How to turn a condition into a disease by “selling sickness”

“Selling sickness” means that the line between healthy and sick becomes blurred – and demand for medical treatment increases. If you’re a drug company, it’s a swell way to get consumers to demand treatment that may or may not even be necessary. So says a Dutch study that investigated industry-funded information campaigns around common conditions like restless legs syndrome, overactive bladder and heartburn.

These “ask your doctor” campaigns focused on symptom advertising or disease mongering.

Dutch law, as in Canada (but not, significantly, in only two countries: the U.S. and New Zealand) prohibits “Direct To Consumer” public advertising of prescription drugs. You might well wonder why these two countries are the only ones on earth who still permit this marketing practice. Continue reading

Can statin drugs really save your life?

When I was hospitalized after my heart attack, cardiologists immediately prescribed Lipitor, a statin drug which happens to be the biggest-selling drug on earth, made by Pfizer, which happens to be the biggest drug company on earth. My LDL (bad) cholesterol numbers went from 4.1 while still in the Coronary Care Unit down to 1.9 a few short weeks later.

(These are Canadian readings, by the way: to convert from Canadian to American readings, just multiply by 40). That’s quite a spectacular result for lowering one’s LDL cholesterol levels – but the question remains: do I really need to take this powerful cholesterol drug every day for the rest of my life?

Dr. Mark Ebell, a professor at the University of Georgia and deputy editor of the journal American Family Physician, says:

“High-risk groups have a lot to gain. But patients at low risk benefit very little if at all. We end up over-treating a lot of patients.”

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Clinical practice guidelines vs. routine screening mammograms

When you need medical help, your doctor and other health care providers may be faced with difficult decisions and considerable uncertainty. So they rely on the scientific literature in addition to their own knowledge, experience, and patient preferences to inform these decisions.

And they also consider clinical practice guidelines, which are published recommendations intended to optimize patient care. But in a New York Times piece last month, Ronen Avraham, a professor at the University of Texas School of Law, observed that these clinical practice guidelines often conflict with one another.

Recommendations for when and how frequently women need mammograms, for instance, notoriously vary depending on which group is giving them. Continue reading

Same old duet: drug companies and psychiatry

Here’s more this month from investigative journalist Alison Bass, author of the book Side Effects: A Prosecutor, a Whistleblower, and A Bestselling Antidepressant on Trial:

“The same drug giants paying millions of dollars to settle claims that they engaged in illegal and improper marketing of anti-psychotic drugs in the U.S. are even now looking for new worlds to conquer. Consider the study published in the Archives of General Psychiatry. It surveyed more than 60,000 adults in 11 countries in Eastern Europe, Asia and South America and concludes that the treatment needs for people with bipolar disorder are “often unmet, particularly in low-income countries.”

“That may indeed be true. But I’d find this result a lot more believable if the study were not funded in large part by the same pharmaceutical companies who make the atypical anti-psychotics used to treat bipolar disorder: Eli Lilly (which makes Zyprexa), Janssen (the unit of Johnson & Johnson that brought us Risperdal), Pfizer (Geodon), Bristol Myers Squibb (Abilify), GlaxoSmithKline (Lamictal), and Novartis (Fanapt).  Continue reading

Are you being “over-diagnosed”?

According to a trio of widely published American researchers, many of us are “over-diagnosed” by being labelled with a medical condition that will never cause us any symptoms or premature death. We are, they tell us, mistakenly swallowing the popular conviction that early detection of everything is always for the best.

Their book, Over-diagnosed: Making People Sick in the Pursuit of Health, claims that over-diagnosis is in fact one of medicine’s biggest problems, causing millions of people to become patients unnecessarily, producing untold harm, and wasting vast amounts of resources in the name of disease mongering. Continue reading

Why are gynecologists still prescribing HRT despite known risks?

How is it possible that half of all gynecologists are still prescribing hormone replacement therapy to their patients for uses that are clearly unsupported by evidence – despite the alarming warnings of the largest randomized, placebo-controlled trial of HRT ever performed?

This reality is “curious”, according to Dr. Adriane Fugh-Berman at Georgetown University Medical Center, in a new study* examining 340 medical journal articles about HRT. Her research was published yesterday in the journal, Public Library of Science Medicine.

But even more curious are her findings that the majority of the doctors who have written pro-HRT papers for medical journals have been funded by the very drug companies that manufacture hormone replacement drugs.

These companies were financially hurt by 2002 results of the massive Women’s Health Initiative study, which meant an almost immediate catastrophic loss of sales revenue for manufacturers of all HRT drugs. Prescriptions dropped by 80% – a major blow to companies like Wyeth Pharmaceuticals, whose HRT drugs Prempro and Premarin had earned the company over $2 billion just one year earlier.  (That still puts the net gain well ahead for the company, who has now settled a third of the pending lawsuits from women who developed breast cancer while on Prempro, after the company set aside over $772 million to resolve legal claims, according to Bloomberg).

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