The November 2007 issue of Consumer Reports features an article entitled “Treatment traps to avoid.” The article focuses on unnecessary and overused health care treatments (in the United States). One major emphasis of the report is the emphasis on the approval of new drugs and the marketing process for drugs in the U.S. in general, which includes both substantial direct-to-consumer marketing (illegal everywhere else in the world except for New Zealand), and extensive marketing to physicians — for both on-label and off-label uses — by means of gifts, samples, meals, and reprints of research sponsored by the manufacturers. Research frequently establishes a drug’s efficacy vs. placebo, but more rarely compares new drugs with the established standard of care and demonstrates incremental effectiveness, much less incremental cost-effectiveness.
As a result of a $430 million settlement between drug manufacturer Warner-Lambert and the U.S. government, several projects have been funded to study and address issues in the marketing of pharmaceuticals. One such project, Formulary Leveraged Improved Prescribing (FLIP) is centered across the street from my office, and is a joint effort between the University of Illinois at Chicago and the John H. Stroger, Jr., Hospital of Cook County.