Pharmaceutical Absurdity

So I just got home from a visit to the doctor and the pharmacy. I have an outer ear infection and got a prescription for some antibiotic ear drops. When I stopped at the pharmacy to get the script filled, I noticed that one of the many products they sold over the counter was a copper wrist band that allegedly (read: pretends to) helps your health. The packaging said "Experience the magic of pure copper!" I found it rather disturbing that a pharmacy, a place that dispenses medicine and advice that people rely on as it concerns their healthy, would be peddling such useless, pseudo-scientific twaddle. They might as well stock kabbalah water, snake oil and healing stones.

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But you see Ed, unfortunately they exist to do more than just dispense medicine... They exist to make money, and I'm sure "pure copper" is probably extra money in the bank for them.

I dislike it also.

If you could make $10 million selling kabbala water, you wouldn't?

steve s wrote:

If you could make $10 million selling kabbala water, you wouldn't?

Of what relevance is this question? Even if I answered yes, would it excuse such deceit and make it okay? They are bilking the credulous and committing fraud. That deserves criticism, regardless of whether greed would make most people do the same thing.

I agree with Ed that it is disturbing. Consumers are encouraged to talk to their phamacists for advice about drugs because they are supposed to know the subject and be trustworthy. This destroys their credibility.

By Mark Paris (not verified) on 27 Feb 2006 #permalink

I actually had a coworker tell me that her magnetic bracelet HAD to have health benefits -- she bought it at the drug store! She would not tell if that meant that the pack of AA batteries I bought at the same drug store also came with health benefits...

By Anuminous (not verified) on 27 Feb 2006 #permalink

Well as a former clerk at a pharmacy I can tell you that the pharmacist typically has little to no say (unless it's a small independent pharmacy) in what gets sent to be displayed there. I know when I was working there they not only had those magnet bracelets that are supposed to cure all ills, but we had the pressure point ones that are supposed to cure sea sickness. My boss would roll his eyes every time we got out weekly shipment in and had to stock the shelves with asinine items like that, but his hands were tied.

Halcyon: Shouldn't there be some sort of label on the packages of these things noting that the FDA have not approved or certified the drug/thing/bracelet/kaballah-water as effective for curing whatever the hype claims they cure? I've seen such warnings before, but now I can't remember on what product. Is it required by law? What advice did you give if asked about them?

Raging Bee: There would have to be if the packaging made any real claims. I recall the bracelet I mentioned above came with a lot of strongly worded non-statements. Especially telling was the bold "PROVEN EFFECTIVE!" in a gold starburst. No place on the package, however, stated effective at what. My best guess is picking paperclips up off the carpet. There were also suggestions "Wearing this item is believed to help circulation" and anecdotal testimony "One customer told us that after wearing her bracelet for a week, her arthritis was gone!". None of that says anything that would require the FDA, sadly.

By Anuminous (not verified) on 27 Feb 2006 #permalink

If the ads have anything to go by all they need to put on the packaging (in suitably tiny print) is "for entertainment purposes only". Amazingly this phrase seems to negate all of the ludicrous claims made about the product.

Halcyon,

what would you if you were asked by a customer if the bracelet works?

By Roman Werpachowski (not verified) on 27 Feb 2006 #permalink

There were also suggestions "Wearing this item is believed to help circulation" and anecdotal testimony "One customer told us that after wearing her bracelet for a week, her arthritis was gone!".

Maybe they went to see Benny Hinn just to be on the safe side...

what would you if you were asked by a customer if the bracelet works?

There are two honest answers:

1. It doesn't work, don't waste your money.
2. There's no evidence to say that it works.

Answer number one is a more complete answer, and will probably lead to the loss of the sale. Answer number two is most likely to be ignored by most prospective buyers.

It's no more disturbing (to me) than pharmacists saying that they can't dispense certain types of medicines because it's against their religion.

Raging Bee: Actually I told several customers that the sea-sickness wrist bands did diddly and squat for me when I was asked. Typically though the people who are going to believe in those type of things aren't going to ask in the first place because they saw the infomercial on them and now want one.

Halcyon wrote:

Well as a former clerk at a pharmacy I can tell you that the pharmacist typically has little to no say (unless it's a small independent pharmacy) in what gets sent to be displayed there.

This one is a small, independent pharmacy (this town isn't big enough to have a chain pharmacy). But the fact that a large chain pharmacy would display such things is even more disturbing to me. It's one thing for some independent crank to do it; for a large pharmaceutical business to do it is far worse.

Ed: "It's one thing for some independent crank to do it; for a large pharmaceutical business to do it is far worse." Well the chain I worked at was a small market with a pharmacy in the back (I'd rather not give out names) and considering that all the people in the head office were concerned about was making profits it didn't surprise my boss or myself to see them selling things people thought they needed. Granted we were never told we had to back up any of the claims that any of the items made, and my boss would typically advise against purchasing things like that and his diatribes against OTC diet pills was something to hear. But we had to stock what the head office told us to stock and sadly we lists of where we had to put certain items.

The problem here is the economics of a pharmacy. Although drug companies generally "get rich", many pharmacies are lucky to break even. Without secondary sales, they would generally lose money.

Say you were prescribed Floxin OTIC -- a common brand name antibiotic drop. Wholesale cost for a community pharmacy is about $66 / bottle. They might get $65 from an insurance company, and less from Medicaid.

Generic markups are generally higher -- traditionally about 50%. However, that recently has been squeezed to 10% by many payers.

After paying for overhead, expensive EDI systems, and pharmacist salary, the actual pharmacy portion of most pharmacies break even at best. The money made is:

1) On cash buy patients who can't/don't negotiate signficant discounts.

2) Non prescription sales such as OTC drugs, bandages, durable medical equipment and the like.

3) Foot traffic (for such stores such as Walgreens, etc.

Alternative medicine is a lot like Creationism. It sounds plausible, fits loosely into an intuitively magical world view, and often manages to convince the general public through superficial means that it's backed up by solid research and accepted by a growing number of scientists. Cry foul on that last one and out come the accusations against a hegemonic close-minded establishment following materialist dogma.

Alt med is also like Creationism in that it's starting to make political advances by first claiming there's an inter-scientific controversy and then making an appeal to the people's right to have a "choice."

Many pharmacies are also selling homeopathic nonsense as well. While I suspect most people don't know the pseudoscience behind these products, they also don't really respect scientific method much and testimonials sound convincing to them. If it's popular and slick, there must be something to it.

Kinda like Creationism.

I'm a bit conflicted, actually. Isn't homeopathy / magnetic bracelets / kabbalah water &c a kind of stupidity tax? Excepting extreme scenarios, like someone desperately spending their food money on snake oil, I don't see it as being any more unethical than Nike selling poor teenagers $200 air jordans.

In fact, maybe the science-loving rationalists should go about creating such snake oil businesses, and using the profits to legally fight things like creationism. That way you'd be using the Forces of Ignorance's own money against it.

In fact, maybe the science-loving rationalists should go about creating such snake oil businesses, and using the profits to legally fight things like creationism. That way you'd be using the Forces of Ignorance's own money against it.

Or rather exploiting stupid people to their own detriment.

By Roman Werpachowski (not verified) on 27 Feb 2006 #permalink

pharmacists saying that they can't dispense certain types of medicines because it's against their religion

Yeah. If their religion forbids them to sell people stuff, how about switching jobs? It's like becoming an army sniper and then saying "oh, I can't shoot people, it's a sin!".

By Roman Werpachowski (not verified) on 27 Feb 2006 #permalink

BTW, I saw this thread begins with mentioning antibiotics and I am very itchy to make a comment on them. I am amazed how many doctors will prescribe antibiotics for even a minor cold, and then people wonder why they are resistant to them.

By Roman Werpachowski (not verified) on 27 Feb 2006 #permalink

I'd be interested to know on what basis a libertarian condemns the selling of copper wrist bands? Are you suggesting the government should step in to act as a nanny and protect the poor, innocent masses from themselves?

Surely you'd rather let the market decide, Ed?

Ian Gibson wrote:

I'd be interested to know on what basis a libertarian condemns the selling of copper wrist bands?

On the same basis I condemn the selling of anything on fraudulent grounds.

Are you suggesting the government should step in to act as a nanny and protect the poor, innocent masses from themselves?

I think the line here is sometimes a bit fuzzy. Since they are careful not to state any claims bold enough to be caught committing fraud, there is no real legal recourse. That does not, of course, mean I can't condemn the selling of them. Just because something is legal doesn't mean it's immune from criticism.

I think the line here is sometimes a bit fuzzy. Since they are careful not to state any claims bold enough to be caught committing fraud, there is no real legal recourse.

Well of course. All advertising is careful to be merely misleading, rather than making outright false claims. The legitimate healthcare business also engage in such practices, not just quacks with magnets and homeopathy water. I don't see how it's any more unethical to sell copper bracelets than to push overpriced aspirin by implying it is better than other brands and could even save your life during a heart attack, for instance.

Ian,

I would have no objection whatsovere if those bracelets were sold in general stores. However, for some reason we have separated the trade in medicines and put it under stricter control. Yes, this is contrary to the libertarian principles, just as the fact that you need a prescription from the doctor to buy a lot of medicines. This is done for the good of the people, because most of us have no clue what medicines are good for what, how much should we take them, etc. Thus, I object to quack medicines being sold in pharmacies, even to the point of making it a law that every item sold in a pharmacy should be clearly labelled with the information about what this item is supposed to do to your health. In fact, in the EU all medicines have to be accompanied by an info leaflet. If the copper bands producers can prove their products do something to your health (positive or negative) they may label their products and sell them in pharmacies. If not, let them sell those at flea markets, where they justly belong. Fair enough?

By Roman Werpachowski (not verified) on 28 Feb 2006 #permalink

Ian Gibson wrote:

Well of course. All advertising is careful to be merely misleading, rather than making outright false claims. The legitimate healthcare business also engage in such practices, not just quacks with magnets and homeopathy water. I don't see how it's any more unethical to sell copper bracelets than to push overpriced aspirin by implying it is better than other brands and could even save your life during a heart attack, for instance.

That's a reasonable point to make. Those legitimate healthcare companies deserve criticism as well.

Alternative medicine is a lot like Creationism...

Actually, many alternative medicinal treatments have real psychosomatic benefits for at least a few of those who pay good money for them: thinking it works sometimes makes it work. Which is more than the creationists can say.

Raging Bee,

I've heard that the reason why so many people with cancer seek "alternative therapy" is that the therapists devote them much more time and attention than clinic doctors.

By Roman Werpachowski (not verified) on 28 Feb 2006 #permalink

Raging Bee wrote:
"Actually, many alternative medicinal treatments have real psychosomatic benefits for at least a few of those who pay good money for them: thinking it works sometimes makes it work. Which is more than the creationists can say."

Oh, Creationism works too, once you decide to focus on the psychological benefits and ignore the science. Become a creationist and you will have firm answers which reassure you that you're a special creation of a loving God, made in His image. This can provide enormous confidence and comfort; you might even be inspired to become a better person. Creationism will make you feel better. Therefore, it works. Therefore, it must be true. And if it contradicts what scientists have discovered, then the scientists must not care about what really works.

This is more or less the same reasoning the alties use.

Quackwatch has a page on this. It comes down to consumers being stupid, and pharmacists being greedy.