Cigarette Packs Get a Makeover

In June 2009, the House passed a tobacco bill that allows the Food and Drug Administration (FDA) to regulate tobacco products through their content, their packaging and their advertisements  (Wilson).  One of the changes in the bill was to have color graphic warnings about the dangers of smoking cigarettes that take up 50% of each cigarette package by 2012 (Wilson).   Yesterday, the FDA unveiled some of the possible warning labels, as shown below (Harris).

Photo taken from The New York Times, Harris

Currently, there are 36 proposed warning labels, some of which are a little graphic, such as a man laying in a coffin and a mother blowing smoke on her baby, but the FDA hired a company to conduct research on which labels would be most effective and want to narrow it down to 9 (Harris).  The company will use survey research to reach 18,000 smokers and find out which labels would most likely encourage a smoker to quit and which labels would most likely discourage teenagers from beginning to smoke (Harris).

The U.S. decision to change cigarette warning labels from the classic “Surgeon General’s Warning” came from 39 other countries that print large graphics of the effects of smoking on their packages, such as in Europe, where they use pictures of “blackened teeth and decaying mouths” (Harris). 

Of these new cigarette labels, secretary of health and human services, Kathleen Sebelius, said, “Today marks an important milestone in protecting our children and the health of the American public” (Harris).  In 2009, Obama said the tobacco bill will “protect our kids and improve our public health” (Wilson).  These anti-smoking efforts appear to want to improve the health of the “20.6 percent of the nation’s adults, or 46.6 million people, and about 19.5 percent of high school students, or 3.4 million teenagers” (Harris) that smoke cigarettes, which they do, but the real reason for encouraging people to stop smoking lies within half of one sentence in this article: “About 440,000 people die every year from smoking-related health problems, and the cost to treat such problems exceeds $96 billion a year (Harris).”  Yes, we are trying to cut down on healthcare spending. 

I personally think that these labels won’t tell anyone anything they don’t already know about smoking cigarettes, but some researchers feel that the graphics will speak more to teenagers than the fine print does.  I think that these new labels could be effective in shaming people into not buying cigarettes anymore, but that’s not exactly good public relations on behalf of the government.  I think that these labels will only annoy and anger smokers, but if they do prevent teenagers from starting then that will be quite an accomplishment.  So what do you think, will these new extreme warning graphics prevent teenagers from picking up their first pack?

Ophthalmologists Face Drug Dilemma

According to an article in The New York Times by Andrew Pollack, the pharmaceutical company Genentech is secretly offering rebates to eye doctors who prescribe their drug Lucentis (Pollack, Genentech Offers Secret Rebates to Promote Eye Drug).

Lucentis is an FDA approved drug to treat macular degeneration and is used in the form of an injection in the eye.  Injections cost about $2,000 each and can be given as often as once a month (Pollack).

Genentech has another drug called Avastin that is only approved by the FDA to treat cancer, but studies have shown that it is as effective as Lucentis when used to treat macular degeneration.  Avastin only costs about $20 to $50 per injection so many doctors are using the drug off-label to treat macular degeneration (Pollack).  Pollack states that the use of Avastin instead of Lucentis saves Medicare hundreds of millions of dollars each year.

Next spring, there will be a clinical trial comparing the efficacy of Lucentis and Avastin in treating macular degeneration, and if results say the drugs are equivalent, more doctors will switch to Avastin, causing Genentech to lose money.  Some are speculating that Genentech launched this rebate program to slow down that switch (Pollack).

Although the rebates offered by Genentech for Lucentis are technically legal, there is an ethical dilemma surrounding the issue.  Should doctors prescribe the more expensive drug to receive rebates, or should they prescribe the cheaper drug off-label?  Earlier blog posts of mine discussed the ethical implications of administering drugs off-label in exchange for kickbacks, but in this case, prescribing Avastin may help the financial standings of the government and patients, so is it okay? 

While I am weary of the use of drugs off-label, I personally think that ethically, if the doctor is prescribing the drug for the correct reasons and not just for monetary gain, it is less of an issue.  In terms of public relations, as this story hits the public, both the doctors and the pharmaceutical companies have valid reasons for prescribing/promoting the use of each drug, so I don’t see this turning into a crisis for Genentech or any of the various doctors who are using the drugs.  Rebates and kickbacks on drugs are so common that I don’t think the average consumer cares as long as they are getting the correct treatment.