Last week I had a bit of a tilt at Big Pharma and some of the underhand ways of influencing the medical profession. This week I would like to look at the other side of the coin and highlight things you should be aware of.
The first and most obvious is the PI, short for Patient Information sheet. This slip is inside the box of genuine medications. The concept is that by having an educated patient, that person will use the new found knowledge to take the medication wisely. Well, that was the initial reason. Sorry, it didn’t work.
Now here comes the other side of the coin. The becoming better informed patient reads the list of side effects and feels that the medication is far too dangerous to take, so leaves the packet in the bathroom cupboard, thus slowing down the rate of recovery.
Now let’s look at some of the dangerous side effects. Did you know that one of the side effects of salt is DEATH. Good old salt that you can buy from your local 7-Eleven. Yes one on every street corner and it can sell you death pills. Makes no difference that you have to eat something like 240 grams and that is a lot of salt on the chips. In fact, that’s more salt than chip. That gets us back to the absolutely true statement that dosage alone determines poisoning (Paracelsus 500 years ago).
What the PI also does not say is what percentage of patients actually show any side effect at all. This can be less than 1 percent, but the governmental watchdog insists that the printed warning must be there. I am not in favor of the PI. Your doctor should explain the medication he is prescribing and the likelihood of side effect problems.
You can see the difficulty. Not everyone metabolizes chemicals the same way. And here is another interesting fact, when testing chemicals for toxicity, the chemical is compared to one called a placebo, which is a supposedly inert chemical. Yet that inert chemical can also produce symptoms on the testing! How can this be?
The answer is in Subjective findings and Objective findings. Subjective means you are recording the person’s thoughts and feelings which can alter, while Objective means you are measuring something and the results can be repeated.
Sorry to make something so confusing, but that’s how it is. Without placebo (no matter how inaccurate) you have nothing to compare against. And the manufacturer sticks it into his PI. And incidentally covering his posterior if anyone tries to sue.
Now there is yet another side to the coin – counterfeiting. We live in a fake world these days. Fake news and fake drugs. The price of medicines is always a contentious subject – and not just in Thailand. In Australia “brand name” drugs are more expensive than “copy” (generic) drugs. However, there is a good reason for the brand name being more expensive than the generic. The pharmaceutical companies spend millions of dollars to develop, test and get licensing for new drugs, costs not borne by the makers of the generics, after the patents expire. But some manufacturers do not wait for the patents to expire and the ‘copy’ drug hits the market and will also be cheaper.
In Thailand, many drugs can be bought over the counter (OTC), which may or may not be a good thing. Self-diagnosis and self-prescribing can be dangerous. That is why I believe that doctors should be prescribing, and pharmacists should be checking and dispensing. If some drugs are only available through pharmacies world-wide, on the prescription of a doctor, is it safe to just buy OTC, without any doctor’s advice? Obviously not!
Through the middle of this pharmaceutical minefield goes the unsuspecting patient, where the only yardstick is price. And it is the wrong yardstick. Believe me when I say, be guided by your doctor, buy only genuine medications from our pharmacy which you can trust.
 |
 |
