A Different Drug Plan

Call it my Casablanca reaction. Much like Captain Renault in that movie, I was shocked, shocked to hear of a study that found Viagra use has increased by 312 percent among men 18 to 45 years old, and that the increases probably reflect recreational rather than medical uses. Imagine that.

    Man (and woman) has sought out aphrodisiacs for centuries. Chocolate, oysters, ginseng, rhinoceros horn–if people think some ingestible will improve lovemaking, they’re going to try it.

    But there is an important difference here: The Viagra study, published in the August 5 issue of the International Journal of Impotence Research, looked at the drug’s use among more than 5 million commercially insured beneficiaries. And while no one tries to get his employer to pay for candy or Kumamotos, I’m willing to bet that your company picked up at least part of the tab for someone’s gone-wild weekend.

    It would be easy to blame party Viagra on people who misuse medications and doctors who won’t say no to pushy patients. But blame-laying won’t keep employees from going after so-called “lifestyle” drugs. They’re not cheats. But they are television-watchers and magazine-readers, and that’s what this is really about.

    Drug companies spend more than $2.5 billion a year on print and television ads, all aimed at the final consumer. The ads run virtually nonstop on cable channels and have the power to make you think you’re in the market for what’s being sold. I’ve answered yes to all the screening questions in the ads for Strattera, which is used to treat adult attention deficit disorder, and I bet nearly everyone else watching does the same thing. We can’t all be ADD-addled, but it’s easy to imagine we are, given that we live in a society where multi-tasking is the norm. A WebMD story about the Viagra study points out that the drug’s ads now feature younger spokesmen than they used to. That’s a change that viewers will pick up on: “That guy uses Viagra? But he’s my age. I wonder if I …”

    Companies are trying to counter the mesmerizing effects of TV ads. They design prescription plans that require higher copays for brand-name drugs and reward the use of less costly generics. As consumer-driven health plans take hold, employees may be even more motivated to bypass the brand-name drugs television pushes at them.

    But until those economic incentives really kick in, perhaps it’s time to fight fire with fire. Just as employers put together financial-planning programs, so could they create an educational packet that gives employees some insight into drug marketing.

    A place to start would be an explanation of generics: why they work as well as brand-name drugs, why they aren’t seen in TV ads (there’s little money in them for big pharma) and why “generic” doesn’t mean second-rate. That is what the term meant when supermarkets sold products in blue-and-white packaging with block-letter labels. When people hear “generic,” I suspect they think BEER. Or in this case, PILLS. Generics have a lousy image. They could use some, well, branding. Or at least testimonials to their first-rate qualities.

    A more radical suggestion is to include a copy of a new book, The Truth About the Drug Companies: How They Deceive Us and What to Do About It. The Wall Street Journal panned it mercilessly, but its author, Dr. Marcia Angell, is a former editor of the New England Journal of Medicine and now a lecturer at Harvard Medical School. Angell’s book is harsh medicine, and if you work for a Pfizer you might disagree–strongly–with her conclusions about how the companies operate. But at the very least, the book could help people view prescription-drug ads more critically.

    Leave the persuasive arguments solely in the hands of the pharmaceutical companies and you might have a Casablanca reaction of your own. You and your company will regret it. Maybe not today. Maybe not tomorrow. But soon, and for the rest of your life.

Workforce Management, September 2004, p. 8 — Subscribe Now!