TAGline - Volume 11 Issue 9 - September 2004

Angell: "You need to know that your doctor's decisions are based solely on what is best for you. And doctors need to be weaned from their dependence on drug company largesse." TTATDC, p 262

When your doctor prescribes a new drug, ask her or him these questions:

1. What is the evidence that this drug is better than an alternative drug or some other approach to treatment?
2. Has the evidence been published in a peer-reviewed medical journal?
3. Are you relying on information from drug company reps?
   Insist on a straight answer and, if necessary, a reference to a journal article or a medical textbook.
4. Is this drug better only because it is given at a higher dose?
5. Would a cheaper drug be as effective if it were given at an equivalent dose?
   Remember, there is usually no reason to think new drugs are better than olds ones. And the older the drug, the better its safety record is likely to be.
6. Are the benefits worth the side effects? The expense? The risk of interactions with other drugs I take?
   Every drug has side effects, and it may be better not to treat self-limited or trivial ailments.
7. Is this a free sample?
8. If so, is there a generic drug or an equivalent drug I can use that is cheaper when the free samples run out?
   Free samples are a false economy. They are designed to get you and your doctor hooked on the newest, most expensive drugs.
9. Do you have any financial ties with the company that makes this drug?
10. For example, do you consult for the company?
11. Other than free samples, do you receive gifts from drug companies?
12. Are you being paid to put me on this drug or to enroll me in a drug company study?
13. Do you make time for visits from drug company representatives?

If the answer to any of these questions is yes, you should consider changing doctors.

You need to know your doctor's decisions are based solely on what is best for you. And doctors need to be weaned from their dependence on drug company largesse.

And ask your senator and representative in Congress this question:

There is no doubt that this industry largely writes its own ticket in Washington, and you have to [help] put a stop to that.

⇒ Pay no attention to direct-to-consumer ads for prescription drugs. These are meant to sell drugs—not educate consumers—and they only add to the prices you pay.

⇒ Finally, remember the admonition of the Washington Post editorial (6/9/2003,A20) to question those arguing Big Pharma's case about its sources of income. I can think of no better advice. Nowadays, even the most distinguished and apparently unbiased academics may be on the pharmaceutical industry's payroll. If they are, you need to be especially skeptical about their pronouncements.

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