BILL MOYERS: With the price of prescription drugs going up and up, politicians of both parties have promised to help old people with the cost. But with a flourish of the old magic — now you see it, now you don't — Senators recently killed the legislation and adjourned to their favorite pastime, raising money for reelection from pharmaceutical companies and other kindred souls. Buying all that influence in Congress is one reason drug costs go up. So is the money — two to three billion dollars a year — the companies spend trying to persuade us to buy their drugs. You know the ads in question. They keep telling us 'to ask your doctor' about the wonders of some expensive new drug. Ok, we'll ask the doctor. We'll ask him for a second opinion about those ads.
MARC SIEGEL: I'm Dr. Marc Siegel.
I am an Assistant Professor of Medicine at New York University and a practicing internist since 1990. In the past five years, there has been a disturbing change that affects the way that I work with my patients. Drug companies, America's most profitable industry, have inserted themselves as a filter between me and my patients. And they are doing it with advertising
PHARMACEUTICAL COMPANY ADVERTISEMENT: "Acid reflux disease can really upset your plans"
"All I want are nights with less pain"
SIEGEL: These ads contain very healthy looking people smiling, havin' a great time. And there's a cue there to the consumer — you'll be like this too if you take this medicine.
PHARMACEUTICAL COMPANY ADVERTISEMENT: "C'mon celebrate"
SIEGEL: And — these ads put a lot of pressure on the patients to come right to their doctors and demand the medications.
PHARMACEUTICAL COMPANY ADVERTISEMENTS: "Go ahead, ask your doctor about Altace"
"Ask your doctor if Zocor could work for you."
WOMAN DRUG REP.: Hi doctor Siegel, how are you?
SIEGEL: Fine how are you?
The doctor is under similar pressures because the drugs salesmen come to the doctors office.
WOMAN DRUG REP.: ... overproduction of the LDL and TriCor reverses that
SIEGEL: They come under a veil of information but the information is always skewed and it's brought to me by someone that isn't particularly an expert in the field.
WOMAN DRUG REP.: It really reverses what's going on with their lipids, good to see you, and I'll leave you some samples.
SIEGEL: They bring free lunches to the office.They wine and dine the staff.
SIEGEL (ADDRESSING DRUG REP.): Your big sales point is that it's longer acting?
MALE DRUG REP.: It is a longer acting product, it's also in some cases well according to this study a head to head head with Lorisartin, Valsartin and Neurosartin, diastolic blood cuff pressure 145 patients in each sample group approximately.
SIEGEL: Today's my wife's birthday so one of the drug reps brought her a cake.
MALE DRUG REP.: Look at how pretty it is.
SIEGEL: Of course, bringing in that cake doesn't mean I'm going to be .prescribing his medication
MALE DRUG REP.: Thank you doctor, thanks for the time.
SIEGEL: Nice to see you.
MALE DRUG REP.: Hope you enjoyed everything.
SIEGEL: Yeah it was a great lunch thanks for bringing it.
This is my drug closet it's where all the samples get kept that the drug representatives bring by. It tends to be mostly stocked with new drugs or drugs that are tryin' to make a pitch at the market. So I look at this closet as kind of a microcosm of the drug wars that are goin' on on television.
An example of that is Lipitor (PH) and Zocor (PH) here. Lipitor it's a very good cholesterol lowering drug
PHARMACEUTICAL COMPANY ADVERTISEMENT: "I only have eyes for you"
SIEGEL: But to go from there to say that it improves lifestyle or that it'll make you healthy is absurd and they use that as a way to kind of get more people to clamor and go to their physicians and ask for Lipitor.
PHARMACEUTICAL COMPANY ADVERTISEMENT: "Taking Zocor everyday has kept my cholesterol where it should be."
SIEGEL: Then Zocor came along and they said, "Wait a minute. We can't let Lipitor do that alone." So they went on television and they put similar kind of ads on where they are — you know, glamorous people getting better on Zocor.
But what's — what's pretty ironic about that is that Zocor is more expensive than Lipitor — has more side effects than Lipitor. And here it is in the closet vying for — for space.
Provocol has probably the least amount of side effects of all three. My thinking is that probably in this class, you need one drug, maximum two. You need the most effective drug in the class and then maybe a drug like Provocol which has less side effects.
Over on this side we have the stomach medications for reflux and heartburn. This is overall a very overprescribed group of drugs.
But they're overprescribed because a lot--they're so heavily promoted and so heavily advertised that patients are asking their doctors for them all the time.
In fact, Prilosec (PH) which is the first of these drugs is an almost $5 billion-a-year drug.
PHARMACEUTICAL COMPANY COMMERCIAL: "If it isn't purple it isn't Prilosec"
SIEGEL: Now, this year because of generic company, taking on Prilosec's patent, Prilosec may lose it's patent.
You would think that that's good news, because that's gonna make it a lot cheaper and a lot more accessible and affordable for people.
PHARMACEUTICAL COMPANY COMMERCIAL: "Today a purple pill called Nexium from the makers of Prilosec."
SIEGEL: But the company that makes Prilosec knowing that it's gonna lose a fortune, has come up with Nexium (PH). And now Nexium is loaded in the closet and its almost natural for a doctor to say, "Well I don't have Prilosec here anymore, but I do have Nexium and it's almost identical. It's made by the same company and it has the same effect." So the patient ends up switching almost inadvertently over to Nexium
This process of drug laboratories creating these new compounds that are slightly different than the old compound. This happens every year there's a new drug on the market. Every year there's only a slight or no improvement. Every year the drug that was on the year before is forgotten about totally. Physicians almost don't even remember its name. And every year more and more millions of dollars are spent in advertising in order to promote the new kid on the block. There is an almost indecipherable difference between these new drugs and the drugs that came out before or that were out previously.
PHARMACEUTICAL COMPANY ADVERTISEMENTS: "It's a beautiful morning…"
"I feel like me again,"
"You can do more"
SIEGEL: We're a very consumer-based society and we're geared to respond to all of this hype.
PHARMACEUTICAL COMPANY ADVERTISEMENT: "Talk to your doctor and call this number."
SIEGEL: The drug companies are selling the American Dream. That you have to have the latest and greatest, the brightest and the shiniest.
And you're not gonna advertise to this extent unless it's working. So let's stop it from working. Let's stop believing in what they're telling us.
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