Drug companies have long used pharmaceutical reps to detail physicians about their product. This is generally a pain in the rear to physicians who put up with the interruptions and annoyance of these salespeople in their offices in exchange for samples of these medications they can give their patients to use to try the medication prior to having to purchase a prescription for the medications. This sounds fine at first glance, but really is doing patients and the medical system in general a disservice. By reaching for samples of expensive drugs to try patients on, physicians may be not prescribing an inexpensive generic medication that would work as well as the pricy branded medication. Once the patient is on the branded drug and is doing well, it is often challenging to get patients to switch to cheaper generics.

Insurance companies figured this out once they started to come under pressure to reduce the cost of health care, and especially the rapidly growing cost of prescription drugs. They responded by making patients pay more for branded drugs in the form of a copayment due from the patient. Drug companies responded by offering coupons physicians can give to patients, or often that patients can print online to reimburse the pharmacist for much or all of the copay cost when their drug is prescribed. Government payers, Medicare and Medicaid, do not allow this practice for patients using their insurance, but it is commonly done for commercially insured patients. This is a blatant attempt by pharma to undermine the goals of the higher copays, i.e. to encourage patients and physicians to use less expensive generic meds to avoid higher cost to the patient. This practice by pharma is deplorable, and should be regulated, but to date has not.

Other ways pharma markets their drugs includes direct to consumer advertising, advertising to physicians and other prescribing practitioners, and by setting up pseudostudies that offer free medication and care to patients in studies of hypertension, diabetes, depression, etc where patients are put on their medication, and if they do well are then sent back to their physician to request that they stay on the "study" drug.

As a patient and a consumer you need to advocate for yourself. Ask your physician if there are good generic medications you can use rather than taking samples of expensive drugs you'll need to get by prescription later, and avoid the use of coupons as an inducement to use more expensive drugs when generics will work for you.

Gone are the days of sneaky glances accompanied by an uneasy silence when anyone talked about erectile dysfunction (ED) or male impotence. Till the 1980s, impotence was labelled as a psychological problem. But later findings proved that it is caused by lack of blood flow into the penis. Then came the elite pool of anti-ED prescription drugs - Viagra in 1998, and Cialis and Levitra in 2003. While you must have already skimmed off the most pertinent information about the three medicines, let's just venture into some offbeat areas about them.