How Do Docs Learn About New Drugs? TV, Of Course
Where and how do doctors get information about new drugs?
If asked, some will equivocate and say they get their facts from medical journals and from published studies, but never from those pesky misleading ads. Others will say they learned about them from colleagues. A few might even credit pharma reps.
Here's what nearly all refuse to admit: They learn about new drugs after hearing a question from a patient prompted by an “Ask Your Doctor” TV ad.
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I'm not sure why they think this admission outs them. One reason that doctors hate these ads may be because they feel the ads put them on the spot.
It's disgraceful that we have no effective way to disseminate breakthrough products short of DTP and DTC marketing. The FDA doesn't send out “great new drug” bulletins. Nor do insurers publicize new medications.
Yet the medical profession refuses to admit the value of industry-provided information. Doctors pride themselves on avoiding journal ads. Hospitals prohibit drug reps. Our critics advocate banning DTC advertising altogether.
A solid account of DTC phobia ran in the May 12, 2017, issue of The New York Times.
In the early 2000s, Dr. Richard Smith, who was studying amyotrophic lateral sclerosis (aka Lou Gehrig's disease), discovered that a combination of dextromethorphan and quinidine helped control a little-understood neurological condition called pseudobulbar affect, or PBA. Patients with PBA are prone to sudden and inappropriate bursts of crying or laughter. An estimated 1 to 2 million Americans have PBA.
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After a long development process, the drug, Nuedexta, was approved by the FDA and marketed by Avanir Pharmaceuticals. The problem was that most patients and physicians knew little or nothing about PBA. Avanir clearly faced a major educational challenge.
The company went with a disease-awareness campaign that did not mention Nuedexta by name. The actor Danny Glover demonstrated his professional ability to cry inconsolably or laugh uproariously on demand in the spot. Then he went on to point out that for people with PBA, such displays are uncontrollable and disturbing. The problem wasn't emotional — it was neurological. For more information, viewers were referred to a website, “Facts about PBA.”
The campaign was a huge success. One drawback: Even after patients learned about PBA and the availability of a treatment, it was hard to get a Nuedexta prescription, despite the fact that it's the only specifically approved treatment for PBA. Instead, doctors were apt to prescribe antidepressants, which are usually ineffective.
As a result, in late 2016, Avanir changed its campaign to “Ask about Nuedexta.” The new ad showed a grown man dissolving into tears at the sight of his child's birthday party.
Patients finally began to get the treatment they needed. Predictably, this campaign was attacked by the usual gang of pharma faultfinders. Some accused Avanir of turning sentimentality into a disease. Others worried that doctors would feel pressured to prescribe.
Baloney! DTC advertising is valuable. It creates awareness of misunderstood and often-devastating conditions and encourages patients to connect with physicians who can help them. It's too bad that our healthcare system, including the FDA, is unwilling to dispense information about new drugs and breakthroughs.
Until their attitude changes, Ask Your Doctor ads are still the best way to go — for patients and physicians.
Sander Flaum is a principal at Flaum Navigators.