard alcohol advertising on network TV.

It was originally thought there would be a pretty big surge of such ads, but it never really materialized. Being at college, I didn't get much opportunity to listen to the radio, so I never really heard a follow up to this.

Just thought I'd pass along what I was aware of, though...

[BigJohn&TheLions]

I'm surprised noone has mentioned the Barbarino reference... "Gimme drugs, gimmie drugs..."

[sterlingice]

Originally posted by cthomer5000
Can someone please write Kordell Stewart a prescription?

Awesome!

Originally posted by RPI-Fan
FWIW, there was an official law or somesuch passed by the FDA allowing hard alcohol advertising on network TV.

Actually, if I recall correctly, this *wasn't* the case. I believe it was a self-imposed ban. People will always buy hard liquor and advertising only in print media was cheap for all companies involved. However, in the mid 90s, they agreed to end this self-imposed ban. I don't really have time to look it up tonight, but I'm pretty sure that's how it went down.

Originally posted by judicial clerk
Also check out the interesting story surrounding the proposed rider to the Homeland Security Bill (SB 2053) shielding Eli Lilly from potential lawsuits by families of autistic children for the use of their drug Thimerosal. For awhile, noone would admit to inserting the provision into the bill. Ultimately, retiring senator Penis Navy (I mean Dick Armee) took responsibility, but conspiracy theorists suspect he took one for the team on his way out the door.

Of course, all this info came from an attorney I know who specializes in pharmaceutical products liability cases. She had even more information but I only heard this much before my eyes glazed over and I slipped into a coma-like state.

Actually, I remember hearing about this at the time for about 30 seconds while everyone else on the news was still practicing duck and cover during their 24 hour terror-a-thon. Seemed fiendishly evil to me at the time. I have to appreciate the art of it all. Hell, I could have tacked on the "Give SI a billion dollars" rider to that bill and no one would have blinked. People were pannicked and acting stupid at the time and that's how the CIA, FBI, and everyone else got in the provisions of "screw everyone out of their privacy" without anyone batting an eye.

Ok, back to the topic at hand. And, again, I don't have time to confirm this at the time so while the arguments are still the same- I'm not sure the story is entirely correct. I believe pharmaceutical companies could not advertise for the longest time as, well, it should be up to the doctor and not the patient to decide what kind of medicine to take. However, they now can and have two options: you have to give both the benefits and side effects or be vague and not say anything at all (I'm pretty sure there is a provision that you can advertise and give no details at all about your drug and then you don't have to give the side effects, as odd as that sounds).

The key issue here is the different levels of responsibility in both a legal and ethical sense (but the names escape me at the moment). A doctor is supposed to give you the best treatment he knows how and if you're going in there telling him you want Levitra because you like being able to throw footballs through a tire swin- I mean... never mind. Then, he is handcuffed, particularly, if you have a heart condition or something else that would be adversely affected by you taking the medicine. Let's say you die while having sex with your wife, 57yo prostitute, boytoy, rubber woman, etc and your wife, 57yo prostitute, boytoy, rubber woman, etc want to sue the doctor, it becomes a much more complex issue because you told him to give you the drug.

Health is not absolute- there are higher risks of certain things (ie heart attacks, etc) if you participate in risky activities. However, am identical 50 year old non-smoker *can* die before an 80 year old smoker, basically from bad luck (the heart being a complex organ and all). So, if you go into your doctor and demand a drug because you saw it on tv but don't understand the risks, a doctor isn't going to be able to sit down and spend 2 hours explaining to you why this is bad for you. Sure he can tell you "it's bad for your heart" but the next question is "is it going to kill me" and his answer will be "probably not" which is *his best guess* but, again, these things are not absolute. And the way the legal system works now, he's going to get partial liability.

The doctor's other alternative is to say "yes, it could kill you but the chances are slight" or "yes, it could kill you". But everything could kill you. The legal system is set up to reward people if something bad happens and to punish people even if something is unlikely (o rings failing on Challenger) or a person is victim of their own stupidity (McDonald's coffee). Of course, if you tell every patient you have that anything could kill them, you're covered your ass in liability but then you're going to be viewed as a poor doctor and never have any patients. So, then you've put the doctor in the awkward position of trying to measure the risk of someone getting hurt versus the doctor's wellbeing.

I, for one, think it's hugely unethical for drug companies to be advertising for this very reason. The doctors should perscribe what they think is best since they're the ones with the years of medical training and all. If you want to order your own stuff, stick with what's available over the counter that has been deemed "mostly safe" because then what you do to yourself is your own damn fault.

SI

[Honolulu Blue]

A followup: I finally got to see the second Levitra commercial that cthomer described earlier in this thread. I think it's even goofier than the first, more famous one.

And there's now a third one - the one with Mike Ditka imploring us to see a doctor if we want to "stay in the game". Dan Reeves must have been off that week.

I don't know about everyone else, but I am so glad that I have commercials to tell me what drugs I should take to get rid of those nagging problems I always seem to have.

[korme]

This is Bob.



Bob is happy. He bones his wife now longer than ever. His wife appreciates it too. Hi Bob.

[Honolulu Blue]

I can't believe there's another one of THOSE drugs on the market, complete with goofy commercial.

Get this - a man and a woman (presumably husband & wife) in separate bathtubs, outside, overlooking a scenic vista. The announcer says some variation of "ask your doctor if Cialis is right for you." If you've parked two bathtubs outside to hold hands, my opinion is that you have bigger problems than a limp... whatever.

P.S. I encourage you to check out the Cialis Web site, if only to check out the logo. I'm sure a lot of thought went into it.

[JonInMiddleGA]

A quick search turns up quite a bit of discussion of the liquor-ads-on-television controversy.

Basically
-- the absence was part of a 50 year old voluntary agreement between the broadcast networks and the Distilled Spirits Council
http://www.rcfp.org/news/mag/26-1/bct-liquorad.html
--a 1996 Supreme Court ruling (44 Liquormart Inc. v. State of Rhode Island) found that restrictions on truthful, non-misleading ads were a violation of the First Amendment
-- NBC was the first network to break the ban, with Smirnoff ads during Saturday Night Live
-- Worth noting, IMO, is that the networks had abided by the ban since the 40's but local tv & radio stations had been accepting the ads for a number of years before 1996. The spots were airing, but in local breaks instead of network breaks.
-- The FCC has occasionally spoken against the ads (I found comments from 1996, 1998,and 2001) but isn't believed to have jurisdiction to regulate them. That more likely belongs with the FTC.
-- There's also been saber-rattling in Congress about restricting the ads, but those efforts usually stall due to the Supreme Court Ruling mentioned above

[Sun Tzu]

Oh, a storm is threat’ning
My very life today
If I don’t get some shelter
Oh yeah, I’m gonna fade away

War, children, it’s just a shot away
It’s just a shot away
War, children, it’s just a shot away
It’s just a shot away

Ooh, see the fire is sweepin’
Our very street today
Burns like a red coal carpet
Mad bull lost it’s way

War, children, it’s just a shot away
It’s just a shot away
War, children, it’s just a shot away
It’s just a shot away

Rape, murder!
It’s just a shot away
It’s just a shot away

Rape, murder!
It’s just a shot away
It’s just a shot away

Rape, murder!
It’s just a shot away
It’s just a shot away

The floods is threat’ning
My very life today
Gimme, gimme shelter
Or I’m gonna fade away

War, children, it’s just a shot away
It’s just a shot away
It’s just a shot away
It’s just a shot away
It’s just a shot away
I tell you love, sister, it’s just a kiss away
It’s just a kiss away
It’s just a kiss away
It’s just a kiss away
It’s just a kiss away
Kiss away, kiss away

[Honolulu Blue]

Cialis and Levitra both advertised twice during last night's game. The first Cialis ad was the same as I've described before and requires no further comment. The second one was a shock - it actually described what it was used for, and the side effects. All this among the backdrop of smiling, happy couples, of course.

Levitra, on the other hand, continues to beat around the bush. Both featured Mike Ditka telling us all to "get into the game". The second commercial implied that Levitra is for he-men and football players, and baseball is for wimps. Hmmmm, let's connect the dots here:

- Rafael Palmeiro plays baseball
- Rafael Palmeiro uses (and is a spokesman for) Viagra
- Therefore, Viagra is for wimps

But I really think someone should write about taking "The Levitra Challenge" on the dynasty boards. I think it involves throwing footballs through tires. QuikSand, you volunteering?

[QuikSand]

Originally Posted by Honolulu Blue

But I really think someone should write about taking "The Levitra Challenge" on the dynasty boards. I think it involves throwing footballs through tires. QuikSand, you volunteering?

Sure, why not.

I have some carpentry tasks around the house - and have to do about 36 hours worth of hammering nails. I'm thinking I'll pick up a pack of the Cialis "weekend pill" and I'll be all set.

[Honolulu Blue]

Originally Posted by QuikSand

Sure, why not.

I have some carpentry tasks around the house - and have to do about 36 hours worth of hammering nails. I'm thinking I'll pick up a pack of the Cialis "weekend pill" and I'll be all set.

Excellent. Mrs. Q will be SO pleased.

[Fonzie]

The following is a lengthy but well-worth-reading commentary by a former clinical supervisor of mine on the issue of drug companies' influence over the prescription practices of physicians in general, and psychiatrists in particular. I think he hits it right the nail right on the head. Or throws the spheroid right through the circular opening. Or something.

This appeared in the NY Times on Jan 20th. Enjoy!


Commentary: Drug Companies Get Too Close for Med School's Comfort

January 20, 2004
By DAN SHAPIRO

One of our psychiatry residents smiles and leans against the wall. A woman, a few years younger, stops filling the mailboxes with pens and sheets of paper advertising a new antidepressant and faces him squarely. Her voice is melodic and bouncing. Her eyes open wide and she laughs at something. He smiles. He moves to scratch his cheek and she makes the same movement, they are scratching in unison now. They remind me of a flirting couple on a first date.

He has completed medical school and is in the second of four years of psychiatric training. Assuming all goes as planned, in a few years he will be licensed as a psychiatrist.

When he starts practicing independently he will write thousands of prescriptions every year; he already writes hundreds. She is "detailing him," teaching him new uses for her company's antidepressant.

My office sits just outside the mailboxes and I've been watching her. She's been lurking, slowly filling the mailboxes. He is the third resident she has "detailed" in an hour.

Our psychiatry department at the University of Arizona is divided over these interactions. On one hand, a number of professors and a few residents have grown concerned that the department is allowing the pharmaceutical industry to teach our residents to embrace newer, more expensive drugs. On the other, many residents have argued against restrictions, suggesting that they should learn to respond to the marketing now and that prohibiting contact would leave them unprepared for the future. A minority have argued that academic freedom gives the faculty and residents the right to speak with whomever they choose.

There have been debates in a grand rounds forum, in faculty meetings, and in the weekly resident lunch. In response, our department head recently formed a committee to draft a new policy governing relationships with the pharmaceutical industry.

Drug company representatives are a major presence. They sponsor Journal Club (where trainees learn to review new data and research), they pay for many of our weekly speakers and regularly offer free dinners for the residents and faculty. They enjoy free access to our mailboxes and regularly detail our trainees in their offices, hallways and in our little kitchen.

This is not uncommon. Meredith Rosenthal at the Harvard School of Public Health reported in The New England Journal of Medicine that the industry spends roughly $15.7 billion annually marketing medications, with $4.8 billion dedicated to detailing individual physicians, or roughly $6,000 to $11,000 a doctor a year.

Studies indicate that most physicians meet with pharmaceutical representatives four times a month. Studies also reveal that most physicians erroneously believe the representatives do not influence prescribing habits.

When doctors and trainees meet with reps, they change their prescribing habits and are far more likely to prescribe the drugs described, even when they are more expensive or have no benefit over alternatives. They are also more willing to request illogical changes to hospital guidelines that govern which drugs can be prescribed.

Estimates suggest that roughly $1 billion was spent advertising antidepressants to health professionals in 2000.

More than 400 psychiatrists were asked by Dr. Timothy Peterson and his colleagues at Harvard to describe their beliefs about antidepressants. More than half said they believed that newer agents were more effective than older antidepressants known as tricyclic antidepressants and that newer antidepressants, called selective serotonin reuptake inhibitors, or S.S.R.I.'s, had fewer side effects than generic S.S.R.I.'s.

But studies conducted at Oxford, Duke, the University of Manchester and the Canadian Coordinating Office for Health Technology that used a statistical strategy called meta-analysis to combine the results of hundreds of independent studies found that S.S.R.I.'s were as effective as tricyclic antidepressants or slightly less effective. They also revealed that S.S.R.I.'s were tolerated by slightly more patients but had as many side effects.

In an 2002 article, Dr. Peterson wrote: "Despite the lack of evidence of a significant difference in efficacy between older and newer agents, clinicians perceive the newer agents to be more efficacious - these findings are significant as they highlight the discrepancy between empirical evidence and clinical practices and suggest that other factors influence clinicians' medication choices in the treatment of depression."

The effect is easy to see in our department. The antidepressants fluoxetine, known popularly as Prozac, and paroxetine, known as Paxil, are now generic and cost patients and insurers pennies a day. Newer, rival drugs including sertraline (Zoloft), escitalopram (Lexapro) and Venlafaxine (Effexor) are 5 to 20 times as expensive.

In the last seven years, I have watched our residents prescribe the newest medications almost exclusively.

While doctors' prescriptions are based on more than efficacy and cost - they must also consider potential drug interactions, lethality of the drug if overdosed, the patient's prior history and patient preference - the abandonment of older medications by our residents cannot be justified given available data.

Programs that limit contact between industry and trainees do result in changes in behavior and attitudes. In 2001, Dr. Brendan McCormick of the University of Toronto and his colleagues published a study in The Journal of the American Medical Association. The research compared internal medicine residents at McMaster University, who were prohibited from meeting with drug representatives during training, with trainees at the University of Toronto, across town, who had no such limitations.

After training, when they were free to meet with whomever they chose, the McMaster trainees had less contact with company representatives and were less likely to find such contact helpful.

In 1999, in response to growing concern in academic medicine, most pharmaceutical companies voluntarily adopted American Medical Association policies restricting lavish gift-giving to doctors. Some training programs went further, developing strict policies that limit access to medical students and residents. Policies adopted by the University of Michigan, the University of Iowa and and New York-Presbyterian Hospital, among others, have restricted pharmaceutical sponsorship of educational activities, have
limited or completely eliminated their representatives' contact with trainees and have restricted gifts and where they can be displayed.

Unfortunately many programs have failed to address the issue.

In his Pulitzer Prize-winning book for 1984, "The Social Transformation of American Medicine," Dr. Paul Starr, the Princeton sociologist, argued that doctors won legitimacy during the early 20th century by aggressively taking on charlatans who offered cures and remedies. At the time, the American Medical Association argued that only doctors were objective enough to evaluate the benefits of competing medications. While there were other factors, the association leveraged physician objectivity to garner greater independence in practice, higher salaries and the legitimacy doctors have enjoyed since.

If medical schools are unwilling to separate trainees from pharmaceutical company representatives, we risk the appearance of being "bought and sold."

This is sure to lead to governmental regulation and greater erosion of independence. And it should.

[Honolulu Blue]

I saw the new Viagra ad twice while I was on vacation - grown men (mostly) dancing in the streets and celebrating while "We Are The Champions" plays in the background. There was a voiceover, but besides the standard "ask your doctor if Viagra is right for you", I don't remember any of it.

Not to be crude or anything, but if I went out dancing in the streets every time I got, um, "excited", I wouldn't get anything done.

Also, the Speed Channel is turning into the Levitra Network. I swear, every fourth commercial I see on that channel is for Levitra. It's worse than it sounds, since it's always the same commercial.

[tucker342]

Originally Posted by Shorty3281

This is Bob.



Bob is happy. He bones his wife now longer than ever. His wife appreciates it too. Hi Bob.

I hate those commericals

Have you guys seen the new one where he's trying to make a buisness deal with guys from Asia? And they keep saying things like "He's a very STIFF negotiator" and stuff like that...

Enzyte commericals suck

[kcchief19]

I've said it before, I'll say it again -- the last thing I need to see on television is Mike Ditka bitching about how he can't get an erection. I'd love to see a parent explaining this ad to a curious youngster --

Dad: "Well, you see, honey, Mike Ditka used to be a really good football coach, and like mommy and daddy, he and his wife like to share a special kind of hug. Mike is kind of old, so he has a hard time giving his wife a special kind of hug."

Child: "So that medicine helps him get his arms up?"

Dad: "Yeah, something like that."

My favorite line from any of these impotence drug ads, courtesy of Mr. Ditka's Levitra:

If you get an erection that lasts more than 4 hours, get medical help right away.

YIKES!

[kcchief19]

Originally Posted by JonInMiddleGA

A quick search turns up quite a bit of discussion of the liquor-ads-on-television controversy.

Basically
-- the absence was part of a 50 year old voluntary agreement between the broadcast networks and the Distilled Spirits Council
http://www.rcfp.org/news/mag/26-1/bct-liquorad.html
--a 1996 Supreme Court ruling (44 Liquormart Inc. v. State of Rhode Island) found that restrictions on truthful, non-misleading ads were a violation of the First Amendment
-- NBC was the first network to break the ban, with Smirnoff ads during Saturday Night Live
-- Worth noting, IMO, is that the networks had abided by the ban since the 40's but local tv & radio stations had been accepting the ads for a number of years before 1996. The spots were airing, but in local breaks instead of network breaks.
-- The FCC has occasionally spoken against the ads (I found comments from 1996, 1998,and 2001) but isn't believed to have jurisdiction to regulate them. That more likely belongs with the FTC.
-- There's also been saber-rattling in Congress about restricting the ads, but those efforts usually stall due to the Supreme Court Ruling mentioned above

You are correct. The Supreme Court decision, if I'm not mistaken, dealt only with commercial broadcasters making an agreement with each other and an outside party to limit certain advertising -- networks and stations are still entitled to limit cetain kinds of advertising or the time of day in which ads air, so long as the policy is strictly defined and enforced. Despite the increase in harder liquor ads, I believe the networks still enforce policies regarding the alcohol content of beverages advertised and the time of day those ads can air. However, those limitations are self-imposed and vary from network to network and station to station, unlike the old days where everybody agreed not to accept the advertising period.

[Peregrine]

The drug companies emply 70,000 sales reps, which equates to one sales rep for every nine doctors in the U.S.

Some other interesting drug company stats. In 2002 the pharmaceutical industry hired the services of 675 Washington lobbyists, spending a total of $91 million dollars on lobbying efforts. When the Medicare bill was being debated in Congress, I heard interviews from several members of Congress who talked about pharmaceutical lobbyists being literally underfoot in many places, to the point where some parts of the bill were being given directly to pharma lobbyists to "review" before they went into the final bill. Pretty crazy.

[Honolulu Blue]

Further developments:

* I've seen a variation of the Viagra "We Are The Champions" commercial, with just one guy coming out of his house. The voiceover says he's happy because he just saw his doctor. We know the truth, don't we?

* Two variations of the Cialis commerical, where pleasant looking but not supermodel-class couples are touching each other while the voiceover goes on and on. Those commercials put me to sleep these days.

* Apparently Bob and the Enzyte crew are sponsporing a NASCAR Busch Series car. I saw the commercial on ESPN News.

Oh, I'd better point out because I haven't already - Enzyte is NOT a prescription drug, but instead a cocktail of aphrodisiacs like ground rhino horn and Spanish fly. OK, maybe not those, but you get the general idea.

* And it had to happen... saw a commercial during the NCAA tournament. The tone sounded familiar - confident looking guy sauntering through the room answering silly personal questions in the negative. He finally gets to his significant other, who asks, "Hey Stu, did you see your..." "No," he replies, "I saw my bartender." It's a Miller Lite commercial, get it?

I'm a sucker for parodies, and this is a decent one, even if Viagra hasn't run those ads for a few months. I'm sure you'll see it dozens of times, so look for it. And if you can't wait, it's on Miller's Web site.

[Peregrine]

Good point H B, I've always found it funny that Enzyte tries to portray itself as prescription drug, even having a fancy "scientific name" on the screen, when it's really just a better funded version of the stuff I could fish out of my email spam.

[Honolulu Blue]

Saw two different commercials for the same drug, Crestor, this afternoon. It had the usual smiling, happy people, but the voiceover was in rhyme. I thought it was one of THOSE drugs, but the people were both male and female.

Anyway, it's an anti-cholesterol drug.