Friday, April 19, 2013

TV Ads for Statins Drive Overdiagnosis and Overtreatment

Continued From Last Post.

    To determine the relationship between estimated exposure to direct-to-
consumer advertising for statin drugs and two clinical variables: diagnosis
with high cholesterol and statin use, the featured study, published in the
Journal of General Internal Medicine,2 used logistic regression to analyze
repeated cross-sectional surveys of more than 106,000 Americans, merged with
data on the frequency of ads appearing on national, cable, and local
television, between 2001 and 2007. Interestingly, those who reported seeing
statin ads on TV were:

        16-20 percent more likely to be diagnosed with high cholesterol
        16-22 percent more likely to be using a statin drug

    That’s quite a boost in diagnosis and treatment, and proof positive that
advertising works, even when you’re selling something with greater potential
harms than benefits, as is the case with statins.

    Tellingly, both the diagnosis of high cholesterol and increased statin
use was driven almost exclusively by those who were at LOW risk for future
cardiac events, indicating that overdiagnosis and unnecessary drug treatment
is quite real. Conversely, those at high risk of heart disease were not more
likely to be taking a statin after seeing the commercials. According to the

        "Our findings raise questions about the extent to which direct-to-
consumer advertising may promote over-diagnosis and over-treatment for
populations where risks may outweigh potential benefits. In addition, we
found no evidence of favorable associations between exposure to statins in
television advertisements and statin use among those at high risk for future
cardiac events."

Turning People into Patients — At YOUR Expense

    The 1997 change in direct-to-consumer advertising laws unleashed an
avalanche of drug commercials. Two years later, the average American was
exposed to nine prescription drug TV ads every day. Between 1994 and 2000, TV
drug ads increased 40-fold.3

    In 2005, two of the top four most heavily promoted drugs were
cholesterol-lowering medications. In that year alone, Merck/Schering-Plough
spent $161.5 million on ads for Vytorin, and AstraZeneca spent $158.6 million
advertising Crestor — down from the $212 million4 they spent the year before.
    In all, pharmaceutical companies spend an estimated $4 billion a year on
these types of consumer marketing campaigns in the US, so you can bet they’re
getting a hefty portion of this expense back in the form of increased

    No doubt you’ve heard that drugs cost so much because it’s expensive to
perform research and development of new drugs. Yet pharmaceutical companies
spend nearly TWICE as much on marketing in the US as they do on R&D! This
finding was published in the journal PloS Medicine in 2008.5 According to the

        “From this new estimate, it appears that pharmaceutical companies
spend almost twice as much on promotion as they do on R&D. These numbers
clearly show how promotion predominates over R&D in the pharmaceutical
industry, contrary to the industry's claim.

        While the amount spent on promotion is not in itself a confirmation
of Kefauver's depiction of the pharmaceutical industry, it confirms the
public image of a marketing-driven industry and provides an important
argument to petition in favor of transforming the workings of the industry in
the direction of more research and less promotion.” [Emphasis mine]
    The US is, by far, the largest market for pharmaceuticals in the world,
representing around 43 percent of global sales. This is in part due to
Americans being grossly overcharged. As I recently reported, Americans pay
TWICE the price compared to other countries for the identical drugs.6

    Well, here’s part of the answer to the question why: You’re paying for
their direct-to-consumer advertising, which is illegal everywhere else (with
the exception of New Zealand).

    Aside from their inherently misleading nature, and the fact that they
dramatically increase drug prices, direct-to-consumer drug ads like those on
TV often plant a seed in your mind that you may be sick. Drug companies are
masters at disease mongering -- inventing non-existent diseases and
exaggerating minor ones, with the end result making you rush to your doctor
to request their drug solutions. It also misleads people into thinking drugs
are the only option for every ill. If you think about it, a child who grows
up seeing these ads is clearly going to be indoctrinated to turn to a drug
when something goes wrong, unless he or she receives a different education
from some other source.

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Neil Diamond...Red Red Wine

God Bless Everyone & God Bless The United States of America.
Larry Nelson


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