Patients Before Innovation

13 Dec

My regular readers will attest that I’m not one much for using my blog as a rant but something really struck a chord with me yesterday…

A few years ago, seeing direct to consumer advertising from pharmaceutical companies was a huge topic of conversation.  Doctors were getting requests and questions from patients regarding the latest thing they saw during a Super Bowl commercial (in between old washed-up performers and nipple slips-man that was awkward) or when reading their favorite magazine.  I still get annoyed sometimes.  I get annoyed (by the drug company) when a family asks for the latest medicine for ADHD that is more expensive and not proven to be any better than their current medicine (which is working well, by the way).  I get annoyed when a family asks for a new, broad-spectrum antibiotic that is overkill and unnecessary for their simple infection because “amoxicillin never works for him.”  (Admittedly, some of this thinking is our fault).  I understand why pharmacy companies do it.  Everyone needs their company to be successful, and to be successful in this world with a constant flow of information, you have to do something to make yourself front of mind in some way.  Cool commercials and flashy advertising is an excellent way to be front of mind.  But, I’m still annoyed.

Fast forward a few years and move on to a different issue.  In January 2008, the FDA comes out with a restriction on OTC cough and cold medicine, stating that they should not be used in children under 2, and then subsequently supports the Consumer Healthcare Products Association’s (CHPA) recommendation that they not be used in children under 4 (FDA/CHPA statement).  The AAP takes an even stronger stance, recommending that parents hold off until age 6 unless directed by a doctor (AAP statement).  This doesn’t technically apply to prescription cough and cold medicines (as far as I can tell), but can’t we all agree that they aren’t a good idea either?  Well, some of us might, but the pharmacy companies disagree.  So it’s frustrating to me that I see my young patients prescribed these medicines in local ERs and urgent care centers all the time.  My partner had a 6 month old walk into the office with a bottle just last week.    Enter the drug rep for brand x cough and cold medicine yesterday (he doesn’t even talk to me because I told him a few visits ago that I don’t prescribe them).  However, that doesn’t stop him from leaving behind his dosing card with (you guessed it) dosing all the way down to 2 years.  I promptly deposited the card in the shred box (the trash just didn’t satisfy me enough).  Ok, now I’m more than annoyed, I’m frustrated.

Unfortunately, the drug rep didn’t stop there.  Not only did he leave his dosing card, he also left another product for our staff to try out (and “don’t forget to post to Twitter and Facebook with a #hastag for a chance to win $20”).

So, what is it?  It’s a salicylate mixed with caffeine.  Oh well, nothing new here.  The problem is that it’s mixed together in a very pretty “5 hour energy” sized bottle with fruit pictured on the bottle and no real child protection.  Oh yeah, and top it all off, it’s strawberry flavored.  It looks just like an energy drink that kids (unfortunately) see their parents ingesting all the time.  Too tempting?  I think so.  And for what benefit?  Are there plenty of other options available for treating adults for their pain?  Yes.  I’m past annoyed and frustrated, I’m infuriated.

This is a good example of something I heard a long time ago: “Just because you can do something, doesn’t me you should.”  I have to admit it was a brilliant marketing idea.  These little bottles of energy drinks are all over the place and there are lots of people spending lots of money on them.  Why not put a little medicine in one and try to corner the market to turn a huge profit?  But, let’s be responsible about it.  I spent about 2 seconds taking the plastic off the top of the bottle and the underlying cap has no child protection whatsoever.  I am fearful of what will happen when these little bottles are left around the house for kids to find.  Will there be injuries related to ingestion: either overdose or disease-related like Reye syndrome?

In the end, I think the concern I have is the battle between innovation and marketing vs responsibility.  This is an idea that everyone should consider before they release a new product, thought or markting idea.  Whether you are a pharmaceutical company trying to corner a market, a TV show trying to get ratings (see Katie Couric and all her issues these past 2 weeks) or a doctor trying to recruit new patients with some new intervention (Robotic surgery), we should all be careful to put our patient first and not the innovation.

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