When reaching for pills is easier than making lifestyle changes

The WaPo has an article on the increased use of sleeping pills, saying that consumers probably rely on them too much.

“We recommend that both the older and newer sleeping pills be taken more judiciously and less often than appears to be the current pattern of use by millions of people in the U.S.,” the report states. CR says increased pill usage is due to a “growing awareness of the health risks of insomnia and intense advertising and marketing to doctors,” as well as direct-to-consumer ads that “imply that medication is the best remedy for sleep problems.”

You don’t say? I could say the same thing for PPIs — why not try lifestyles changes, and then if that doesn’t work, move to an H2 blocker, and then reach for the PPI? Why go right for the Nexium?

Because going for the Nexium and Ambien is simply easier for an overworked doctor to do than help a patient make healthy lifestyle changes that might work just as well, and more permanently. Consumers like magic bullets, too, again because they’re easier. Take this, your problem will disappear. Easy. In the case of PPIs, they’re almost guaranteed to work. The classic case of using a bazooka to kill a gnat — always effective and usually always overkill.

This trend isn’t the healthiest, of course. Or the cheapest. Or the best. I think we’ll see a swinging away from this style of medicine over the next ten years. Insurers are beginning to realize that CBT is often less expensive in the long run than medicating someone ad infinitum.

[tags]Medicine, pharmacy, therapy, ambien, sleep[/tags]

2 thoughts on “When reaching for pills is easier than making lifestyle changes

  1. I don’t see why it needs to be either CBT or drugs. Pfizer seems to be using a new model with its smoking cessation drug, Chantix, of bundling a CBT service with the drug. This seems like a smart approach for Pfizer for several reasons: 1) it differentiates their product, 2) it potentially means that a very high percentage of the people who use their product achieve the desired outcome, 3) it deepens the customer relationship which will presumably help increase compliance and word of mouth marketing.

    Yes, there is a need for a new medical model, but it seems to me that pharma should see this as an opportunity rather than a threat. For better or worse, nothing changes physician behavior like detailing and masses of clinical data. Seems like it’s time to put those traditional pharma strengths to a use that is both good for patients and increases profits.

  2. Hrm. I didn’t think I implied that Big Pharma was threatened by CBT. CBT takes more effort than reaching for the pills, which is why I think a lot of practitioners would rather write a script. There’s a pretty big stigma against therapists in this country, and that’s something that’s working against a doctor as well when s/he suggests therapy instead of drugs.

    Drugs are widely accepted. Therapy is not. It’s an uphill battle for providers who are already overworked and underpaid for their efforts.

    For better or worse, nothing changes physician behavior like detailing and masses of clinical data.

    I don’t know that that’s a substantiated claim. I’d like to think that’s the case, but I suspect it might not be as well. Let’s not forget that doctors are individuals who have bad days too — not cattle that can be broadly categorized as X or Y. I’m sure there have been times when a doc has done one thing instead of another simply because he was overworked/tired/whatever.

    I also think there’s an idea that if you’re taking pills, you don’t need therapy. I know better, and you know better, by try telling Mr Construction Worker that when he’d rather go home, drink beer, and watch the game. ;)

    But you’re certainly right — I hadn’t considered the angle of Big Pharma collaborating with docs and therapists as a means of brand differentiation. I still think it would be bad for them in the long run, but so is emphasizing selling over old-fashioned R&D, and look where that’s gotten them…

Leave a Reply

Your email address will not be published.