Popularity by Physicians as a Basis for Patient Drug Prescribing: Is That Good Medical Practice?

I have already complained about the misleading and incomplete information presented to the public by pharmaceutical companies in their direct-to-consumer advertising. Now I want to present an example of misleading information being presented to physicians in medical journal advertising.

In the current May 5, 2005 issue of the New England Journal of Medicine, there is an advertisement for physicians by Pfizer regarding their cholesterol lowering drug Lipitor.
The lead title says: “According to a recent physician survey Lipitor is the #1 choice of physicians (especially when they need treatment).” The graphic of the ad shows a friendly appearing middle aged black physician (whom I presume is one of those who is need of Lipitor treatment.) The text of the ad follows: “Lipitor is the world’s #1 prescribed treatment for patients with dyslipidemia. And now—according to a recent survey of physicians who take a prescription medication for their own dyslipidemia—Lipitor is far and away their #1 choice, too. So when you choose Lipitor for your patients (or maybe even yourself), you should know that you’re in extremely good company.”
This text is then followed by a trademarked tag line “Health takes Lipitor”.

My concern about this ad for physicians is that it is not providing the scientific basis for prescribing the drug for their patients as the main point of the ad, but instead is using the pitch that because other doctors take the drug for their own use, this information should be included in the decision to prescribe Lipitor for patients. This is totally misleading. The number of persons taking a drug has nothing to do with its efficacy or safety.. Should I remind our visitors of the Vioxx and Celebrex safety concerns despite the millions of users who were taking the drugs? Further, whether physicians themselves are Lipitor users is immaterial with regard to prescribing it to others. We don’t know what motivated each physician in the survey to take the product. Was the drug available gratis from the pharmaceutical company for physicians? Was it based on comments from pharmaceutical company reps during their office visits? Was it because a colleague was using the drug?

It is my opinion, that while we do practice medicine by the numbers: cholesterol, LDL, HDL, triglyceride fasting blood levels, blood sugar levels, patient’s age, number of family members with cardio-vascular disease or diabetes as examples, we don’t or shouldn’t practice medicine based on popularity numbers either related to the public or ourselves.

I welcome and hope for a comment by a representative of a pharmaceutical company or Pfizer to present a defence to my comments that I can publish on this blog. ..Maurice.