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Why are those brand-name drugs


so expensive? The prescription costs cover the massive expense of pharmaceutical testing. Because drug patents lapse after 20 years (from the date of invention, not from when the drug actually hits the market, which can be as much as a decade later), pharmaceutical companies have only a short amount of time to recoup the costs of devel- oping a new drug. Intensive DTC advertising helps them sell new medications more quickly. Dr. Gregory Smith, a pain-man- agement and addiction specialist in Los Angeles whose clientele includes retired military officers as well as veterans returning from Iraq and Afghanistan, says he thinks DTC ad- vertising has created a medicated so- ciety. “People see the ad and believe there is something fundamentally wrong with them and may even start manifesting the symptoms they see in the marketing.” Dr. Murray Grossan, an ENT spe-


cialist in Los Angeles, says he doesn’t believe DTC advertising is neces- sarily a bad thing, as he has known patients to seek help for chronic conditions as a result of seeing ads on TV. “I had a patient who was a veteran suffering from depression, and he felt he was just being weak,” Grossan says. “But then he saw an ad about Prozac [and] asked for it from a VA hospital.” “The ads can be beneficial,” he


adds. “They will often encourage a patient to seek a solution.” He is quick to admit, however, the adver- tising is excessive. Grossan suggests if drug companies could extend their patents another 10 years, the intensive DTC advertising wouldn’t be necessary, and it also would help reduce the costs of medication.


Influencing decisions Patients aren’t the only ones taken in by the advertising. Physicians can be,


HOW TO TRIM YOUR PRESCRIPTION DRUG COSTS • Be active in the examination room. Ask your doctor if lifestyle changes, like losing weight or exercising, might free you from the need for some of your medications, such as pills for high blood pressure.


• Don’t be a victim of advertising. If you ask your doctor for a specific brand of drug to treat your high cholesterol, that might be what you get, even if it’s three times the cost of a generic drug that offers the same benefits. Ask your doctor if there is a generic alternative that would work just as well.


• Take advantage of mail-order pharmacy options, which allow you to order a longer supply of prescriptions (say 90 days’ worth instead of the usual 30 days’ worth you get from the pharmacy), often discounting the cost and saving you on monthly trips to the drugstore.


• Talk to your pharmacist about all the drugs you are taking (including vitamins and supplements) and where you might be duplicating medi- cations or risking drug interactions. This is especially necessary if you have conditions that require you to see more than one physician — and thus have prescriptions from multiple sources. You might be taking more medications than you need.


• Ask your doctor about splitting pills. If you require 10 mg of a par- ticular drug, it might be cheaper for your doctor to prescribe the 20 mg version and have you cut the pills in half. But talk to your doctor before doing this to make sure it’s safe.


too, and they often are further bom- barded with slick sales pitches and free samples from pharmaceutical company representatives. Some states are fighting back,


however. The West Virginia Public Employees Insurance Agency, for example, is working to train a team of pharmacists to educate the state’s doctors about the fiscal effects of prescribing brand-name drugs. Smith says time also affects doc- tors’ decisions about prescriptions. “Doctors are in a bad situation right now,” he explains. “They have to see more and more patients in less time, and it’s easier for a doctor to write a prescription than to spend 10 or 15 minutes trying to figure out what’s wrong.” Smith is concerned the health care system in the U.S. is too focused on treating patients with pills and surgery as opposed to ad-


dressing lifestyle habits that often lead to illness. Dr. Robert A. Linden, a specialist in internal and geriatric medicine in Connecticut and author of The Rise & Fall of the American Medical Em- pire: A Trench Doctor’s View of the Past, Present, and Future of the U.S. Healthcare System (Sunrise River Press, 2010), agrees, saying his big- gest concern about DTC advertising is it encourages patients and doctors to seek relief for chronic conditions through medicine when healthier lifestyle choices might do the trick for a fraction of the cost. To keep abreast of FDA warnings and notices related to prescription drugs, visit www.fda.gov/drugs.


MO


— Deborah Huso is a Virginia-based freelance writer. Her last feature article for Military Officer was “From Battlefield to B&B,” February 2011.


APRIL 2011 MILITARY OFFICER 65


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