The Happy Hospitalist is a board certified internist who works in the hospital and writes regularly on several blogs, including The Happy Hospitalist.
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How do you know when direct to consumer advertising is working?  It’s pretty easy to tell. For example, if you have a patient coming to you with a chief complaint of restless legs syndrome you know they’ve been watching direct to consumer advertising on television. If a patient tells you that they want to try Plavix for their peripheral arterial disease, I’m sure they’ve been watching direct to consumer advertising during NASCAR.
What are those pesky direct to consumer advertisements? You’ve all seen them. They are those commercials in which drug companies describe their most expensive offerings by using a combination of excitement and fear in an effort to force conversation between you and your physician. They give you just enough information to pique your curiosity but not enough for you to know when the medication is indicated or when cheaper alternatives are available.
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The worst offenders of direct to consumer advertisements are the statin manufacturers. Statins are cholesterol lowering drugs which reduce the risk of recurrent heart attacks and stroke. When I was a resident in training, the statin of choice at the VA was simvastatin. Simvastatin is now generic. And the brand name makers of Crestor and Lipitor are running scared with their potential to major loss of market share. At drugstoreDOTcom thirty tablets of 40mg simvastatin costs under $30. How much for Lipitor? Yes folks, that’s $135. For 999 out of 1000 people, the clinical difference between simvastatin and Lipitor or Crestor will be irrelevant.
Now, the direct to consumer advertising will make you want to think twice about switching your Lipitor to simvastatin, selling you on the idea of sticking with what works. Well, what they don’t tell you in the ad is that simvastatin works too and it works just as well for 80% less cost. That’s the little scam that direct to consumer advertising runs. They tell you their drug works. But they won’t tell you that something else works just as well for a fraction of the price.
While there are some powerhouse direct to consumer advertisers out there, the coup d’etat will forever be Viagra. I still remember watching the Super Bowl years ago and up popped Viagra. Viagra made erectile dysfunction cool again. In fact, I leave it to direct to consumer advertising for changing the way we talk about impotence. And how do I know that Viagra ads had the greatest effect on a generation of elderly? When you hear your 87 year old patient say:
I take too many damn meds. I take medicine for my diabetes. I take medicine for my heart. I take medicine for my cholesterol. It’s no wonder I have erectile dysfunction.
You know they’ve been watching the Super Bowl and all those direct to consumer advertisements. Score a win for big pharma. They know exactly what they’re doing.