Tuesday, May 30, 2006

Defining Disease

According to an editorial in the NYT, a recent proposed shift in defining hypertension was funded by -- and perhaps pushed by -- drug companies standing to increase sales via a larger number of patients being diagnosed with hypertension.  The editorial notes that the new definition (which looks at other risk factors in shifting people who would now be pre-hypertensive into the hypertensive category) has some merit and defenders, but focuses on the funding as a concern.

The Post has a closely-related piece about Restless Leg Syndrome, a bona fide but previously-little-known syndrome that has become much better-known via direct-to-consumer advertising via GSK (the first drugmaker to gain an RLS indication).  The basic issue, policy-wise:

The debate has focused attention on what some have dubbed "disease-mongering" -- taking something that is within normal bounds and labeling it a disease needing pharmaceutical treatment.

"We're increasingly turning normal people into patients," said Lisa M. Schwartz of Dartmouth Medical School.

Shy people have "social phobia," requiring psychotropic drugs. High-strung boys have attention deficit disorder and need amphetamines. Baby boomers with slightly elevated blood pressure have "pre-hypertension" and line up for beta blockers. A few nights of restlessness calls for sleeping pills.

"The ordinary experiences of life become a diagnosis, which makes healthy people feel like they're sick," Schwartz said.

On the issue of DTC advertising:

"The argument the pharmaceutical industry is always making is that this is patient education -- that this is an under-diagnosed condition and 'we're just trying to raise awareness,' " said Michael Wilkes of the University of California at Davis. "If you're talking about something like hepatitis C or measles, that might be true. But if you're talking about toenail fungus or baldness or restless leg syndrome, I just don't buy it."

[Hypertension story via Greedy Trial Lawyer.  Disclosure: I perform litigation consulting for a couple of drug companies.]

http://lawprofessors.typepad.com/tortsprof/2006/05/defining_diseas.html

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Comments

First someone invented new holidays so we would send more greeting cards and now they are inventing new diseases that require new drugs. I’ve seen ads on TV for Caduet. It has two ingredients. One is Amlodipine and the other is Atorvastatin. With my RxDrugCard I can get 30 tablets of Amlodipine for $9 and 30 tablets of Simvastatin for $9. I’ll bet they are charging more than $18 for this new drug! The unthinking public is going to pressure their doctors into giving them something just because it’s new, when something old or generic would do the job for cheaper.

Posted by: Rita | Sep 8, 2008 2:17:03 PM

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