DR. MOHLER: Disease Mongering — How the pharmaceutical industry sells illness
MOHLER’S MEDICATION MAXIMS
Free Press Health Columnist
What do the following illnesses have in common?
• Male pattern baldness
• Premenstrual dysphoric disorder
• High cholesterol
Answer: These are all “illnesses” that were created by the pharmaceutical industry to sell more drugs. Thirty-five years ago, Henry Gadsden, then the chief executive of the pharmaceutical giant, Merck, bemoaned the fact that his company’s market was limited to sick people. Henry’s dream to make drugs for healthy people has come true.
HOW DOES IT HAPPEN?
One of the chief strategies of the pharmaceutical industry is to change how people think about their common ailments. Their goal is to make the natural processes of aging into medical diagnoses. Wrinkles, declines in sexual prowess, balding and loss of bone salts are no longer the realities of getting older, but opportunities to create new disease markets.
Pharmaceutical companies sponsor medical meetings where disease definitions are created and updated. The unsavory part of this process is that the physicians who are defining (creating?) pre-diabetes or premenstrual dysphoric disorder are all too frequently on the payrolls of the pharmaceutical companies that are making the products for these “diseases.”
High cholesterol, the poster child for selling sickness, is a risk factor for heart disease, but it is NOT a disease in and of itself. In 2002, a pharma-friendly guidelines committee of physicians lowered the bar for prescribing cholesterol drugs (statins) and overnight 20,000,000 Americans developed a new “disease,” hypercholesterolemia and were candidates for statins. For those high cholesterol patients who have had a heart attack or a stroke, cholesterol-lowering drugs provide some protection against another bad event. For healthy patients with high cholesterol levels, these drugs have little protective effect.
A study published in March 2013 followed the TV viewing habits of 106,000 Americans and found those who had viewed ads for statins had 16%-20% more of a chance of having their cholesterol level checked and 16%-22% more of a chance of taking a statin than those who had not seen the TV ads. Unfortunately, the TV viewing had almost all of its effect on healthy individuals with high cholesterols who will not benefit from taking a statin.
1) Be wary of “new diseases,” particularly ones you see advertised on TV, for example, restless leg syndrome and pre-hypertension.
2) Be careful about asking your physician for a particular medicine. Often your doctor’s desire to please will trump his/her good clinical judgement.
Dr. Mohler has practiced family medicine in Grand Junction for 38 years. He has a particular interest in pharmaceutical education. Phil works part-time for both Primary Care Partners and Rocky Mountain Health Plans. Email him at firstname.lastname@example.org.
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