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Tuesday, August 13, 2013
Are you sick and tired of prescription-drug commercials? You know, the ads on TV for drugs to treat arthritis, erectile dysfunction or overactive bladder.
People think these commercials are aimed at patients. In fact, they’re called direct-to-consumer advertising, abbreviated DTC by those in the know. But here’s a dirty little secret: These ads also affect physicians.
There was a time when the pharmaceutical industry fielded an army of sales representatives who visited doctors’ offices in person. They would bring little gifts, free drug samples and lunch, and in exchange would get a few minutes of face time with the physician to promote new drugs.
The system worked extraordinarily well for drug companies for decades. Even though the cost of maintaining thousands of reps traveling the country was astronomical, so were sales.
But today’s doctors often are far too busy rushing from patient to patient to spend much, if any, time with a sales representative. Most pharmaceutical firms have laid off large numbers of reps in the past decade. They have shifted marketing resources to other avenues, such as Web and TV.
One drug-industry insider told us that a new TV drug ad resulted in increased prescriptions within days. This period of time is so short that patients would not have had time to make appointments to see a doctor. The conclusion the company drew was that the ads were very effective at reaching physicians and stimulating new prescriptions.
Despite the extraordinary cost of making and airing such TV commercials, the companies reach both physicians and patients at the same time.
The rewards are handsome. Some experts estimate that for every dollar spent on DTC ads, the company earns back more than $4 (Henry J. Kaiser Family Foundation, June 2003).
We have polled groups of consumers at public talks, in this newspaper column and online through our website, and have yet to find enthusiasm for DTC drug commercials. Patients dislike them, and doctors said the same.
Even though these spots frequently include dire warnings about side effects, the voice-over usually goes so fast that it is difficult to comprehend the significance of the words.
The message also is obscured because it doesn’t match the visual images on the screen. People may be smiling and having fun while the announcer suggests that the drug could cause thoughts of suicide, confusion, uncontrollable muscle movements that could become permanent or high blood sugar that could lead to coma or death.
The commercials are so sophisticated in their structure that most viewers won’t notice that they have emphasized the drug’s benefit and downplayed the risk. Before asking your doctor if any drug you have seen on TV is “right for you,” do your homework. Look up the drug at sites that are not controlled by the drug company. At www.PeoplesPharmacy.com, for example, you will find personal stories from individuals who have tried the drug and reported their actual experiences. This may provide a more balanced perspective.
If you are fed up with DTC commercials, why not let your congressional representative know? The U.S. and New Zealand are the only countries that permit this sort of advertising.
Q: When I was 18 years old, I went to join the Army Reserves. I weighed 165 pounds and was in great physical condition. When they took my blood pressure, however, it was 200/70. They said I had a very dangerous pressure and told me to go right to my doctor.
My physician put me on a blood pressure med that basically turned me into a zombie. I purchased an old-fashioned blood pressure cuff and found my blood pressure was 130/70 when I took it.
I recently purchased a high-end digital blood pressure unit, and I take and log my pressure regularly. To this day, 35 years later, I still have white-coat hypertension. I went to the doctor last week, and it was 200/90. I went home and took it, and it was 125/80.
A: White-coat hypertension refers to a situation in which blood pressure readings taken in a doctor’s office or hospital are significantly higher than those taken at home. Studies have shown that home readings are more reliable as a predictor of organ damage or heart-disease risk (Hypertension, June 2010; Journal of Hypertension, June 2013).
To learn more about the do’s and don’ts of blood pressure measurement, along with information on drugs and nondrug approaches, you may wish to consult our Guide to Blood Pressure Treatment. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (66 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. B-67, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.
Q: I am a veterinarian and want to let people know that tea tree oil is very toxic to pets. It is rapidly absorbed through the skin and GI tract, and can cause tremors, a drop in body temperature, sedation and, rarely, liver toxicity.
A dog could lick it, or a well-meaning owner could try using it for an ear infection. Don’t do it! If accidental ingestion or skin absorption occurs, please take your pet to the vet. He will probably need hospitalization if he received a large dose.
While we’re on the subject, stay away from Bengay, Noxzema, Heet, Clearasil and oil of wintergreen on your pets. Anything with salicylates could be toxic.
A: Thanks for the warning. It is helpful to remember that what might work for people may be dangerous for pets. Tea tree oil has antifungal activity, which is why people have used it for their nail fungus and might try it for dog ear infections. As you point out, this is a bad idea.
Q: I have read that aluminum exposure might contribute to Alzheimer’s disease. This alarmed me, as I routinely wrap food in aluminum foil to reheat it. I also cover with foil when I bake, and wrap raw chicken, pork and fish in individual packets for the freezer. I also “tent” a turkey while roasting it. Is any of this a problem?
A: There is not much information about aluminum leaching into foods. What there is suggests that acidic foods such as tomato sauce, lemon juice or vinegar could corrode aluminum (Food and Chemical Toxicology, March 2009). These researchers found that boiling the foil for at least 10 minutes in water decreased the problem. The foods you describe are not particularly acidic, so you may not need to worry about this issue.
Q: I had a huge wart on my index finger and other small ones on my hand. I also had plantar warts on the ball of my foot and on many toes.
Freezing them off was very painful, and they came back. Compound W, duct tape and banana peel didn’t work. I started soaking in Dead Sea salts from Israel. The warts slowly started getting smaller and eventually died.
I soaked every morning and sometimes twice a day after I realized they were shrinking. It has been more than a year, and I’m still wart-free!
A: We have read that Dead Sea salts improve the barrier function of the skin and can ease eczema symptoms (International Journal of Dermatology, February 2005) and psoriasis (Seminars in Arthritis and Rheumatism, October 2012). Yours is the first report we have received that such a solution might work against warts.
“The People’s Pharmacy with Joe and Terry Graedon” airs Saturday at 7 a.m. on WVTF (89.1 FM) and at 4 p.m. Saturdays and Sundays on RADIO IQ (89.7 FM). Joe and Teresa Graedon’s column runs in Tuesday’s Extra.