Thursday, December 1, 2011

America's epidemic of over-prescribing | Cory Franklin

5:33 PM | Posted by Free Game Zone | | Edit Post

aggressive marketing was an important factor in stimulating drugs in patients beyond the point of clinical utility

If all drugs were thrown into the ocean, everyone would be better ... except fish.

- Oliver Wendell Holmes

This maxim of the 19th century physician and author Oliver Wendell Holmes, is today an exaggeration, but still contains a grain of wisdom. For generations of doctors, teachers were not to prescribe too many drugs to avoid side effects and drug interactions. No more.

Even with the remarkable technological progress - organ transplants, surgical robotics, lasers, electronic medical records - the largest difference in American medicine since the 1970s is the increase the number of prescription drugs to patients today. To treat chronic diseases and symptom control, the average American has about 12 drugs per year, compared to seven, 20 years ago. Patients who once walked into the office with your medicines in a bag or pocket, now need a shopping bag.

In the 1970s, drug expenditures increased by approximately 5% of total U.S. health care costs. Today, it has doubled and is increasing rapidly. While the new drugs used to treat conditions once treated with surgery can effectively reduce costs, because the surgery is usually more expensive. Just include increased spending on drugs and ignoring the compensation awarded surgical costs a misleading picture of the total costs of prescription drugs. However, spending on prescription drugs has increased the figure of 200 billion dollars over two decades.
  • Why
  • exponential increase in prescription medications? There are a number of reasons, some more legitimate, it is not. The average American is bigger, heavier, high blood pressure, high cholesterol, diabetes, osteoporosis and arthritis than a generation ago - all conditions effectively treated with drugs
  • marketing directly to patients is another trend to increased revenue. According to government restrictions on DTCA were relaxed, patients have become more "proactive" approach to their doctors for new treatments that have heard of: searching the internet or watch the Super Bowl commercials as told the proverb, "Ask your doctor ..."
  • Finally, in an effort to please their shareholders, pharmaceutical companies have been highly effective marketing campaigns. Influential doctors qualified employees as speakers and advisory committees, companies have expanded markets for their products. These same doctors often write guidelines about who are candidates for drug therapy. Between "disease management" and "expand the market share" blurs when candidates for therapy includes not only patients, but those with risk factors for future disease that might be sick.
Recently, a number of studies in cardiovascular medicine have cast doubt on the conventional wisdom regarding treatment strategies against drugs. The researchers found that overly aggressive control of blood glucose and blood pressure drugs more type II diabetes did not prevent heart attacks and, in fact, led to high rates of complications. In one study, diabetic patients taking an average of 3.4 medications for systolic blood pressure less than 120 had more complications than those taking only two drugs to lower your blood pressure below 140. As a researcher, for diabetics with heart disease, "Get a good control of blood pressure is good. Get complete control of blood pressure can only be good. "

In another study, two different drugs against cholesterol reduction used in the concert were not better than one drug. A former president of the American College of Cardiology, said, "push harder with more medications and higher doses are not necessarily help patients in all areas." A New England Journal of Medicine editorial commenting on the results, said the belief that aggressive treatment of cardiac risk factors in diabetics is logical and understandable in certain situations, which turned out to be risky. "In no necessarily better."


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