Now Big Pharma Doesn't Want You to Read Drug Labels

Steve - just how low can Big Pharma stoop? Well I guess the abyss is limitless. According to Alabama attorney James Barton Jr., who represents pharmaceutical companies, says information on side effects that appear on drug labels really is intended for physicians, not consumers. So, what he is saying is that because most doctors do not discuss side effects with their patients, and most patients do not read the labels anyway, that consumers should just be ignorant.

Here are excerpts from two articles, one discussing how pharmacists need to be of more assistance to patients because their doctors are not, and the perspective of Big Pharma.

Power of Suggestion: When Drug Labels Make You Sick.
Wall Street Journal

Is it a good idea to read about all the possible side effects of medications you're taking? Not if you have difficulty concentrating, headaches, fatigue, dry skin, irritability, a big project due, or an active imagination. Research has shown that expecting to feel ill can bring illness on in some instances, particularly when stress is involved. The technical term is the "nocebo effect," and it's placebo's evil twin. "It's not a psychiatric disorder -- it's the way the mind works," says Arthur Barsky, director of Psychiatric Research at Brigham and Women's Hospital in Boston. Michael SloanNocebos can even be fatal. In one classic example, women in the multi-decade Framingham Heart study who thought they were at risk for heart attacks were 3.7 times as likely to die of coronary conditions as women who didn't have such fears -- regardless of whether they smoked or had other risk factors. "All that information is really for the doctor, not the consumer," says James Barton Jr., a Birmingham, Ala., attorney who represents drug makers.

Under the Learned Intermediary rule, once a company warns the prescribing doctor about a drug risk, responsibility in case it occurs shifts to that doctor. "There's an incentive to warn everybody about everything, but it fosters this climate of supervigilance and alarm," says Dr. Barsky. If you are inclined toward health anxiety, reading up on your malady or medication on the Internet can fuel your fears. "Once you are anxious, there is all kinds of ambiguous information you can find that will make it worse," says Dr. Barsky. Doctors may unwittingly foster placebo or nocebo effects by how enthusiastically or warily they discuss medication. "Physician communication with patients is the closest thing to magic. It gets communicated in incredibly subtle ways—a flash in the eye, a smile, a spring in the step," says Daniel Moerman, an emeritus professor of anthropology at the University of Michigan-Dearborn.

Should doctors discuss all those risks with patients, or can they be a self-fulfilling prophecy? It depends on the patient and the drug. "Patients should be made aware of anything that could be dangerous, so they don't keel over on the street," says Flavia Golden, an internist in New York City. "But if it's minor like a headache, I don't mention it. It's better to keep the channels of communication open and say, 'Call me if you have any problems.' " Some patients are more prone to worrying about side effects and researching them, in which case a discussion of nocebos might be helpful.

Steve - nocebo effect or not, I want to know about the potential side effects of any medication I would put into my body. It is amazing how cavalier the people quoted in this article were.

Dispensing advice Pharmacists are being relied on more as medical counselors, but some physicians are concerned about the new role.
Baltimore Sun

A new brand of pharmacy is on the rise, known as medication therapy management, in which pharmacists counsel patients on managing chronic diseases and are core members of the medical team.

In a nation with a large aging population, a staggering array of prescriptions on the market and increasingly complex drug therapies, pharmacists say their medication expertise is needed more than ever. Unlike busy primary care physicians, pharmacists say, they have the time to advise patients about medications. Such advice is critical to patient safety, they point out, and can reduce health care costs.

Some physicians fear the trend could erode the role of the primary care doctor as the coordinator of a patient's care. But pharmacists say the model is struggling, as overburdened primary care doctors have less time for patient counseling. Meanwhile, more patients have chronic diseases and are taking numerous medications, increasing the need for supervision and advice.

The medication therapy management model can succeed only if doctors and pharmacists join forces, said Brewer, who has partnered with the Wyman Park practice for a decade. Brewer is employed by Hopkins and bills for his services separately from the doctors at the practice. His patients' insurance covers their visits with him.

"I'm not talking about you coming to the drug store and consulting with you over the counter," said Magaly Rodriguez de Bittner, chairwoman of the department of pharmacy practice and science at the University of Maryland School of Pharmacy. "You should have the right to sit one-on-one, privately with the doctor and someone reviewing your medication."

Medication errors are among the most common medical errors, injuring about 1.5 million people annually and costing hospitals about $3.5. billion a year, according to a 2006 report from the National Academies' Institute of Medicine. The report suggests that more monitoring from pharmacists can prevent problems.

Steve - I don't blame pharmacists for getting involved. They have a conscience and see how some of the millions of errors can be prevented.