Thursday, February 24, 2011

The Article Too Hot For Drug Topics.

So, yeah, some of you know I spend some time cooking up words for the industry's leading trade magazine, Drug Topics. I admit I try to be a little edgy and push the envelope a bit in my columns for them. After all, I firmly believe if you're not pissing someone off with what you're saying, you're probably not saying anything very important.

Evidently I finally pushed them too far though, although not with the piece with which I thought I would. I've been working on a a column about Walgreen's POWER program, and although they decided to take out my favorite line about being at a bar and overhearing the company's CFO, it looks like that one's gonna run.

Walgreen's CFO, you see, has been busted for drunk driving twice. That line was absolute gold and you'd have to see it in context to fully appreciate it. Oh well. It's nice to have these professional writer type problems I guess.

The article that got rejected was about worstpills.org, which I thought was tame compared to the Walgreen's one. Evidently though, it got a little too close to the industry that actually buys ads in trade magazines. Don't get me wrong. I'm not the least bit angry at Drug Topics. They've been very good to me and the chance to make some money without having to mortgage my soul is one I'm happy to have. Given a choice between pissing off the pharmaceutical industry or one of the corporations responsible for destroying our profession, I'll choose pissing off Walgreen's every time.

I just thought it would be a shame to let the article go to waste. So here it is:


I don’t have to tell you retail pharmacists are overworked. The constant whir of the fax machine, the never-ending ring of the five phone lines, the three customers demanding our immediate attention, that’s been the story line in our profession since long before my first day as an intern. Actually, the more I think about it, the more surprised I am you’re even reading this, and the more I wonder.

Where are you getting your drug information? If you’re looking at these words, I’ll guess you’re getting a good part of it from the advertisements on these pages. Which worries me a little.

Not that there’s anything wrong with a drug manufacturer taking out an ad to tell pharmacists about the introduction of Zegerid (omeprazole/sodium bicarbonate), or to make a sales pitch touting the benefits of Lexapro (escitalopram) mind you. As someone who ends up with some of the dollars generated by these ads, I wholeheartedly encourage such behavior. Let’s not kid ourselves though. By educating us about their products, the corporations that take out these ads are aggressively advocating for their interests, which is exactly what they should be doing under a competitive capitalist economic system.

In this competition though, who is advocating for the interests of our patients? After all, no sane corporation would ever take out an ad to let us know they think Fanapt (Iloperidone) isn’t as effective as older medications for the treatment of schizophrenia, or that the risk to benefit ratio of propoxyphene probably doesn’t justify it remaining on the market. You’ll never see a commercial on “60 Minutes” telling you to ask your doctor about alternatives to sleeping pills.

That is, however, exactly the kind of information and opinion you’ll find at the website worstpills.org. Part of Public Citizen, a nonprofit consumer advocacy group founded in 1971, worstpills is as aggressive in advocating for the interests of patients as Merck and Schering are in advocating for the interests of Zetia (ezetimibe). As a profession that serves as a bridge between the makers of medicines and the people who take them, we should welcome a no holds barred argument between the two sides, the same way the American judicial system values intellectual combat as a way to find the truth. I would love nothing more than to see the pharmaceutical industry and worstpills.org in a steel cage death match.

Unfortunately it wouldn’t be a fair fight. One side has a multibillion dollar advertising budget, the other is supported by foundation grants, publication sales, and member dues. One side fields a sales force army to make in person contacts with health care professionals across the country, while I have never had a representative from Public Citizen ask for some of my time at work. Some days there are so many direct to consumer drug ads on the evening news I feel like I should get continuing education for watching, while if it weren’t for the occasional e-mail reminder, I might forget about my subscription to worstpills.org entirely.

Which would be a shame, because I consider the money I spend to access worstpills.org as a sound investment in my professional career. Because of worstpills.org, I was able to sound a warning to doctors who asked my opinion of Avandia (rosiglitazone) well before stories about that controversial drug made the papers. I told a friend of mine to forget about their Darvocet (propoxyphene/acetaminophen) prescription and just go with some Tylenol instead, and I was able to get some sober, clear headed advice regarding Tamiflu, (oseltamivir) during last year’s H1N1 flu mania. I don’t always agree with the opinions of worstpills.org, but I have found them to be valuable.

So by all means, look over the ads you find in this magazine, pay attention to the messages that bombard your customers every time they turn on the television or open a magazine, and give the sales rep at your counter a few minutes of your time. You’ll probably learn something and be glad you did. But then, make an effort to get some balance in your drug information from sources that have different biases than those you are used to. Make them compete for your attention and opinions.

I know you’re busy, but you’ll be glad you did.

5 comments:

Anonymous said...

I can not wait to read the WAG article.....

And I am so glad you posted this "rejected" article. I also understand why they chose not to publish it but it is a shame because it's very well written and I didn't know there was a place I could find out about stuff like Avandia before it's too late.

I am the point in my career where I feel nothing matters, meaning having the knowledge that Avandia isn't the best treatment option or knowing years ago that Darvocet was crap (and harmful crap at that) just doesn't matter--who will listen? The Doctor's don't want to hear it, even pharmacists I work with don't believe it and patients, well they still think doctor knows best...and trust the FDA...

Anonymous said...

When will the POWER article run?

Ashley said...

I think that was a great, very well written article. Presented BOTH sides, but informed readers of an option that they are probably less aware of. Drug Topics needs to grow a pair. Your closing paragraphs urges readers to look over the ads, too.

Anonymous said...

Thank you for this info on worstpills.org.
34yrs in the biz and I have never run across it.
Will share with my colleagues, because it always good to have 2 sides to the story.
Because of the environment I was in before I was aware of the dangers of proposxyphene. AMazing that we knew about it over 5yrs ago and the FDA finally got around to taking it off the market.
I wonder how many patients were harmed back in the 70's and 80's who I dispenesed massive amount so of Darvocet to.
Thanks again for trying to get the article published. Maybe it will get around more through your blog.

Tonina said...

Thanks for posting this, DM. I'm going to go check out worstpills right now.