Pharmed Out!!

[Slik Geek]

I'm not a doctor or a pharmacist (but when I was kid I wanted to be a pharmacist until I realized that their job had morphed into mostly counting pills)...

My frustration with medicine in the U.S. is that the drug companies have managed to turn our doctors into chemists - almost every "answer" is a pill. Even if the pill doesn't fix the problem, as long as it treats the symptom.

I do fault docs who jump on the "latest and greatest" new drugs. New drugs are tested in most cases against placebos, not against their competitors. Thus there is never (or hardly ever) information showing that the new one is better than the old one, but docs jump on it just the same.

Doctors seem to always want to prescribe something new - but they rarely seem to realize how outrageously expensive that new medication is. What was wrong with the old one? Is it really not similarly effective? Or is it just not heavily promoted any more?

The drug companies make their big money off the new, patented drugs, so they push them really hard. Unfortunately, in addition to being very expensive, the newer drugs seem to have a greater tendency for undesirable side effects. (Just my limited experience - but I've seen far more examples of bad results in recent years).

In general, I'm hesitant to use newer drugs and always open to generics except for one special case...

The pharmacists didn't like the the generics for certain things, such as medicine for the thyroid. I can't remember why, but they would push the name brand of those. I think I recall them saying the generics were not as good in those situations.

As far as narrow therapeutic window drugs (eg. Synthroid...
Synthroid has had a major head to head study with it's generic funded by Synthroid's manufacturer that showed that the two had identical clinical outcomes, much to the dismay of the manufacturer. This study was covered up for a while then released and shortly afterwards the generic was approved for marketing. Some endocrinologist associations argue that the clinical endpoint that was measured was not appropriate, though it is important to note that these associations receive funding from Synthroid's manufacturer.

I'm not funded by Synthroid's manufacturer... but I've seen the difference in efficacy between Synthroid and a generic in a loved one. I'm convinced that there is more about thyroid function that doctors don't know than they really do know. I've seen test results that say "everything is okay" - but the patient knows something isn't right - and others can see it clearly too. It appears to me that all the necessary parameters are getting measured.

[MilDoc]

It appears to me that all the necessary parameters are getting measured.

That is part of the point I was trying to make. "Bioequivalence" is one thing, but "effectiveness" is another. generics are tested for the first in several ways, but never tested for the latter To do so would cost $$$, just as it does for new drugs (which must be tested for safety and effectiveness).

I have seen the same thing happen in patients on generic thyroid vs. Synthroid, on several generic antidepressants, and on several hypertension medications.

[JoeyGee]

There was a Scrubs episode on this very topic. Heather Locklear was the drug company rep. I think that about sums it all up .