How does buying an advertised prescription drug work in America?

General Questions
#1

Being from one of the almost-every-other-countries where prescription drug advertising isn’t allowed, how does it work in America - not the advertising itself, but the getting ahold of the stuff. Do you just go to your doctor and say “I don’t want cialis, I want viagra” or what?

This is very bizarre to me. Don’t get me wrong, I don’t even beleive that you should need a prescription to get ahold of any drug you like, but the idea of telling your doctor what is best for you based on a bloody advert seems peculiar at least.

How’s it actually work?

#2

You go to a doctor, describe the symptoms listed in the commercials, personalized a little bit of course and voila, instapainkillers/antianxiety/antidepressants!

#3

Says it right in the commercials. Ask your doctor. If you have a good trusted doctor he will weigh the benefits of that drug against others that are for similar afflictions. The drug company hopes he likes their drug.

#4

The commercials always say ‘ask your doctor about XYZ’. (XYZ=drug name) While the commercial is saying that, the drug companies are sending drug reps (attractive young women) to go to the doctors office and ply them with various free items (pens, notepads, stress balls, etc anything with the drug name on it) as well as tons of free samples to give to patients.

So you go to the doctor and say ‘I saw an ad for XYZ’. Then the doctor sees he is writing note with a pen that was given to him that says ‘XYZ’ on it in big letters and remembers he has a box of free samples of XYZ given to him by the drug rep, and he prescribes XYZ.

Humorously, I once read a blurb saying the majority of doctors do not think their prescribing habits are influenced by the free samples and the free stuff from the drug companies. What the same study found was that the only doctors who weren’t influenced were the ones who thought they could be influenced by that kind of behavior. The doctors who thought they were above that behavior were the ones being influenced.

A lot of the time the drugs being advertised on TV are ‘me too’ drugs, meaning there is a generic that does the same thing, has about the same side effect profile and is 10x cheaper. A different drug in the same class can work differently on one person to the next, but generally if you are strapped for cash it is better to start with the cheaper version.

I know someone on Nexium (a lot of people are on nexium). Nexium is just an isomer of Prilosec (prilosec is both isomers). You can buy a months supply of prilosec OTC for about $15 at walmart, nexium costs something like $100 a month. Seeing how I work for a drug company, I should keep my mouth shut with what I post online. I remember the guy who worked at a budweiser factory being fired for drinking coors at a bar after work.

In America we have tons of ways for the wealthy to squeeze money from everyone else. Do you have payday loans in whatever country you are in?

#5

There’s a small window in which I actually like drug advertising. That is the window in which they raise awareness that there are some frickin’ weird medical conditions out there, and what you thought was just your body being annoying may actually be treatable. See: restless leg syndrome. Can’t tell you how many people just thought they had to live with it, and had no idea that other people got wiggly legs at night.

And occasionally, there’s an ad for an actually new drug for an old problem. See: Pradaxa. Say you work full time or you don’t have a car; your doctor may not know how difficult it is for you to get in for monthly PT/INR tests for your warfarin, so he’s not going to bring it up, and before you saw the ad, you were under the impression that it was warfarin or nothing. It’s nice to at least have enough knowledge to have a conversation about it, even if you decide not to switch.

But, to answer the OP, yeah, the idea is that you go ask your doctor if you have this condition you heard about on TV. Chances are very good that you don’t, and even if you do that there’s something older, cheaper and better to treat it than the drug you saw the ad for. And there are some doctors who actually get offended, thinking you’re telling them how to do their job, so they’ll prescribe anything BUT the drug you’re asking about. But enough doctors are willing to prescribe what you ask for (especially if you do have the condition in question!) that it’s worth the gazillions of dollars the drug companies pay for advertising.

#6

I think Covered_In_Bees! got it on the first swing. The purpose of the drug advertising is to create a market for your product, never mind if people are actually sick.

Health insurers usually require a less expensive generic equivalent to be tried before allowing a brand-name (advertised) drug to be prescribed. This blunts the effect of the adverts somewhat, and does take some of the decision-making out of the doctor and patient’s hands. But, who else knows what’s best for you besides the pitchman on TV?

#7

Doctors in the USA often have prescription drug samples in office, they can hand them out legally whether a script exists or not.

This can create sticker shock when the patient runs out of the sample and gets a script or goes to fill their script, OMG are you kidding me 10 USD a tablet?!

My mom saw a commercial for boniva, she told her doctor she’d like to try it. He gave her samples he had, he got them from a pharm company rep. Even though she never had an issue with osteoporosis she started taking it, she wasn’t even sure what it was she assumed it was calcium!

#8

Pretty much.

You can’t get it up anymore so you go to the doctor. Usually they’ll be a discussion about various treatment options, but if you say “I want Viagra” and there’s no good reason not to let you have it (and non-controlled substances are always easier to talk a doctor into), than usually that’s what you’ll get.

The doctor rights the prescription. If he rights “Dispense as Written” you’ll get Viagra. If he writes “substitutions allowed” then you’ll likely get sildenafil citrate. All this is assuming you’re paying cash for the prescription, and brand names can be absolutely fantastically expensive in the US. If your insurance is paying, they’ll usually demand you use the generic if it’s available. And even if it isn’t, sometime you’ll even need there permission if there’s generics in the same therapeutic category, if not for that particular drug.

#9

Interestingly, the US and New Zealandare the only western countries that allow direct-to-consumer advertising of pharmaceuticals.

The drug manufacturers are big businesses. They are constantly on the prowl for ways to make a cheap buck, and a big buck. Some of their tactics involve branding old timey drugs like quinine (malaria) and colchicine (gout) by doing the necessary FDA testing regimine and then getting a monopoly to sell the drug at unheard-of prices. Viagra was developed as a treatment for blood circulation in heart patients; they discovered it was not very effective at that, but the study participants reported an interesting side effect - et voila - major blockbuster drug was born. They also “develop” drug treatments, and markets, for treating conditions no one ever heard of 10 years ago - *restless leg syndrome *as mentioned above. That is their business model - to develop drugs and markets for treatable conditions, never to “cure” anything - they want you to be dependent on a drug for the rest of your life. Adverts are a big part of the equation.

There is science going on, but there are no Jonas Salks working for these big pharma companies today.

#10

Those are extremely rare outside the US (Spain doesn’t have them), but so are check-cashing businesses (then again, checks are almost extinct in much of the world). I have a brother who works in Finance and when he came to visit me in Philly, the most personally-stunning view (as opposed to “view that anybody finds stunning”) was the block-long line outside a check-cashing/payday-loan business. The idea of “it may be impossible for someone to open a bank account, and I don’t mean only immigrants without papers” blew his mind.

What exactly counts as “direct to consumer” advertising? In Spain you don’t usually see printed-media ads for medication, but there are TV ads both for medication and pseudo-medication (vitamin suplements, homeopatic crap, miracle food) as well as mailbox ads and promotional materials in pharmacists and parapharmacists; in other countries of the area I’ve seen promotional materials in pharmacies.