There is no doubt that prescription drug policies have wreaked havoc in America. From doctors being trained to overprescribe opioids, contributing to a massive opioid epidemic to the overprescription of antibiotics leading to individuals often self-medicating to avoid costly and time-consuming visits to the doctor, pharmaceutical companies have potentially done far more to harm to American health than good. Understanding the damage that over prescribing medications causes is one thing, however, stopping it is an entirely different one.
The issue is not likely to be solved by simply forcing doctors to prescribe less or fewer medications. Doctors have to do what they feel is in the best interests of the patient and are also held liable if they don’t provide adequate care. Not everyone reacts to medications the same way, so what might be enough medication for one patient may not be enough for another or too much for someone else. Medication dosages are not an exact science and every body is slightly different. One half of a prescription opioid tablet may be more than enough to dull one person’s pain, which might recede in just a few hours, while another person may need to take a full tablet every few hours for 2-3 days before their pain recedes.
The same is true of antibiotics. If a round of antibiotic treatments don’t fully eradicate a virus or infection the first time around, the initial virus or infection can come back and be twice as strong the second time. Doctors – quite rightly – tend to overprescribe antibiotics to make absolutely sure they take care of the issue the first time around. Unfortunately, in many cases, people stop taking the antibiotics when they feel the problem has been resolved, rather than for as long as the doctor has recommended they keep taking them. This leads to individuals often having an excess supply of antibiotics in their medicine cabinets. If they have families that all have a range of different issues, they may have essentially an entire pharmacy in their medicine cabinets.
Unfortunately, this can sometimes lead to them simply skipping a trip to the doctor the next time they are sick and instead taking whatever they have in their medicine cabinet. The truth is, however, not all antibiotics are the same. Different antibiotics interact differently with different medications and actually work differently to attack different issues. In addition, individuals can also end up building up a resistance to antibiotics which can make future issues more difficult to treat.
Perhaps one reason we have such a massive issue with pharmaceuticals in the US is that consumers themselves have largely been kept in the dark about the products they are directed to consume. Drug manufacturers tell doctors what dosages of what prescriptions to prescribe and doctors simply follow their recommendations, without the consumer having any idea of what is going on. They, in turn, are expected to just blindly swallow whatever pill their doctor prescribes.
On the one hand, this is somewhat appropriate, since a doctor has spent many years studying and becoming educated about how to heal and treat certain conditions. On the other hand, the consumer is still literally consuming the product and therefore also has a right to be informed and educated about the product they are being directed to take. There has long been something of an arrogance in the medical community in regards to how much the patient or consumer should be told about what they are being prescribed or told to consume. Unfortunately, it is often not even doctors making these decisions but the pharmaceutical companies actually selling (and profiting from) the product. When both medicine and medications become for-profit businesses, then it becomes all-too-easy for the bests interests of the patient to take a back seat to profits.
This is further complicated by the fact that many, if not most, medications are simply covered under medical insurance. Therefore, consumers (or patients) have no idea how much they are actually paying for these medications, since they are simply rolled into the price of their health insurance. What they do know is that health insurance premiums are skyrocketing out of control, what they don’t know is why.
But new legislation may change all that. A new proposal is in the works that would force drug companies to actually disclose the list prices of all of their pharmaceuticals in advertising. In 2017, prescription drug advertising was the seventh largest ad spending category, contributing more than $5.77 billion to Madison Avenue coffers. While patients themselves will generally pay considerably less than the list prices, thanks to the prescription coverage offered by many health care plans including Medicare and Medicaid, what it will do is wake consumers up to the actual costs of pharmaceuticals and the massive profits being generated by big Pharma.
At current, consumers don’t understand why health care coverage is so high and that is generally because the costs associated with various treatments are hidden from them. In part, this is to keep them from making health care decisions based on cost, but at the same time, it also shields drug companies and other distributors of medical products from any kind of consumer pressure. Unhappy consumers can create major headaches for a disreputable brand, which drug companies and other medical supply companies are largely shielded from thanks to insurance package pricing. Consumers pay one price for insurance, but then have no idea of the actual costs of the products that insurance covers.
The proposal to force pharmaceutical manufacturers to disclose the costs of their products is part of an ongoing attempt to drive the prices of pharmaceuticals down and may be the most effective one yet. While big Pharma has shown itself quite adept at mitigating “bad news” by communicating it cleverly, even they can only hide so much. Several years ago, legislation was enacted requiring pharmaceutical companies to list potential side effects of their drugs in advertising. At first the public was shocked by the disclosures, but eventually they just became white noise. It remains to be seen if they will also recover from initial sticker shock, allowing big Pharma to simply conduct business as usual.