Aug. 24, 2010 -- Nearly half of all Americans take at least one prescription drug on a regular basis, and they have concerns ranging from economics to safety to whether the doctor prescribing the drug is unduly influenced by pharmaceutical companies, according to a new poll.
Consumer Reports National Research Center conducted the poll, in which 2,022 adults aged 18 and older were surveyed by phone in May 2010.
''Consumers are not finding out about the safety issues of drugs," says researcher John Santa, MD, MPH, director of the Consumer Reports Health Ratings Center. The poll results also suggest people are concerned about the expense of drugs, and as a result, are sometimes not taking them as prescribed.
Since 2004, Santa tells WebMD, Consumer Reports has been following the prescription drug market from a consumer’s point of view, conducting surveys about prescribing practices and other factors.
The researchers narrowed down the 2,022 adults to 1,154 who currently take prescription drugs.
Among the findings:
- Patients are trying to save money on drugs, sometimes in ways that could be hazardous. In the past year, 39% took action to reduce costs (such as switching to generic, a good idea in Santa's view). But 27% failed to take prescription drugs properly -- for example, taking a pill every other day instead of daily.
- Average out-of-pocket cost for those on prescription drugs is $68 a month, but 14% spend more than $100 monthly.
- Patients complain that doctors don't consider their ability to pay when prescribing a drug, with 51% feeling the expense isn't considered.
- Even though many poll respondents took generic drugs, 43% had some misguided concerns about them, such as generics not working as well as brand-name drugs.
- More than two-thirds said they think pharmaceutical companies have too much influence on a doctor's decision about which drug to prescribe. And half said their doctors are too eager to prescribe a drug rather than consider other treatment options. About 47% said they think gifts from drug companies influence doctors to prescribe specific drugs.
- 20% of those surveyed said they have asked their doctor for a drug they saw advertised, with 59% of doctors honoring the request.
The Marketing Issue
In an interview with WebMD, Santa focused on the advertising issue, using as an example overactive bladder drugs. "Last year the industry spent $126.9 million for five overactive bladder drugs," he says. "The most popular three had total revenues of more than a billion."
He takes issue with the ads themselves. "They give you the impression the problem is more serious [than it typically is] and that treatment with drugs should be the first thing you do, when in fact for most of the people who have problems with incontinence it's a mild to moderate problem that almost universally gets better with exercise programs [such as Kegels] or bladder training."
Side effects, he says, are downplayed in ads and commercials.
Victoria Davis, a spokeswoman for Pfizer, which makes overactive bladder drugs, takes exception with the report and Santa's views about marketing. In a statement, she says:
"We have always been committed to responsible advertising that provides clear information about medical conditions and treatments. We adhere to all requirements on DTC [direct-to-consumer] communications set forth by the FDA and the FTC, as well as guidelines set by Television Advertising Standards and Practices and Pharmaceutical Research and Manufacturers of America (PhRMA)."
"Our advertising campaign for Toviaz encourages people with overactive bladder who may be just coping to talk to their doctor about their symptoms and ask if Toviaz may be right for them. The ads also include important safety information."
Allen J. Vaida, PharmD, a spokesman for the Institute for Safe Medication Practices, who reviewed the survey for WebMD, says he was surprised poll respondents showed a ''lack of understanding about generic drugs, the fact people think they are not as good, may not work as well."
The findings about people skipping medication due to financial concerns reflect anecdotal reports, Vaida tells WebMD. "Having it come out in the polls should be another wake-up call that some people are cutting corners" due to drug costs, he says, and not always in safe ways.
The practice of pill splitting to save money, he says, ''makes us nervous. Some medicines aren't meant to be split. You may not get the correct dose."
The perception that drug companies are controlling prescribing practices may be slightly out of proportion, Vaida tells WebMD, as new regulations and ethical guidelines about the relations between pharmaceutical companies and doctors have been phasing in. For instance, the American Medical Association has issued guidelines about pharmaceutical company gifts, consulting fees, and free samples.
''We know from this survey and others, consumers are not finding out about safety issues," says Santa. He urges consumers to ask their doctors about side effects of new medications.
Vaida urges consumers to ask for generic drugs, typically less expensive. "Patients may be shy about telling doctors they are having a hard time financially," he says. But they shouldn't be, he says.