Friday, March 4, 2016

Don't Ask Your Doctor II

Back in November 2012 I wrote a piece called “Don’t Ask Your Doctor.”  The primary message was that problems with discipline lead people to seek out easy answers, in this case, the pills instead of the lifestyle change.  That behavior makes them particularly susceptible to the advertising of drug companies featuring the healthy-looking actors portraying cured patients enjoying good times with their families and friends as the required warnings and side effects stream along the bottom of the screen.  It’s typical advertising playing upon our insecurities and fears.

I concluded with another important reason not to ask your doctor.  “When we ask our doctors, we put them on the spot.  The drug may not be the best choice.  At this point the doctor can give us the lecture about how we should take better care of ourselves, or else take the easy way out for them by writing a prescription.  They must choose between disappointing or angering a patient or just giving in.  The drug companies count on this pressure, betting that some proportion of doctors will choose to avoid the often-fruitless argument.”  When the doctors cave the drug companies win. 

Last November, three years after I wrote that, the AMA called for a ban on direct advertising to consumers for yet another reason.  A spokesman for the group said, “Today’s vote in support of an advertising ban reflects concerns among physicians about the negative impact of commercially-driven promotions, and the role that marketing costs play in fueling escalating drug prices."  Only two countries do not ban direct-to-consumer advertising of prescription drugs, the United States and New Zealand. “Advertising dollars spent by drug makers have increased by 30 percent in the last two years to $4.5 billion,” and economic understanding tells us that all these costs must be baked into the final price of the drugs.

Last week the New York Times expanded on the issue pointing out that these ads generally emphasize high-cost drugs and “big-ticket treatments like joint replacements and cancer care.”  It is not just the drug companies, but the entire healthcare industry driving up costs with slick advertising.  “The health care industry [overall] spent $14 billion on advertising in 2014, according to Kantar Media, a jump of nearly 20 percent since 2011.”  This trend raises concerns within the medical profession that the practice will increase prices of all treatment by encouraging patients to seek out more expensive and possibly inappropriate treatments.

So there are at least four good reasons not to ask your doctor and to let him or her help you make the best possible decision without outside interference.  I know it would be hard to mute or ignore an ad that seemed to be addressing a cure for some condition making me miserable, but the alternative (as we wait for a legal ban) is to watch the prices of all treatments, and drugs in particular, continue to escalate.

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