Map of life expectancy at birth from Global Education Project.

Friday, February 08, 2008

Medical Ethics

Long time readers know that I have at times been unkind to Robert Jarvik, inventor of the useless and now forgotten artificial heart, for going on TV and trying to convince you to buy an expensive statin when there are generics available that do precisely the same thing for less than 1/10th of the cost.

Well, the awesome power of Stayin' Alive is once again revealed as Rep. John Dingell has taken up our cause. I already told you that Jarvik is not a cardiologist and has never practiced medicine, but what I did not know is that he also has never rowed a boat -- that guy sculling across the pristine lake is an impostor. I also didn't know that Pfizer is paying the clown $1.35 million over two years to con you.

The drug companies claim, of course, that consumers benefit from advertising which supposedly "educates" them about pharmaceutical products, but that is transparent nonsense. The purpose of the ads is to get you to buy the pills. A properly educated consumer would never take Lipitor, but rather Zocor or another generic. It never occurred to Pfizer to start advertising until Zocor went off patent and it faced competition from a cheap alternative. Furthermore, of course, a properly educated consumer would discuss the risks and benefits of statins with his or her physician and make an informed choice about whether or not to take them. Dr. Jarvik's opinion should have nothing to do with it.

Unfortunately, an outright ban on Direct-to-Consumer advertising of drugs in the U.S. is probably not possible, because of the way in which the courts interpret the First Amendment. The rest of the civilized world, with the curious exception of New Zealand, has banned it, without any evident crisis created by uninformed medical consumers. While we're probably stuck with some amount of DTC advertising, once we have a president who has some concern for the public interest she or he can work with the Congress to give the FDA both power and an affirmative charge to put strict limits on it. There are many regulatory approaches, which should be fully constitutional, which would be sufficiently discouraging to the thieves who run the pharmaceutical industry that we would see minimal, and largely harmless, DTC ads.

But don't hold your breath. The pharmaceutical industry can bribe Democrats just as well as it can bribe Republicans.

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