One aspect of this media epidemic:
C-Span2 has the 4-hour (Flash) video of today's [5/08/08] House Committee hearing on this very subject. The Committee plays hardball with 3 different BigPharma representatives, asking the very same questions the public themselves might put to them. A surprising grilling (and chastising), with the promise of a second hearing to come:

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The Onion had a good spoof on this quite a while back. A middle-aged couple in an idylic picnic setting (on a blanket, next to the river, hand-in-hand, and smiling in blissful romance). The caption read:

Local man to ask his doctor about Levecor, Fastin, Claritin, Viagra, Procrit, Lipitor, Rogaine, Tramadol, Adipex, and Levitra.

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Don of Borg - Cool, Calm, Collective.

"Within the next generation I believe that the world's leaders will discover that infant conditioning and narco-hypnosis are more efficient, as instruments of government, than clubs and prisons, and that the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

By the way, the strongest advice I ever got from a pharmacist was not to ask for or use the latest new drugs unless you are terminal and have exhausted all other options. The level of testing and trials required for approval is absurdly low.

When taking the latest and greatest drugs you are, in effect, only the next phase of testing.

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Don of Borg - Cool, Calm, Collective.

"Within the next generation I believe that the world's leaders will discover that infant conditioning and narco-hypnosis are more efficient, as instruments of government, than clubs and prisons, and that the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

I'm of two minds with this issue. While many of the ads are insidious, some are useful. I break them down into two categories: ads for drugs to alleviate conditions a consumer can diagnose or notice themselves, and those that require expert medical opinions or tests to discover.

Example of former: Viagra
Example of latter: Lipitor

The reason I don't have a big problem with the former is that many people are aware of conditions, (ED, allergies, etc) but may not know that there are prescription medications to help. They may not have seen a doctor about the condition.

With the latter, conditions such as high cholesterol necessarily involve a trip to the doctor before you even know about it. So these ads just serve to get you to influence your doctor despite your being pretty ignorant on the options. I speak generally, of course. Researching your options is always a good thing and many people are fully capable of sorting through medical information and coming to an informed opinion. But that's not who the ads are targeting.

I'm bothered by the ones for mental health issues. (My best friend loathes the one telling you how much your depression hurts those around you; that'll make you feel better!) There are a lot of people who are self-diagnosed there who may or may not be really in need of those pills; that's a decision for a medical professional. While the commercials may get to a small percentage of those who need them and would not otherwise seek help, I doubt the majority of people who ask for the drug after seeing a commercial actually need to take it.

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Gillian

"Now everyone was giving her that kind of look UFOlogists get when they suddenly say, 'Hey, if you shade your eyes you can see it is just a flock of geese after all.'"

"You can't erase icing."

"I can't believe it doesn't work! I found it on the internet, man!"

The biggest fallacy is the assumption you will have knowledgeable questions to ask your doctor, and that you will understand the answers.

"Y'know, Doc, I'm still not quite clear on the effects of cyclooxygenase inhibitors on thromboxane/PGE2 ratios."

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The Devil offered me power. I told him I preferred aperture.

But unfortunately the doc just might understand the benefits to his mental health of the free round of golf and lunch the pharma rep treated him to. That's probably a bit unfair but I'm just not sure.

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Cum catapultae proscribeantur tum soli proscripti catapultas habeant.

Any time you deal with a professional who is giving you advice, you run the risk that he is giving advice suggested by someone who has influenced then. There are no guarantees in the world, so choose those you ask advice of carefully.

And sadly, between doctors' incomes being strangled by the HMO-shuffle, exorbitant malpractice insurance rates and re-paying student loans, vulnerability to any lucrative outside influences can't be ruled out, IMO.

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I saw a stand-up comedian do a bit on commercials that are so vague with their imagery of how you'll live a better life on their drug that you have no idea what it's for or what problem it's supposed to treat. He said he'd gone to his doctor for something else and remembered at the end, "Oh, wait, I'm supposed to ask you about..."... and when he said the drug's name, the doctor looked confused and said "Why didn't you tell me you have anal warts?"

Next thing you know, they'll start attacking commercials for colloidal silver!

The horror!

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"Better living through chemistry!"

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Perhaps interesting, in Denmark, pharmacies are required by law to offer the lowest priced equivalent medication unless the doctor in his prescription explicitly defined which of the alternatives to use, and even then they're likely to ask why he did specify a pricier alternative.
It's one of the reasons why it takes several years of studying to qualify for working even at the counter, since they have to be able to catch unintended drug-interactions as well as unintended overpricing.

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An emperor without enemies, a king without a kingdom, supported in life by the willing tribute of a free people.

I think that's the case in many states in the US too--and in all states you can request the lowest-priced substitute unless the prescription explicitly says you can't (and I know of no case of that happening on a prescription). If your insurance pays for it, the insurance company will likely insist on lowest-priced substitute.

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Todd (Bowie, MD, US, North America, Earth, Sol System, Vega region, Local Bubble, Orion arm, Milky Way Galaxy, Local Group, Virgo A Cluster, Virgo supercluster, the universe in which spock is clean shaven)

Quidquid latine dictum sit, altum sonatur.

personal page: http://blog.astrosketches.info

That's the reason drug companies develop and patent new brand-name clone drugs once their patent runs out. There's a minor change in the formula, and perhaps no change in efficacy, but there's no low-cost substitute so they can charge what they like as long as they can con the doctors into prescribing it or con the patients into requesting it. Insurance companies, of course, are on to this and at least in some cases pass more of the cost on to the patients.

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Cum catapultae proscribeantur tum soli proscripti catapultas habeant.

I'm starting on generic alendrolate this week instead of brand-name Fosamax. Let you know how it turns out.

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The Devil offered me power. I told him I preferred aperture.