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3:57 AM Tue, Sept. 25th

Debate: Do TV ads for prescription drugs do society a service? CON

In the classic 1953 western "Shane," Van Heflin suspects that Alan Ladd is part of the clan trying to run him off his homestead and tells him to get off his land. Ladd says he'll leave but he'd like it to be his idea.

That's exactly the position that direct-to-consumer advertising of prescription drugs imposes on primary care doctors.

Today, drug makers are spending millions of dollars hawking prescription drugs to consumers. They are bringing all the resources to bear with which they used to hawk over-the-counter remedies.

They create a need by asking consumers if they feel tired, if they "go" too much or can't "go." They promise all sorts of fast relief and miracle turnarounds, followed by caveats and legalese crammed into a couple of seconds.

Thus, full of unreasonable expectations and with the jingle still playing in the subconscious, the patients troop to their doctors' offices to demand that their doctors prescribe these perceived miracle cures for them.

Now, newspapers and their editors generally crusade for the unrestrained dissemination of information, and we still do when it shines the light on important issues.

Direct-to-consumer advertising of prescription drugs, however, generates far more destructive static between patients and physicians that it does light.

Prescription drugs are subject to prescription because the medical community wants discretion over choosing the best means of treating individual patients' unique problems. Doctors know what drugs work best on particular health problems.

Direct-to-consumer advertising creates the same often unrealistic expectations in the minds of patients that over-the-counter drug marketing does. But if

an over-the-counter medication doesn't work well, the patient is out a few bucks. If a patient successfully bullies a doctor into prescribing a hotly promoted prescription drug that doesn't work, the patient could suffer harm and the doctor could face a lawsuit.

As it is, primary care physicians don't get enough time with their patients to discuss their health issues and decide on the best course of treatment. Now they have to waste an inordinate portion of that time explaining to patients why a touted prescription drug may not work for them.

In some cases, direct-to-consumer marketing may bring relief to sufferers of certain maladies, but not out of any altruism on the part of the drug makers. They just want to move their item, and bringing pressure on doctors through their patients is not an ethical way to do it.

Enacting a law to prohibit this would do more harm than good. But people need to wise up to the fact that anything that sounds too good to be true usually is.