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