Have you ever noticed how Big Pharma in the United States has things exactly backward? Instead of developing new pills that people need like non-addictive painkillers and antibiotics for resistant infections, it develops new diseases.
You know those ads that try to scare you into thinking you have restless leg syndrome, non-24-hour sleep/wake disorder or exocrine pancreatic insufficiency— the poop disease? They’re not from the Centers for Disease Control and Prevention or a government public health agency. They’re from Big Pharma trying to churn "demand" for a drug and disease you’ve never heard of.
Whenever a reporter reveals how Pharma sells diseases to sell pills, we get veritable hate mail. "How dare you imply that Can't-Wake-Up-in-the-Morning disease doesn’t exist? I have suffered for years!" they scream as they threaten us and our editors and claim we are trying to take their drugs away. "I have adult ADHD and no one can tell me I don't!"
Almost 10 years ago, reporter Howard Wolinsky exposed how drug advertising had made routine "human conditions like unhappiness, bone thinning, stomach aches and boredom" into diseases we “suffer with” and treat with drugs. Even risk factors like high cholesterol and high blood pressure became diseases thanks to Pharma.
Before drug advertising, when you had symptoms, you went to the doctor and he or she demystified them for you. Now, people go to the doctor and tell him or her what disease they have and the drug they need. What's a medical school education compared with what you learned on TV? Direct-to-consumer advertising even tells people what kind of radiation therapy they need—it should be proton therapy for "brain, lung, prostate and left breast" cancers. Patients don’t just know as much as their primary care doctor, they know as much their oncologist!
In his excellent book, Generation RX, Greg Critser traces the history of direct-to-consumer advertising and unveils early concerns from major drug companies that it would raise fears of disease, sell unnecessary pills and corrupt the doctor/patient relationship. That’s exactly what has happened and Pharma is lamenting it all the way to the bank.
Here are some diseases you may be at risk for—especially if you watch too much TV.
1. Exocrine Pancreatic Insufficiency
Who knows or wants to know what exocrine pancreatic insufficiency is when it's characterized by frequent diarrhea, gas and bloating and stomach pain? To make exocrine pancreatic insufficiency a more patient-friendly disease, AbbVie has given it the snappy initials EPI. (After all, snappy initials helped launch new diseases like ED, Low T or RLS.) If you have even one of the intestinal symptoms, warns AbbVie, it could mean you have EPI. Ads send the curious and questioning to the website Identify EPI which shows an outsized toilet to pay off the campaign line "Don’t Keep a Lid on It.” Get it? Don't be embarrassed to tell your doctor about your "poop" problems, the ads say, because treatment is available. AbbVie's drug, Creon, will treat the poop disorder but its warnings say it can also cause a poop disorder—it may cause "frequent or abnormal bowel movements; bloating" we are told. Maybe you will have poop problems either way—but with the advertised drug, Pharma will make money.
2. Chronic Idiopathic Constipation
People have had constipation since time began. Milk of Magnesia has been around since our grandparents' day and ancient texts instructed people to squat in the river to allow fluids to flow into their intestines for constipation. But now, Pharma says, your constipation may actually be a disease. It may be chronic idiopathic constipation or CIC and require an expensive prescription drug. "'Chronic' means the constipation is long-lasting or keeps coming back," say ads for the CIC drug Linzess. When it comes to poop, Linzess does double duty. It also treats irritable bowel syndrome or—any guesses?—IBS. FierceBiotech predicts Linzess could be a $1billion a year drug thanks to the growing bowel drug "market." To coax the bowel drug market along, a quiz in WedMD magazine asks "Could you have IBS?" and helps people assess their symptoms. WebMD is known for fostering and driving “cyberchondria” with its popular “symptom checker.” Is anyone surprised WebMD’s original partners were drug companies?
3. Chronic Widespread Muscle Pain
"What's causing your chronic widespread MUSCLE pain," asks a recent ad for the prescription drug Lyrica."The answer may be over-active NERVES." Many people have muscle pain from exercise, aging, posture, a bad bed, overexertion and strain, PMS or a cold or flu. But now these people can ask themselves if they may have a disease. Instead of using an over-the-counter pain reliever for their aches and pains, they may need an expensive prescription drug. Lyrica is approved for fibromyalgia, which causes pain but not for all the other and less serious reasons for muscle pain. Treating your “chronic widespread muscle pain” from a bad day at the gym or “overactive nerves” from overexertion with a prescription drug doesn’t just raises everyone's healthcare costs, it also poses unneeded risks. Drug raters on Askapatient.com report serious side effects on Lyrica like memory loss, mental confusion, extreme weight gain, hair loss and impaired driving.
4. Frequent Heartburn
One of direct to-consumer drug advertising's biggest successes is gastrointestinal: it has convinced millions their "heartburn" is a serious disease that needs serious treatment, though many medical professionals disagree. Not only do you need expensive and usually prescription medications if you overindulge instead of the Tums and Maalox people used to take, you need to take the meds all the time, just to be on the safe side. Amazingly, Pharma now recommends you take acid blockers before any heartburn happens! “If you get heartburn two or more days a week, treat it by blocking the acid with Prilosec OTC and DON'T GET HEARTBURN IN THE FIRST PLACE," says an ad in WebMD magazine. Clearly, proactive treatment—treating a condition before it even happens—is lucrative to Pharma. Patients don’t know if the drug is working, if they need it now, orif they ever needed it. But a terrible thing happens if they don’t take their heartburn medicine reliably: Pharma doesn’t make any money.
5. Oppositional-Defiant Disorders
Oppositional Defiant Disorder. Antisocial Personality Disorder. Temper Dysregulation Disorder. Impulse Control Disorder. Many of the newer "diseases" the psychiatric establishment has rolled out would be funny if they weren't being assigned to children at Big Pharma’s bidding. Children are increasingly dosed for such behavioral problems because parents, teachers and doctors make children’s medication decisions for them. Often the “disorders,” which are also sometimes assigned to adults, boil down to someone simply not doing what they are told to do—and authority figures pushing back. It is no secret that many poor and institutionalized kids are on heavy cocktails of drugs for such behavioral issues. Many leading child psychiatrists like Harvard's Joseph Biederman have made a cottage industry out of diagnosing children with psychiatric problems like ADHD, obsessive compulsive disorder, mood disorders, mixed manias, pervasive developmental disorder and a host of “spectrum” disorders for behavior that was once called growing up. Ka-ching.
6. Reduced Tear Production/Chronic Dry Eye
Everyone who has worn contact lenses or pulled an all-nighter knows about dry, irritated eyes. Why else are some airline flights called “red eye specials"? But now dry eye conditions have become a lucrative new "disease," especially as the population ages and cell phones make people into text addicts reading minuscule type. “I used artificial tears often, like when at lunch with my friends," says a glossy, high-budget ad for the prescription eye medicine Restasis in the magazine Health. "So I saw my doctor—after all, these are my eyes. And she said I have a disease." The woman in the ad doesn’t just have dry eye, she has chronic dry eye. She has reduced tear production—a deficiency disease as real as EPI. The ad boasts that 16 million prescriptions have been written for Restasis in the last years. If that is really true, why isn’t the disease called RTP or CDE yet?
Martha Rosenberg is an investigative health reporter and the author of "Born With a Junk Food Deficiency: How Flaks, Quacks and Hacks Pimp the Public Health (Random House)."