Monday, 20 May 2019

On Retirement: Do prescription drug ads do more harm than good? – Charleston Gazette-Mail

Think you are seeing more drug ads on television? You are probably correct.

And guess who they are targeting?

Us. Older people, that is.

Television’s direct-to-consumer drug ads rose by 6.7 percent in 2017 from a year earlier, the most recent data I could find indicates. And the media has proven effective among the elderly, who have the greater therapeutic needs, analysts report.

Not a surprise. But do we pay attention to them?

Personally, I tend to hit the mute button.

Apparently not everyone does.

In light of the announcement early this month by Johnson & Johnson that it will begin giving the list price of its prescription drugs on television ads, I asked for reactions from a group of retirees.

“I will check if it is a drug I take,” one said.

Another recalled his doctor saying that every time a new drug is advertised, he gets a lot of inquiries about it.

Still another of the retirees in our group with Medicare Part D called a number of pharmacies when she had a new prescription. The costs did vary, she said.

The pharmaceutical industry has been under pressure to post list prices, we know. It has responded, in part, by saying, fairly accurately of course, that the list price is not the price paid by most people. Certainly that is true of those of us with Medicare Part D and/or other insurance.

Johnson & Johnson, which announced it will start the ads in late March with the popular blood thinner Xarelto, plans to address that concern. The list price, appearing at the end of the commercial, also will offer a website address where people can enter their insurance information for the specific cost to them. Great for those who are computer savvy.

According to The Associated Press article announcing the plan, about 1 million Xarelto prescriptions are filled each month in the United States. It costs $450 to $540 per month without insurance, depending on the pharmacy.

The United States and New Zealand are the only nations that permit direct-to-consumer drug ads. Companies spent $6.1 billion on direct-to-consumer ads in 2016, the last year for which data was reported.

That it is big business is no surprise. Nor is the fact that they have been able to deduct it as an marketing expense for tax purposes (probably still true with the tax changes).

The federal Food and Drug Administration tries to monitor the ads to ensure claims are accurate, a Harvard Medical School article reported. Somewhat to my surprise, the promotions are submitted to the agency only when they first appear in public. That means people could see inaccurate information before the Food and Drug staff detect an error and seek corrections.

Harvard’s Dr. Ameet Sarpatwari, who studies pharmaceutical marketing, is among those who cite highly promoted and expensive name-brand drugs for rising health care costs. They translate into higher insurance premiums, coinsurance rates and copays, he said.

“Seniors have been particularly hard hit, facing high out-of-pocket costs for select so-called specialty medications.”

Always ask if there are lower-cost generics, alternative medications or even nondrug treatments for your condition, he advises.

Meanwhile, drugmakers have altered their explanation for price increases, now saying they receive little benefit. Instead it is the middlemen — that is, pharmacy-benefit managers and health plans — who reap that gain, the script claims. This claim is hard to verify, as those contracts are done in secret.

For many years, pharmaceutical firms told us the price increases were necessary to fund research and development.

Some new drugs simply have little advantage over the tried and true, but others truly are more effective.

In our early adult years, there was little hope with most cancer diagnoses. Now, friends with even rare and serious varieties continue to live vibrant lives.

In a Wall Street Journal op-ed last week, Stanford Hoover Institute’s Scott Atlas argued that while patented drugs are five times higher here than in foreign markets, we also have faster access to lifesaving medicines. As an example, he said 12 new cancer drugs were approved in the United State in a 10-year period. During the same time, about the same total were approved but in six different advanced countries, indicating none had all of them.

It’s too late, but I now better understand my grandfather’s grouchiness and lack of appreciation for anything we did for him. In a wheelchair most of his adult life with rheumatoid arthritis, he was in pain. Aspirin provided his only relief.

Now there are multiple possibilities.

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