I'll supply the tar if you supply the feathers

30. November 2009 William Davis (13)
The results of the latest Heart Scan Blog poll are in.


DIRECT-TO-CONSUMER PHARMACEUTICAL ADVERTISING HAS:

Increased public awareness of medical conditions and their treatment
19 (11%)

Has had little overall effect on health and healthcare
29 (18%)

Needlessly increased healthcare costs
81 (50%)

Further empowered the revenue-obsessed pharmaceutical industry
130 (81%)


Clearly, there's a lot of negative sentiment against direct-to-consumer (DTC) drug advertising.

It looks as if a small minority believe that good has come from DTC advertising, judging by the meager 11% who voted for increased awareness. In fact, the poll results are heavily weighed towards the negative: 50% voted for "needlessly increased healthcare costs," while an astounding 81% voted for "empowered the revenue-obsessed pharmaceutical industry."

It is, indeed, an odd situation: Pharmaceutical agents available only by prescription being hyped directly to the consumer.

Personally, I would vote for choices 1,3, and 4. While awareness has increased, it has come with a hefty price, not all of it well spent. I believe the pharmaceutical industry still adheres to the rule that, for every $1 spent on advertising, $4 is made in revenue. They are, in effect, printing money.
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Comments (13) -

  • Jim Purdy

    11/30/2009 1:06:16 PM |

    I would add this answer:

    Led to the massive over-prescribing of dangerous and powerful drugs to millions of patients, resulting in very large numbers of deaths and harmful side-effects.

  • Anonymous

    11/30/2009 4:51:34 PM |

    I have a young Cardiologist who told my husband and me on the last visit that drug companies are suffering from the downturn in the economy because of the billions that they are spending on research, and seems to believe it!!

  • Dr. William Davis

    11/30/2009 7:05:47 PM |

    Yes, among the most brainwashed of all are my colleagues.

  • Kathryn

    11/30/2009 11:59:50 PM |

    When this first began (& i was firmly ensconced in the medical system) i strongly believed the DTC ads would be helpful.  I was working for a doctor at the time & believed that folks should educate themselves & be their own advocates, to learn more of the meds they took & be more aware of side effects.  (The doc i worked for was not very impressed with my thoughts, however.)

    Sadly, that is not at all what has occurred with these ads.  

    Instead, ads give folks a false impression of what they do & then the folks insist on the meds to their docs.  No one is better educated or making a better effort at partnering with docs rather than taking their word as gospel.

    I'm long out of the conventional medical field (it has been over 5 years since i was on staff at a hospital).  But we still need to help folks learn to be their own advocates & educate themselves.  I'm so impressed with your website Dr. Davis, as it is a wonderful tool to do so.

  • Anonymous

    12/1/2009 1:24:45 AM |

    Sad that the results of your poll show only the opinion of a small more enlightened minority...

  • Dr. William Davis

    12/1/2009 3:05:45 AM |

    True, but it's a start!

    I can only hope that the "enlightened" further enlighten those around them.

  • renegadediabetic

    12/1/2009 2:19:52 PM |

    Some of that "awareness" may just be the power of suggestion making people think they have a disease and need that drug.  For example, restless leg syndrome is rare, though it is real.  Why advertize drugs to treat a rare condition???  I'm sure individual doctors can diagnose it and know what to prescibe.  Could it be that they want people to think they have restless leg syndrome when they really don't so that drug sales will increase?  Any why is it necessary to advertize antipsychotic drugs?  Do they think the entire population is crazy???  I'm sure that psychiatrists are capable of knowing what to prescibe without direct advertizing.

  • Richard A.

    12/1/2009 8:11:43 PM |

    I do not understand what advantage expensive Plavix has over dirt cheap low dose aspirin.

    From LAtimesblogs --
    Plavix advertising indirectly cost taxpayers an extra $207 million over five years

    http://latimesblogs.latimes.com/booster_shots/2009/11/plavix-advertising-indirectly-cost-taxpayers-an-extra-207-million-over-five-years-1.html

  • Allen

    12/26/2009 7:44:49 AM |

    Hello, you have tried to your best. I agree with you and really liked it. Great effort... Keeps it up!!!!

  • Anonymous

    5/23/2010 3:36:30 AM |

    Hey I just a got a VAP blood test and my results stunned me.

    LDL 173 with 80% Type B. I was stunned, because I have been taking my fish oil, eating low carb, and no grains for 8 months now. She said your HDL is 44 so a statin is a better choice than niacin, but I insisted on niacin. My Doctor isn't happy, but it's my body, so my decision.

    Well yesterday I went brought that glucose meter and been taking my glucose reading and found them to range between 70 and 84.

    That is until today. I went out to dinner and ordered mussels and shrimp cooked in olive oil with cherry tomatoes with a side of spinach. Low carb right?

    Well an hour later I took a reading and found my blood glucose to be 137.

    What the Heck?

    I eat out a lot; maybe these places have been adding sugar to my Low Carb orders and that is the reason for my poor VAP test results? I am hoping the glucose meter helps me understand the weaknesses in my diet and with the niacin help me score better in my next VAP test.

    All I can say is thank you Dr. Davis for sharing your knowledge with us.

    Steve

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"Your heart scan score means nothing"

"Your heart scan score means nothing"

1. June 2007 William Davis (7)
Charles was visibly confused.

He'd gotten his CT heart scan after hearing one of the local scan center's ads on the radio. His score 2773, obviously in the 99th percentile for any age.

"Do you think the score means anything? My primary doctor said that it was meaningless because it was all in the deep wall of the artery. He said that it has nothing to do with risk for heart attack. As long as I feel good, he says don't do anything."

What exactly did his doctor mean, in the "deep wall of the artery"?

What the doctor is referring to is the fact that some people with a long history (many years) of diabetes or kidney failure (also for many years) tend to develop calcium deposits in the media, or muscular layer of arteries. The media is the tissue thin layer just below the intima, the most inner layer of arteries that we usually associate with atherosclerotic plaque and the layer that is most prone to calcium accumulation that we score on heart scans.

Aging, generally into your late 70s, 80s, and onwards, also increases the likelihood of medial calcification. Lastly, longstanding deficiency of vitamin D encourages medial calcification.

Is there any way to distinguish intimal vs medial calcification on a heart scan? No, there is not. Having read many thousands of CT heart scans, I can tell you that there is no practical way in 2007 to tell the difference.

Then how did this doctor "know" that Charles' calcium was "deep walled" or medial? Simple: He didn't. This was yet another example of ignorance based on old thinking. Unfortunately, he did Charles a serious disservice by dismissing his heart scan score that predicted a 25% per year risk for heart attack.

Interestingly, whether calcium is intimal as in atherosclerotic plaque, or medial, both are strongly associated with risk for heart attack. In other words, if calcium is confined to the intima, heart disease risk is present. If calcium is limited to the media, risk is still present.

In all practicality, the only difference we make of the intima vs. media argument (that is, when the distinction has been made by some other means like intracoronary ultrasound, the test that is truly necessary to distinguish the two patterns) is that medial calcification may be more powerfully related to vitamin D deficiency. Thus, someone with heavy medial calcification may require closer attention to maintaining a perfect year-round blood level of 25-OH-vitamin D3. But that's the only practical difference.
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Comments (7) -

  • Anonymous

    6/1/2007 5:26:00 PM |

    Will maintaining the Vit D level at the optimal range, reverse the media calcium build up?

    Thanks,

    Marilyn

  • Dr. Davis

    6/1/2007 9:24:00 PM |

    Our emerging experience in the Track Your Plaque program suggests that medial calcification may, in fact, be MORE amenable to regression/reversal.

  • mike V

    1/10/2008 3:31:00 PM |

    Dr Davis:
    I am 72.
    I recently had a CTA scan with "no detectable paque"
    I am also aware of recent research which shows evidence of menaquinone both preventing and reversing calcification.
    Is scanning thought to be less sensitive to medial calcification (as opposed to intimal), and at risk of being 'missed'?

    If so would preventive menaquinone be justified in a 'clean' case like mine?
    Thanks, MikeV

  • Dr. Davis

    1/10/2008 4:25:00 PM |

    Hi, Mike-
    No, the scan quite reliably detects both intimal and medial calcification. Taking K2 is very optional. How about some traditional, fermented cheese? I do not believe that K2 supplementation would yield substantial heart benefits. However, if bone health is in question, that migyht be a reason.

  • mike V

    1/10/2008 4:52:00 PM |

    Thanks, Doc:
    My cheese score is already fairly high.
    I forgot to mention that I have already been taking fish oil, coQ10,vitamin D3, magnesium etc for some years, so I *heartily* endorse your standard recommendations.
    You perform a great community service.  

    mike V

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    Interestingly, whether calcium is intimal as in atherosclerotic plaque, or medial, both are strongly associated with risk for heart attack. In other words, if calcium is confined to the intima, heart disease risk is present. If calcium is limited to the media, risk is still present.

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