Pot times July 16, 2005
'Lifestyle' Drug Makers Choking On Sexy Pills
URL: http://www.mapinc.org/drugnews/v05/n1123/a04.htmlNewshawk: M & M Family
Pubdate: Fri, 15 Jul 2005 'LIFESTYLE' DRUG MAKERS CHOKING ON SEXY PILLS
Source: San Jose Mercury News (CA)
Copyright: 2005 San Jose Mercury News
Contact:
letters@mercurynews.com
Website: http://www.mercurynews.com/
Details: http://www.mapinc.org/media/390
Author: Ellen Goodman, Boston Globe columnist
You have to say that the drug companies asked for it. I mean really asked
for it.
Remember when Viagra first came on the market? The spokesman was Bob Dole,
veteran, Senate leader and prostate-cancer survivor who urged other men to talk
to their doctors about erectile dysfunction. The slogan was: Courage.
Fast forward through the millennium. The spokesman now is a hunky
40-something guy with a two-day-old beard and a slogan that says: ``Keep that
spark alive.''
The message today is less about disease and more about delight. We've seen
ads for ED drugs that feature one man throwing a football through a swinging
tire -- say what? -- and another getting his mojo back while window-shopping for
lingerie. We have a leading lady oozing her satisfied testimonial to
Levitra's ``strong and lasting'' effects. We have romantic scenes with the
Cialis tag line: ``When the time is right, will you be ready?''
The only warning missing from the stream of side effects listed in these ads was
to the drug companies themselves. Beware: If you pitch Viagra, Cialis and
Levitra as lifestyle drugs, you can't complain when they get targeted as
lifestyle drugs.
It shouldn't have been a surprise when the House of Representatives voted to ban
Medicare and Medicaid payments for erectile dysfunction drugs. It happened
soon after the brain-numbing news that 800 sex offenders in 14 states had been
given Viagra under Medicaid. Paying for Viagra for sex offenders is like
funding assault weapons for impoverished felons. But in this case, the
vote was less about sexual abuse than sexual recreation.
As Rep. Steve King of Iowa put it, ``We provide drugs through Medicare and
Medicaid that are lifesaving drugs; we don't pay for lifestyle drugs.'' We can't
tell taxpayers, he added, ``we're going to take the money you earned on overtime
to pay for Grandpa's Viagra.''
Now sex is ready to rear its head in the Senate version of the spending bill.
Is it possible to have a rational conversation about rationing?
At the heart of it, this is a conversation about rationing disguised as a
conversation about lifestyle drugs. I don't know anyone who thinks the
government should pay for hair replacement drugs, nail fungus treatments or
cosmetic surgery. But what exactly is a lifestyle drug? Is there a
difference between medicine that enhances our ``lifestyle'' and our ``quality of
life,'' and our life itself?
King said Medicare and Medicaid are only for life-saving drugs. But where
do we draw that line? A drug that reduces the nausea from chemo doesn't save
lives. Reconstructive breast surgery after a mastectomy doesn't save a
life. A nose job to meet beauty standards may be a lifestyle choice, but
what about a nose job after a car accident? When is a cataract operation
life-saving and when is it ``merely'' life-enhancing?
While we are on the subject, if you lose your sense of taste, should the public
pay for a cure? How is that pleasure different from sexual pleasure? Bioethicist
Art Caplan calls the debate about Grandpa and Viagra ``Puritanism masquerading
as medicine.'' It seems that a Congress that can't even negotiate prices with
the drug companies has no trouble whatsoever with values-based rationing.
There are many, like Jonathan Weiner, a health-policy professor at Johns
Hopkins, who believe that ``we should not be paying for sex for elders as long
as we aren't paying for basic coverage for everyone.'' But the issue of coverage
for everyone isn't even on the table.
While we talk about cost containment for sex, we haven't even begun to think
about what we'll do with the truly expensive drugs coming down the pike.
Some of the new cancer treatments can cost $100,000 to prolong life for a few
weeks or months.
I have no interest is using my tax dollars so a perfectly normal 70-year-old can
be ready whenever ``the time is right.'' On the other hand, sex is not just a
Cialis ad. One of the reasons why many men close their eyes to prostate
cancer is the fear of impotence. It's possible and sensible to distinguish
between the dysfunction caused by disease and the superfunction that urges
70-year-olds to behave like 40-year-olds. We can fund one and not the
other.
For the moment, drug companies have produced their own advertising blowback.
It's too easy to attack the notion of government-funded sex. But anyone
who embraces health care costs and choices had better remember the very first
tagline on this subject: Courage.
Ellen Goodman is a Boston Globe columnist.
