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Doctors want ban on prescription drug, device advertisements
- phren0logy 11y agoI'm a doctor, and I think this is a good idea. The information provided to both doctors and patients by drug companies is marketing material. The best source of information is peer-reviewed publications, and even those are subject to some bias. Still, that's the best source we have, and should be the primary way all of us get health care information. If you, as a patient, do not understand what the reasearch articles are about, bring them with you to your appointment. In my clinic, I do not accept visits or items from drug reps (including glossy marketing materials, pens, etc); the only thing they can leave me is a copy of a peer-reviewed article.
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- jessriedel 11y agoThis logic applies to all consumer products. The best way to tell which car is safer is to read the original cash-test reports. Furthermore, if you make a mistake in choosing your car, there is some chance you'll die as a result. Should we ban car commercial? Even car commercials that merely report (as they usually do) summaries of the crash-test reports ("best is class safety!", "4 stars from the car insurance safety board!"), because they may be biased in how they do so?
- phren0logy 11y agoCars are not only available by prescription.
- jessriedel 11y agoSo? You've identified a difference between cars and drugs, but it's not one that prevents your argument from applying to cars.
- woodman 11y agoVehicles are though, by way of DOT standards, various state regulations and licences... Wanna drive on the highway? That better be a vehicle perscribed for such activity.
- jerf 11y agoCars are already heavily regulated. The minimum-legal car may not be comfortable and may not be pretty, but it'll be pretty darned safe and be decently efficient (considering the amount of material it is hauling around to be that safe). You can't advertise a death trap because it's already illegal to sell one. It's a poor comparison to the medical world where you can not help but do dangerous things to solve even more dangerous problems.
- jessriedel 11y agoYou are vastly more likely to die in a car crash than from a non-abused prescription drug. Furthermore, small cars are significantly more deadly than large ones and trucks. Car companies obscure this by comparing cars to ones "in their class", thereby misleading the consumer into thinking that their high-scoring small car is about as safe as it gets. (I am putting aside opiate abuse, since illegal use is a different thing and opiates aren't advertised anyway. But this wouldn't much hurt my argument, since the deaths from cars are very comparable to opiate abuse, so one still can't argue that drugs are more dangerous than cars.)
- bcoates 11y agoTrucks? Last I researched this the Ford F150 and Dodge Ram -- popular, mainstream pickup trucks -- were by a large margin statistically among the least safe vehicles allowed on roads in America, compared across everything, not just in-class.
- jessriedel 11y agoDoesn't really matter to my argument, but for fun: In general, heavier vehicles are vastly safer. If you raise the center-of-gravity off the ground a lot, and don't increase the weight much, it's probably possible to increase the roll-over risk enough to make you worse off. But if you look at the data, you see that the deadliest vehicles are mostly compacts, and the safest ones are mostly SUVs. http://www.thecarconnection.com/news/1096667_the-most-deadly-and-least-deadly-cars-in-america http://www.thecarconnection.com/news/1096667_the-most-deadly... These differences are huge, like, factor of 100 huge.
- johnward 11y ago> If you, as a patient, do not understand what the research articles are about, bring them with you to your appointment. As a doctor do you actually take time for questions? Can you be my doctor? Most of the time the doctors I visit are quick to write a 'scrip to treat symptoms instead of taking the time to find the root cause. After 10 years still no luck.
- jacquesm 11y ago> In my clinic, I do not accept visits or items from drug reps (including glossy marketing materials, pens, etc); the only thing they can leave me is a copy of a peer-reviewed article. That's absolutely super good and I wished that more (all?) doctors followed your example.
- a3n 11y agoThat's a great approach. However ... when I was unemployed, I was very happy that my doctor had free samples from her rep of $DRUG_THAT_KEEPS_ME_ALIVE. Our pediatrician also had free samples for some of the things our kid needed.
- TeMPOraL 11y agoThis is one of the more insidious techniques used by pharma companies. See [0], search for "free sample". [0] - http://slatestarcodex.com/2015/02/17/pharma-virumque/ http://slatestarcodex.com/2015/02/17/pharma-virumque/
- creshal 11y ago> However ... when I was unemployed, I was very happy that my doctor had free samples from her rep of $DRUG_THAT_KEEPS_ME_ALIVE. Our pediatrician also had free samples for some of the things our kid needed. Just remember, public health care is communist! Better dead than red.
- a3n 11y agoI wonder how long it's going to take to get our heads out of our asses, calm the fuck down, and really exploit civilization's gifts to take care of ourselves and our brothers.
- Florin_Andrei 11y ago> In my clinic, I do not accept visits or items from drug reps (including glossy marketing materials, pens, etc); the only thing they can leave me is a copy of a peer-reviewed article. Thank you. This is the only rational approach.
- masterleep 11y agoWhat rubbish! Let speech be free, and let people make up their own minds about things.
- t_t_t_TTT_t_t_t 11y agoAgreed! Bring back the cigarette commercials.
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- masterleep 11y agoI'm glad we agree on that.
- tosseraccount 11y agoThey're better than those AARP commercials.
- wpietri 11y agoWhen someone values their personal notions and pet theories over the addiction and death of millions, it mainly looks creepy to me.
- masterleep 11y agoNot a big fan of the Enlightenment, eh?
- paviva 11y agoI'm a doctor, and very into free speech, but the problem here is that in healthcare, patients' choices are paid with other people money.
- tosseraccount 11y agoWhat if they pay with their own money?
- ChuckMcM 11y agoI would support such a ban. But mostly so that watching the nightly news without being able to skip commercials would be more palatable.
- thieving_magpie 11y agoGet ready for more Draft Kings one day fantasy duel promo code: GambleYourFamilysMoneyAway.
- ChuckMcM 11y agoThere is that. It is interesting to see how television in particular seems to have lost a lot of advertising diversity, excluding advertising for other shows on the same network, these days just drugs, cars, lawyers, and pay-to-play games, with the occasional movie trailer for good measure. Bad news for television networks.
- thieving_magpie 11y agoYeah - to the point that I can't stand it. I can't even watch football anymore. I generally end up muting the commercials and forgetting to check back when they're over.
- johnward 11y agoMonday night football is like USAA and IBM Watson commercials over and over. With erectile disfunction thrown in.
- brightball 11y agoThere's a part of me that wants to agree completely...and there is another part that has concerns about the messenger. The end result of that would be that the gatekeeper to knowing about these drugs or devices are the doctor's themselves meaning those companies just have to work harder to advertise to the doctors to recommend their drug/device. From Last Week Tonight w/ John Oliver: https://www.youtube.com/watch?v=YQZ2UeOTO3I https://www.youtube.com/watch?v=YQZ2UeOTO3I
- chrisprobert 11y agoKey question for digital health / biotech startups is whether direct to consumer (D2C) advertising for testing services (e.g. genetic carrier screening; cancer risk screening) would be included.
- Dwolb 11y agoThis is an issue for both doctors and pharmaceutical companies. Doctors hate it because patients may want a drug that's not optimal for them (but I saw if on TV) and it's bad for pharmaceuticals because they've had to become marketing machines, investing massive amounts of money into advertising and sales apps. The biggest issue with an outright ban is consumer education. Someone, something, or some organization needs to be responsible for properly communicating and educating consumers on a drug, its benefits, and its negatives. It needs to be educational, supplemental, and neutral. Stuff like this does exist for cancer drugs but should spread to other drug areas as well.
- sanderjd 11y ago> Someone, something, or some organization needs to be responsible for properly communicating and educating consumers on a drug Why shouldn't this just be their doctor?
- jonlucc 11y agoThe best reason, in my opinion, is that there are new drugs all the time. The FDA approves on the order of 20 or so drugs per year (that's new drugs, not including new generic versions of old drugs). So physicians have to learn 2 new drugs per month in enough depth to consider how it should change their current prescribing habits.
- wpietri 11y agoEven if consumers were informed by some mysterious agency, doctors would still have to learn new things all the time, including which new drugs are appropriate to prescribe for which conditions. Since doctors have to learn that stuff anyhow, and since they already talk to patients, I don't think explaining drugs to patients is a particularly big burden.
- aquadrop 11y agoAnd now, when advertising is allowed, doctors don't have to learn those new drugs?
- joshuaheard 11y agoI've never understood the logic behind prescription drug ads. The first rule of sales is to pitch the decision maker. You can't buy prescription drugs without a doctor's authorization, so basically the ads are asking people to go beg their doctors for medicine they may, or may not, need. The doctor, in turn, may give in to the patient's emotional pleas, since they are, in effect, in a customer service business. This would be an ethical violation. This rule would remove the ethical temptation of doctors Further, it will be nice not to hear about an erection lasting over 4 hours, and not being too old for sex, in front of my 11 year old daughter while watching the news after dinner. From a policy perspective, since the patients are not usually paying for the meds (you and I do), it makes sense to keep demand and prices low, as the doctors assert. As for the free market, we do not have a free market in medicine. It is highly regulated through insurance and government regulation. So, I don't see a problem there.
- mindcrime 11y agoYou can't buy prescription drugs without a doctor's authorization, so basically the ads are asking people to go beg their doctors for medicine they may, or may not, need. FWIW, I asked my GP about this when I went in for a physical recently. He said he really doesn't get patients coming in asking for specific drugs in response to TV ads, and said he doesn't think it is an issue. Of course that's just one anecdote, but it shows that doctors are hardly in unanimous agreement on this.
- nedwin 11y agoThough the majority of AMA members voted for it.
- MichaelGG 11y agoFlip side is that it's vile that we need a "doctor's authorization" to even buy chemicals. While there certainly should be regulation to curb abusive advertising (e.g. fraud), it's sad anyone would find it wrong to ask a doctor for drugs. The way things are set up, that's exactly what many people are forced to do. Also, nitpick, but the news and ads in general are almost certainly far more harmful (for your daughter; perhaps you, too) than hearing about ED meds.
- tosseraccount 11y agoCan't a free market sort out the problems with drug use?
- ksherlock 11y agoAs it is, there are too many distortions. You don't pay for your drugs, your insurance company does. You don't even pay for your insurance, your employer does. So once a year, maybe, you grumble that your insurance premiums (the part you pay, at least) are going up, then the next day ask your doctor about Scrotium.
- wooter 11y agoAlso, tying health insurance to employment is a direct result of the Feds wage and price controls of the past. Business couldn't compete in cash, so they went for the next biggest benefit.
- sbov 11y agoOr that the exact same drug may be 1,000 times cheaper in another country but it is illegal for you to buy it there and bring it here.
- littletimmy 11y agoIn the long run, yes. However, in the long run we're all dead.
- kansface 11y agoThere is no free market for drugs or medicine. I also don't think markets converge on free over time.
- pdeuchler 11y agoNo, because a free market gives its consumers what they want and even rational people will take opiates over a constructive life
- paxtonab 11y agoOne of the arguments I've commonly heard against a ban like this is that pharmaceutical companies need to market their products because of the cost developing new drugs. However, this has turned into a strategy of expanding the medical uses of already approved drugs and then marketing the "new uses". Tylenol is the perfect example of this. Everyone "knows" that it reduces the risk of heart attacks, because of the marketing campaigns. But what most people don't know is how little of an impact Tylenol actually makes.
- nickff 11y ago>"Tylenol is the perfect example of this. Everyone "knows" that it reduces the risk of heart attacks, because of the marketing campaigns. But what most people don't know is how little of an impact Tylenol actually makes." Do you mean Aspirin?[1] [1] http://www.scq.ubc.ca/should-i-take-tylenol-advil-or-aspirin/ http://www.scq.ubc.ca/should-i-take-tylenol-advil-or-aspirin...
- johnward 11y agolol
- DanBC 11y ago> Tylenol is the perfect example of this. Everyone "knows" that it reduces the risk of heart attacks, Wait what? Tylenol is acetaminophen, which is not associated with any heart benefit. If anything long term use of paracetamol is possibly linked to a small increased risk of problems. http://www.nhs.uk/news/2015/03March/Pages/Is-long-term-paracetamol-use-not-as-safe-as-we-thought.aspx http://www.nhs.uk/news/2015/03March/Pages/Is-long-term-parac...
- mindcrime 11y agoTylenol is the perfect example of this. Everyone "knows" that it reduces the risk of heart attacks, because of the marketing campaigns. I've never heard a soul mention Tylenol in connection with decreased heart attack risk. Are you sure you aren't thinking about aspirin?
- 6502nerdface 11y agoSuch a ban would probably be damaging to many publicly traded companies (not just in health care, but also media and related) that are large components of the Health Care index funds and even broader market index funds sitting in Americans' retirement accounts... which might make this difficult to accomplish politically. (Aside from constitutionality issues, etc.)
- Florin_Andrei 11y agoAh, yes, the "it will hurt the free markets" red herring.
- 6502nerdface 11y agoHow is it a red herring with respect to political feasibility? (Which you'll note is my point; I'm not arguing anything here about the merit of the idea itself on this basis, except insofar as one counts feasibility as in-scope for merit.)
- dannysatan 11y agoWhy not remove a ban on buying whatever you want WITHOUT prescription.
- Aloisius 11y agoI'm surprised the AMA, insurance companies or the US government haven't built a simple website that compares the drugs used to treat various conditions to combat the problem of people switching drugs because they are new or are heavily advertised. While a layman can't be expected to fully understand the benefits/drawbacks/interactions of a drug in detail, it seems like it should be possible to have an easy to understand grid of positives, negatives, retail price, etc. that would make comparing say, the brand new bipolar drug to old generic lithium.
- pyrocat 11y agoGood the fuck luck. Pharmaceuticals are one of the biggest lobbying groups in DC. Advertising firms would be heavily against this as well. I'm all for this, but it's never going to happen without severe public outcry, and even then...
- donatj 11y agoI'm a grumbly old man despite my age, and am rarely in favour of new laws. That said, I find outlawing prescription drug ads entirely reasonable.
- eevilspock 11y agoOver and over people on HN come to the defense of advertising. Doctors tend to be Republican and free-market adherents. So why would they be against drug advertising? "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" - Upton Sinclair
- vonmoltke 11y ago> Doctors tend to be Republican and free-market adherents. Where did you get this idea from?
- TeMPOraL 11y agoNot to mention this idea: > Over and over people on HN come to the defense of advertising.
- eevilspock 11y ago> Doctors tend to be Republican and free-market adherents. This was based on an outdated[1][2] understanding and personal experience (my father is a physician and nearly every physician I knew supported Reagan). I retract. > Over and over people on HN come to the defense of advertising. I know this because in my comments here I frequently criticize the role of advertising on the internet and society in general. The downvotes are many. Not everyone defends ads, but many do, and my comment is directed at them. Here's one thread[3]. I can't spend more time on this, so if you guys still don't believe me, you win (for the moment). I'd rather you were right anyway. - [1] "In the mid-90s, 72% physicians' campaign donations went to Republicans." https://www.advisory.com/daily-briefing/2015/04/30/how-doctors-political-affiliations-have-changed https://www.advisory.com/daily-briefing/2015/04/30/how-docto... [2] "The percentage of contributions that doctors have given to Republicans has mostly declined since 1996. It dipped below 50 percent in 2008 before rebounding in 2010." "The study attributed the partisan shift to an increase in female physicians and the shrinking number of doctors running their own solo and small practices." http://www.nytimes.com/2014/06/03/upshot/doctors-arent-strongly-republican-anymore.html http://www.nytimes.com/2014/06/03/upshot/doctors-arent-stron... [3] https://news.ycombinator.com/item?id=10398290 https://news.ycombinator.com/item?id=10398290
- sehugg 11y agoI'd like to know more about the strategy for disrupting that $4.5 billion gravy train. The pharma industry and consolidated media is going to fight tooth and nail, and our current surgeon general seems too close to the industry to act as the heavy in calling for more regulation, as did his predecessors with tobacco.
- pjc50 11y agoAs part of the UK's single-payer system, it is illegal to advertise prescription medicines to the public. Seems to work.
- refurb 11y agoYou mean DTC advertising? There are still sales reps in the UK, no?
- pjc50 11y agoYes, although actual prescribing is supposed to be limited by the government agency NICE. (see also https://www.gov.uk/guidance/advertise-your-medicines https://www.gov.uk/guidance/advertise-your-medicines )
- Shivetya 11y agoI would not mind keeping them provided that they were required to mention the generic if it exist by name in regular sized print and voice. Most of the drugs I see are ED/PE related and yes you can get prescriptions. Still in the end, if we are going to allow untested by the FDA and others supplements to be advertised then why would we block drugs which have passed rigid testing from being advertised. Sorry, that would make zero sense.
- slr555 11y agoDoctors are very good at keeping tabs on earnings of others but have no limits on the estimates of their own value. We in turned are conditioned to respect doctors as the vessels which carry the whole of healthcare. Nothing could be further from the truth. Talk to a very large percentage of doctors outside the office and you find that money is there bottom line. They're all for tort reform so you can't recover a large settlement when they are negligent. They grouse endlessly about how much they have to pay for malpractice insurance. I recently saw a doctor get into a private chauffeured limousine with a vanity plate outside a major NY hospital. I don't know too many pharma execs that live that high on the hog. Did I mention the chauffeur was armed. I guess you can make people angry when you flaunt wealth like that. My own doctor lamented not making as much money as "those wallstreet guys" just before he forgot I was in the hospital for a week. Oops.
- anonymous30 11y agoAbsolutely. US doctors have the highest income in the world. Even our supposedly underpaid GPs have higher salaries than specialists in almost every other country. And the public accepts it, even defends it! Yet our health outcomes aren't any better.
- marcoperaza 11y agoHealth outcomes are determined by more factors than the quality of medical care. Obesity (and it's bed fellow diabetes), sedentary lifestyles, drinking & drugs, etc. Given current medical knowledge and technology, no medical system can undo the harm caused by those cultural factors. Doctors' advice is just that, advice that you are free to ignore. Even more specific metrics can be misleading. E.g. we know that cancer patients are more likely to be cured in the US than in Europe, but there's enough confounding factors to muddle any conclusions. It could be that earlier detection in the US leads to treatment for a cancer that would have gone into remission on its own and never been detected by doctors in another country. Or it could be that US cancer care is superior.
- nsxwolf 11y agoThese ads are one of the main reasons I became a cord cutter. I'm very happy they have not yet followed me onto any of the streaming services I use. They are the creepiest thing ever on television. The actors sit around dinner tables with family members speaking unnatural, FDA manipulated dialog ("Oh, I'm doing great, I've been taking Pradaxa for my afib, not caused by a heart valve problem!") Then you get the unending list of side effects read aloud ("death" almost always one) while the actors smile and stare off into space. Occasionally, one of these ads will come in a 2 minute and 30 second variety that fills the entire commercial break. A regulation I'd like to see is that all the side effects must be acted out in the commercial as they are read. Show the peacefully sleeping woman suddenly awakened, choking on her swelling tongue. Or a man running around with an actual 4+ hour erection.
- kristopolous 11y agoDave Barry, is that you?
- hockeybias 11y agoThat would meet the great entertainment criteria 'informative AND entertaining'.
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- DanBC 11y agoDid you check comment history?
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- aquadrop 11y agoGreat news, so pharma companies could focus more on drugs itself and less on marketing. It's huge money waste with mysterious intention - if your drug is the best, doctors should use it anyway, and if it's bad but you can increase its usage with huge marketing campaign, then mankind just gets screwed for own money.
- refurb 11y agoif your drug is the best, doctors should use it anyway Amazingly that is untrue. Doctors have to know that it's the best drug and they often don't. Doctors are often creatures of habit. If I gave my last patient Crestor and it lowered their cholesterol, why not try the same with the next patient?
- chrisan 11y ago> Amazingly that is untrue. Doctors have to know that it's the best drug and they often don't. Doctors are often creatures of habit. If I gave my last patient Crestor and it lowered their cholesterol, why not try the same with the next patient? What you need is a clinical pharmacist not an advertisement. I am perhaps biased as my wife is a clinical pharmacist and one of her biggest things is to make the doctors use evidenced based practice rather than "this worked before" or "I saw this on TV". The amazing part is despite actual studies (all readily available on pubmed etc) she gets ignored and the doctor does what he/she wants anyways. Some older male doctors (who perhaps lack some respect) will literally throw the printed out studies my wife brings to them in the trash.
- refurb 11y agoThanks for sharing that. I think you summed it up nicely. Physicians do have a need for information about new drugs. They simply don't have the time to do the research themselves. That said, the crux of the argument is around how that information is transmitted. DTC seems less than ideal which I can understand.
- TeMPOraL 11y ago> if your drug is the best, doctors should use it anyway, and if it's bad but you can increase its usage with huge marketing campaign, then mankind just gets screwed for own money. That's 100% true for everything - just replace "drug" with "product". As soon as an advertisement is leaving the point of informing about product's existence and features, it's starting to trick people into chosing a suboptimal option.
- sosuke 11y agoYay! I was thinking they should be unable to use actors and only be able to use people with the conditions they treat.
- SilasX 11y agoThis is a great idea, so long as you also ban doctors who fail to keep up with advancements in medicine.
- brandonmenc 11y agoAre family doctors able or willing to keep up on the flood of new medicines available, each of which may only apply to a handful of their patients? Aren't drug ads, in a way, a good method for matching medicines to the people who need them? As far as I know, your family physician isn't going to call you when a new drug comes out that better treats your semi-rare, non-fatal condition - and patients aren't going to read medical journals to discover new drugs to ask their doctor about.
- ejstronge 11y agoI replied to this comment elsewhere: Family doctors are not likely to be treating a semi-rare condition. To put it in programming terms, a front-end web developer would seek advice from a networking expert if her or his application was experiencing a lot of networking difficulties. Further, even if your family physician is monitoring the progress of your disease, you'll likely also be seeing a specialist who will also be monitoring the progress of your disease.
- brandonmenc 11y ago> Family doctors are not likely to be treating a semi-rare condition. Really? I have family members with rare conditions - for example diverticul(it/os)is, which affects 0.74% of the population - and they don't see specialists. The family physician monitors it. And this is with a "Cadillac" insurance plan. I don't think every rare condition automatically gets you in with a specialist.
- ejstronge 11y agoIt likely sounds like a rare condition for you and your family members but that particular example happens to be something regularly discussed in first year medical school courses. See [1] for a discussion of how common this is. Also consider that a family practitioner might easily have 2,000 patients. Thus, she or he will likely have direct experience with diverticulitis. Further (and this is more inside baseball), your family members would need to be admitted to a hospital if their disease worsens to the point that a standard course of antibiotics won't help. There might be better examples of 'rare' conditions than this, but the point stands - for any condition where extensive domain knowledge is required, you'll have a specialist involved. Incidentally, diverticulitis is a very American disorder, likely attributable to our eating habits. You and all other readers should be sure to include fiber in your diet. [1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780269/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780269/
- ck2 11y agoHow about banning reps from visiting doctors and pushing their products?
- teddyh 11y agoEven though many commenters here write about how creepy these ads are, I don’t think many people realize how weird this looks to the rest of the world. The US and New Zealand are the only two western nations which even allow them to exist. As I am not residing in the US myself, the only experience I have of this phenomenon is in parody form: Progenitorivox! https://www.youtube.com/watch?v=mYodDH4qZQo https://www.youtube.com/watch?v=mYodDH4qZQo (I may or may not have written this comment with the exclusive purpose of linking that video.)
- gjm11 11y agoSee also: Paracetamoxyfrusebendroneomycin, https://www.youtube.com/watch?v=qWfwNdmK2lA https://www.youtube.com/watch?v=qWfwNdmK2lA. (Warning: contains some rude words.)
- guelo 11y agoGlad to see AMA expand their lobbying efforts beyond protecting incompetent doctors from lawsuits.
- privacy101 11y agoColor me surprised and happy... I hope this become a reality.
- evanpw 11y agoRelevant slatestarcodex: http://slatestarcodex.com/2015/04/30/prescriptions-paradoxes-and-perversities/ http://slatestarcodex.com/2015/04/30/prescriptions-paradoxes... TL/DR: Doctors like to prescribe new flashy drugs, and patient vs. doctor's ratings of various drugs are negatively correlated.
- hackbinary 11y agoI live in the UK, and I love that there are no Rx TV commercials here. Then again, I live in Scotland, and I get my prescriptions for free. The NHS is an incredible service, and it surprises me that most Americans don't want publicly funded healthcare. Even those darn Canadian guys north of your boarder have a good public healthcare system. BTW, the UK economy spends almost half in, relative terms, at 9.6% of the UK GDP vs the Americans spend of 17.9% of GDP, on healthcare. In real terms (2012 dollars), the UK spends $3480 per person vs the US spending $8362 per person. And we have a health care system free at the point of delivery.
- duderific 11y agoWe're 'MURICANS! We don't need no stinking gubmint telling us what doctor we can see! Now let me get down to Walmart on my Medicare provided scooter because I'm too obese to walk... https://www.medicare.gov/Pubs/pdf/11046.pdf https://www.medicare.gov/Pubs/pdf/11046.pdf
- hackbinary 11y agoJust so we're absolutely clear, I can choose my own doctors. GP's, specialists, dentists, and even a Homeopath!; if I don't like 'em, I can find another, and all on the NHS. I think, in fact, I have more choice than Americans--don't you have to go to whomever your HMO tells you to use? Also, your Canadian neighbours to the north get to choose their doctors.
- hackbinary 11y agoAlso, the NHS funds our transport. http://www.nhs.uk/NHSEngland/Healthcosts/Pages/Travelcosts.aspx http://www.nhs.uk/NHSEngland/Healthcosts/Pages/Travelcosts.a... And scooters: http://www.nhs.uk/conditions/social-care-and-support-guide/pages/mobility-equipment-wheelchairs-scooters.aspx http://www.nhs.uk/conditions/social-care-and-support-guide/p... And we subsidise cars for the disabled: http://www.motability.co.uk/cars-and-wavs/ http://www.motability.co.uk/cars-and-wavs/
- JoeAltmaier 11y ago
- oneJob 11y ago"Patients want ban on doctors taking money from prescription drug companies"
- lando2319 11y agoThere is one I see advertised regularly, one of the side effects is "suicidal thoughts, or actions", can you believe that, OR ACTIONS. It's one thing when a pill causes my body to fail and I die, it's quite another to have a pill put me in a state of mind where I kill myself. Also I have seen recently the words, "these are not all the side effects, see our website for a complete list". It's unbelievable what it has come to.
- netheril96 11y ago> It's unbelievable what it has come to. I don't understand your sentiment. Do you think that the drugs you take before do not have this many side effects, including suicidal thoughts or actions? Or do you find it unbelievable these side effects are now required to be spelt out in front of you?
- thadd 11y agoI agree the ads suck. Banning things rarely makes things better.
- pinaceae 11y agoonly the US and NZ allow direct-to-consumer advertising of prescription drugs. let that sink in a bit. from germany to japan to ghana to timor leste - everyone else has disagreed on this approach.
- davak 11y agoSee how much money your physician takes from drug companies. https://www.cms.gov/openpayments/ https://www.cms.gov/openpayments/ As a physician I can tell you that this type of public reporting has radically decreased the amount of stuff that doctors take from drug companies. Removing advertising from the TV will do the same. It is much easier for a physician to give a patient the most correct medication without these biases. Remember that in the US, we spend about 2-3X as much as anybody else for less length and quality of life. http://qz.com/553181/americans-spend-nearly-three-times-as-much-on-healthcare-as-other-wealthy-countries-and-die-earlier/ http://qz.com/553181/americans-spend-nearly-three-times-as-m...
- maerF0x0 11y agoI would argue the opposite. By creating a separate class of individual that receives information about medicines we obfuscate what the options are. Under the current model a doctor could say "You should take <x>" and I would have little to no exposure to alternatives" . IMO the real issue is that advertising (not just pharmaceutical) is not very informative anymore, we need a return to fact based ads. No more "sexy" women draped over whatever, no more saccharine smily women glowing after their husband took <y> ... Ads today are propaganda.
- Florin_Andrei 11y ago> information about medicines TV ads are not "information about medicines", that's just ridiculous. They are mind-games the advertisers play with potential customers in hope of squeezing more cash out of them. You want true information? Read peer-review studies. > Under the current model a doctor could say "You should take <x>" and I would have little to no exposure to alternatives Right, 'cause doctors are evil like that. I just saw an ad revealing what doctors don't want me to know, I am totally going to believe it!
- crusso 11y agoYou could say similar things about political ads. They're mind-games. Do we want to get rid of them too?
- c3534l 11y agoI guess I'll be the one to go against the grain here. I've seen a lot of doctors over the years, primarily for mental illness, but my experience has served me well generalizing to normal, physical health. The model of a doctor as a paternal guardian who knows better than you so you should just do as he says is a very bad model. They're as flawed human beings as anyone else and the only person qualified to fight for your best interests is you. Doctors get complacent, lazy and fail to keep up with the latest information unless you press them to do so. You HAVE to stay informed and aware to get the best treatment. Ads can serve an important function of informing patients of new treatment options and if doctors could truely be entrusted with your health without question then there wouldn't be a need to regulate these ads at all since doctors would only be perscribing the best treatments anyway. Medicine works best when it's a two-way, active dialog. In my personal experience anyway.
- arawde 11y agoAs someone who also has mental health issues, I want to say I agree. However, I don't think ads are the optimal way for a populace to stay educated. Personally, every medication I've been prescribed has been followed by my own research as to how the medication is designed to work. I will agree though that the relationship between me and my doctor should be a two-way one. I am completely open with my doctor and make it known what i expect out of them, and they are the same with me.
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- c3534l 11y agoIt's not the best solution, but I don't think banning them will do any good. I'm more rebutting the attitude in this thread that medical information is only for your doctor and not you. I don't think you'll get better health outcomes by focusing all of your medical advertising budget on influencing doctors behind the backs of patients. And advertising does serve a legitimate purpose; I knew a woman with restless leg syndrome who had suffered from it for all her life, but a treatment wasn't developed until something like 5 or 10 years ago. She'd have never asked her doctor about it had she not seen the advertising since she had gone without medication for 50 or 60 years at that point.
- kozukumi 11y agoI am from the UK. When I first went to the US in the 90s I was shocked to see adverts on TV for prescription meds. Sure I was used to an ad for some "premium" paracetamol in the UK but drugs to treat depression? nerve pain? Etc. When I released it was the norm I wasn't surprised the US never established an NHS style system. Way too much money to be lost.
- DigitalSea 11y agoWhen I was in the US for most of last year for business this is the one thing that really perplexed me. In Australia the only advertisements we have are for Nurofen and popular paracetamol product Panadol. In the US, things are ramped up quite substantially, ads for blood pressure medication and erectile dysfunction. I just stopped turning on the TV in the end. These ads seemingly dominate television over there and some of the side effects for those drugs sound horrible, death is mentioned a lot.
- danans 11y agoOne of my parents is a doctor, and I grew up getting a amazing front-row baseball seats courtesy of pharmaceutical sales representatives. Not to mention dinners out at nice restaurants when I tagged along to medical conferences. I thought that practice was forbidden, but perhaps not: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811591/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811591/
- cperciva 11y agoWhile I agree with the idea here, it's important to not take it too far. In Canada "advertising to patients" is interpreted to mean almost any communications at all -- including putting up websites with purely informational content. As a patient who sometimes needs information about drugs I'm already taking, this is not helpful. (Fortunately many such websites allow a "why yes, of course I'm a doctor" checkbox to get access to more medical information. But not all.) I think disallowing "push" advertising while still allowing companies to make information available to patients who deliberately seek it out would be a good compromise.
- aggieben 11y agoMedical advertisements aren't the problem. The problem is that consumers aren't spending their own money and don't know how much things cost because medical providers can't/won't tell them. Let's fix that problem.
- docb 11y agoThe doctor has to write a prescription for the drug based on his knowledge and experience the tv add therefore is superfluous and solicitous and Unnessary the add is an attempt push the new expensive drug on the patient and their doctor
- solipsism 11y agoI'm trying to understand, but I'm pretty confused. There must be something I'm missing, because it seems that this is an obvious move to the majority of the world, as well as the majority of Hacker News. Could you all help me out? What am I missing? First, implicit in most of the comments here is the idea that whether you need or don't need a drug is a simple, black-and-white thing. The idea seems to be: if you truly had a need for a drug you'd be going to the doctor for it already, and if you were going to the doctor for it already you'd get the medication. It seems to me there's a lot more nuance. There are many, many classes of drugs that solve problems that aren't obviously "go to the doctor!" kinds of problems. I take a prescription medicine sometimes when I do public speaking. It never occurred to me to talk to a doctor about that problem, because it just seemed like a "problem" some people have and others don't. I happened to find out that this situation is easily treatable online, but I easily could have found out by watching a commercial. And this medicine makes my life significantly better, so that commercial would have been of enormous benefit to me, the consumer. Secondly, it seems obvious that commercials which increase demand would inflate price. For the class of drugs like above -- drugs that make people's lives better but aren't saving lives or addressing significant medical problems -- why should that not be the case? I pay zero dollars for this drug because I have good benefits. Why should that be? I make plenty of money, and I can survive just fine without this drug. Why should I pay zero dollars for it? Why shouldn't the free market be in play in that situation? If we pretend my insurance didn't pay for this drug, I would be happy to pay a bunch of money for it -- or choose not to pay a bunch of money for it because it's too expensive. It's exactly the same decision I make about food at the store, or a new TV. I understand that there are many prescription drugs that aren't "casual" in this way. I think it's good for society to do everything it can to grant to citizens a certain level of health, and therefore I'm all for restrictions on how these kinds of drugs are priced. And therefore it makes sense to have restrictions about how these kinds of drugs are advertised. But Viagra? Why shouldn't Viagra be subject to the free market? I'm an ultra-progressive (though rational) liberal here, so I don't really understand what I'm missing. Clue me in!
- ArkyBeagle 11y ago1) Please, please, please... 2) There goes TV. "May Cause Death." That's some good advertisin' right there. Of course, it's interleaved with the ads from law firms trolling for the victims of the stuff advertised from five years ago...
- Cub3 11y agoThey're banned in Australia, I've never actually seen one before just heard about them from American comedians. I find the practice very strange
- akg_67 11y agoI wonder if HN community reaction would have been different if the headline was "Doctors want ban on access to information to general public on prescription drug and device." This community sees the word "advertisement" and flips out. I guess health insurance and medical special interest groups did their homework on how to phrase the argument in their favor.
- ddingus 11y agoYes, please do. Completely agreed. I find these ADS very highly disturbing, and I'm old enough to remember times before these ADS too.