By Any Other Name

So, I am offering my services to the Big (and small) Pharma companies as the guy who invents the names for new medications (as well as making up better names for some established brands. Obviously the drug companies don’t want you to buy just any old “dabigatran etexilate mesylate” capsule, so they invent a name, in this case,  Predaxa.

Usually the name has zero to do with the compound and everything to do with making you feel good about taking it because the name sounds semi-reassuring. If your doctor prescribes “Eszopiclone”, you might say “What?”  But called Lunesta, it sounds so benign and peaceful - Luna as in “moon” and nesta (as in “nesta?”) sound so tranquil and downright sleepy, doesn’t it.  Heck, it’s all so soothing that you might not even read the enclosed warning regarding: “Allergic reaction: Itching or hives, swelling in your face or hands,  swelling or tingling in your mouth or throat, chest tightness, trouble breathing, abnormal thinking and behavior, anxiety, aggressiveness, confusion, depression, or dizziness, burning while urinating, fever, chills, cough, sore throat, and body aches, lightheadedness or fainting, numbness, tingling, or burning pain in your hands, arms, legs, or feet, rapid weight gain, swelling in your hands, ankles, or feet, seeing, hearing, or feeling things that are not there, severe diarrhea, severe pain or bleeding during menstruation. thoughts about hurting oneself or others, altered or bad taste, decreased interest in having sex. depression (sadness) or agitation, difficulty in coordination, dry mouth, nausea, or increased thirst, enlargement of breasts in males, headache, memory loss, rash or redness on your skin, swelling, stiffness, or pain in your joints.”

          It seems that there are many substances we (“they”) rename to make them sound so much better. Senokot sounds sort of like an Indian tribe, huh? Phloe Powder sounds like, oh, I don’t know, maybe a plant food?  Another fave is Benefiber. In fact “Bene” is tacked onto many products, including dog food (“Beneful”), probably because it is the first two syllables of “beneficial.” Of course all the above are laxatives, but renamed to have more consumer appeal. Why not just “Bob’s Colon Cleanout?” simple, direct and we all get it! Maybe “Gut Buster,” or even “The Eliminator” ( Not Just a Monster Truck!)  Oh well, the list is endless. The issue with branded drugs is the effort (exhibited by Big Pharma to get people to self- diagnose based on a 30 second TV spot, and ask their doctor for a specific drug by name. 

Prescription drug prices are cited as one of the three top reasons for Medicaid expenditure growth, and prescription drug costs have increased by an average of 15.4% per year between 1994 and 2004. Meanwhile, spending for direct-to-consumer drug advertising has increased more than 330% in the last 10 years.    Restating this in an easier to understand example, using a simple rule of 72 calculation, that is a doubling of prescription drug costs every 4.67 years!!!

          Ready for a surprise that proves my point?  There was no consumer (media) advertising whatsoever for Clopidogrel Bisulfate (Plavix) from 1999 to 2000. Then, from 2001 to 2005, U.S. spending on consumer advertising for Plavix exceeded $350 million, an average of $70 million per year.  Data from Medicaid programs in 27 states shows that, despite all of that advertising, the use of Plavix by patients in those states' programs did not change. However, the price of a Plavix pill increased by 40 cents, or 12%, after the ad campaign began. Overall, this change resulted in an additional $207 million in total pharmacy expenditures. Multiply the example of Plavix by the seemingly endless number of “new/better” drugs hyped by media advertising and the sum is staggering! Remember, there has been no correlation shown between advertising and actual increases in usage by prescription, so this truly amounts to expenditures by the manufacturers which are reflected in increased costs for your meds, whether or not you use that particular product!.   

Simply put, while we are seeing a large increase in media direct advertising of prescription meds to consumers, the most significant result is higher cost to consumers to pay for advertising which doesn’t seem to have much effect on the frequency of prescription by doctors! But it sounds so good! I know plaque on artery walls can be bad, so Plavix, must be great, I mean it has the first three letters of “plaque” in its name, doesn’t it?   

Those who are in favor of direct-to-consumer advertising of brand-name drugs (Big Pharma) argue that advertising makes patients more knowledgeable, allowing them to ask for treatments from their doctors, while opponents of this practice claim that more often such advertising misleads consumers about the benefits and risks of many drugs. Neither side ever questioned whether ads would increase medication use or not.

          Most countries in the world don’t allow advertising of prescription medications directly to patients. Period! Meanwhile, we  Americans spend more than all other nations on health-care - 16% of U.S. GDP in 2007. It seems that both sides in the direct-to-consumer advertising debate are wrong in their estimates of the effect of drug advertising on use. But the research does support what both sides agree on -- that consumer advertising costs contribute to that higher American health-care bill.

          I would maintain that, as in other really bad [non]science - (homeopathy, the entire “toxin” scam, mega vitamins, “purging’) which has found an audience in America, we now are conditioning a wide spread portion of the populace to self diagnose and demand brand name prescription drugs which previously would be the option of their doctor/pharmacist - you know, someone actually trained and competent to do so.