Drug Company’s Direct Marketing to Patients---Yeah or Nay?

Drug Company's Direct Marketing to Patients---Yeah or Nay? The Affect on Medication's Used to Treat GERD.

There has been a lot of talk about pharmaceutical company's practice of direct marketing to patients. Many drugs are now advertised on television as well as in newspapers and magazines. A recent article in USA Today discussed just how common this practice is and what affect it had on physician prescribing. 32% of American's ask their physicians to prescribe a medication that they had seen advertised. When physicians were asked by patients to prescribe a medication, 82% did, with 44% getting a prescription for a drug they inquired about, and another 54% getting a different prescription.

Gastroesophageal reflux disease, likely because it is extremely common, is greatly impacted by direct marketing to patients. The most popular of these drugs is probably Nexium, "the purple pill". There are pros and cons to patients asking about specific drugs by name. As far as gastroesophageal reflux is concerned, there are probably more advantages than disadvantages. When it comes to the treatment of gastroesophageal reflux disease, the drug classes, proton pump inhibitors and H2 receptor antagonists, are generally all very good and very safe. I am asked about "the purple pill" virtually on a daily basis. Most of the time, Nexium is an appropriate drug for the patient to take, so I will comply. At times, after discussing with the patient, it might be more cost effective for them to try another medication and they will comply. Additionally, I frequently will have samples of another proton pump inhibitor, and the patient will be more than happy to try that one. Whether a patient is given Nexium, Prevacid or Aciphex to treat their symptoms typically will not make a difference, as they all will likely work. These drugs are effective over 90% of the time.

The positive aspects of this approach by drug companies is that they will likely increase awareness of the disease as well as encourage patients to see physicians so that they will receive proper care. This also stimulates discussions between patients and physicians about topics such as cost of medication. While a downside might be that some patients might be given medication just because they ask for it, when it comes to gastroesophageal reflux disease, most patients that seek medical attention have already exhausted all of the over-the-counter treatment options, so they probably really do need it.

One potential problem with direct marketing to patients with respect to gastroesophageal reflux disease, is that there are drugs available over-the-counter that are very similar in efficacy to their brand name counterparts. One such drug, Prilosec OTC can be very effective in treating reflux. The problem would be that while in the past, patients with symptoms might have sought medical attention for recommendations for treatment from a physician, now they are self-treating based on a recommendation from the drug company. In gastroesophageal reflux disease, this can be very dangerous, as medications such as Prilosec OTC can mask Barrett's esophagus, a pre-cancerous condition of the esophagus. Patients can self treat this condition for a long time, possibly preventing an earlier diagnosis of esophageal cancer.