Lurking,

You bring up a very important topic...that of desperation by drug companies and normally I'd back up their apparent greed in a heartbeat, but we need to look from larger perspective. First and foremost all this goes down because our health is a commodity on an a free market. This never ever should have been and now will be half-***ed to try and make everyone happy. The next big issue is the FDA; I can't stress enough how much they need reform and far less power.

Take a gander at this site FDA Reform The FDA requires both safety, which of course we all agree is essential, but do we really need the efficacy proof in drug development? This puts a tremendous amount of financial strain on drug companies and squelches innovation. We all wonder why everything is so so dopa-centric; here is the answer. Drug companies going against the grain have to spend millions up front to go up against a fifty year old "gold standard" and if the new drug fails endpoints...they lose all that money.

This is in turn, I think, is driving drug companies to start pushing for vaccines or to develop frivolous drugs like the one now available for thickening your eyelashes. They need a bread and butter to bring in funding for their more "innovative" ventures.

I'll admit though the adverts are sickening. Recall the good old days when smoking could be advertised? Doctors were often a feature of the old time ads of the 40's and 50's. I have included a couple links to print and TV ads. Tobacco companies were in fierce competition to prove that their product was less harsh on the throat. Yep, obviously something that burns your throat is not so good for you, but hey docs smoke too, so what do they recommend?

http://www.archive.org/details/tobacco_tle13d00

Now that they know about cancer...but really our ads now take on a new tack. The media makes us health obsessed especially as a culture obsessed with youth, so now we need to get vaccinated against hangnails and medicated for urinary frequency. Doctors are still endorsing drugs they know very little about...I have seen a few here and there, and yes I agree the coupon coercion technique is beyond obnoxious.

Yet there is something more insidious that goes on now. In the era of cigarettes, you wouldn't see your doctor endorsing a daily pack of Camels unfiltered on your way out of the office. This is what we have going on now. Doctors are "bought" with gift giving; wining and dining, and in return Teva can count on 97% market share for newly diagnosed PWP. Who is going to question their doc? Same with the agonists but since they are post-patent they tap into the Restless Leg market. It all rather comes full circle back to the beastly FDA; this is why we have the situation at hand. I really think the print or TV ads are just there to give us the brand name recognition for when we go the doc. He is already a product endorser, all we have to do is ask for the drug.

What makes this even worse, imho, is that doctors become so "taken" with a current drug or class of drugs, they overlook what is best for the patient. Why would any doctor in his right, logical mind prescribe an SSRI for anyone with a profound neurotransmitter imbalance? There is clinical trial support in favor of the old school tri-cyclic antidepressants, and not many doctors will offer unless you ask.

I guess this just highlights how we are pawns in this system. With so many livelihoods at stake...I can see why the key players are so resistant to change, but I still cannot fully blame pharma for our woes.

Laura