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Ask your doctor if these advertised drugs are right for you

Ask your doctor if these advertised drugs are right for you

Picture of Martha Rosenberg

It has been 17 years since direct-to-consumer advertising was permitted in the U.S.--and the results were almost immediately apparent. As soon as people began viewing "ask your doctor" ads, they realized they weren’t as healthy as they thought. Suddenly, they suffered from seasonal allergies, social anxiety, high cholesterol, depression, bipolar disorder, gastroesophageal reflux disease (GERD), irritable bowel syndrome, dry eye, restless legs syndrome, and worse. In fact, the parade of symptoms was so all encompassing, comedian Chris Rock said he was ready for an ad asking, “Do you fall asleep at night and wake up in the morning?”

But direct-to-consumer advertising has done a lot more than sell pills. Through its "educational" efforts, it has sold diseases themselves.

Many people when they hear a radio or TV announcement about depression or ankylosing spondylitis think it is from the Centers for Disease Control and Prevention or other medical group concerned with public health. Wrong. Most "disease awareness" messages are from Big Pharma trying to get people to diagnose themselves with a certain disease to churn "demand" for a new Pharma drug. The ads, also called "unbranded advertising," are supposed to include the name of the Big Pharma company paying for the message. But, because the FDA has thousands of ads to monitor, Pharma often omits the disclosure until it gets caught. It's punishment? A letter from the FDA pointing out the error.

When it comes to convincing people they have dry eye or seasonal allergies or even GERD, the harm from such disease awareness ads may not be great. But, now Pharma is "selling" diseases that require expensive and dangerous drugs because the profit has gone out of its pill franchise. Many of the drugs are MoAbs (monoclonal antibodies) or TNF-blockers (tumor necrosis factor blockers) that suppress the immune system and make Pharma as much as $20,000 a year per patient. They are useful for autoimmune diseases but unconscionable to market to people who don't really need them because of their safety profiles.

For example, patients treated with one popular immune suppressor, Humira "are at increased risk for developing serious infections that may lead to hospitalization or death," according to the drug's warnings. These include "Invasive fungal infections, including histoplasmosis, coccidioidomycosi," and "Bacterial, viral and other infections due to opportunistic pathogens, including Legionella and Listeria."

In 2008, the FDA announced that 45 people died from such fungal diseases from taking Humira, Enbrel, Remicade and Cimzia -- 20 percent of those who got sick. The same year, the FDA investigated Humira for 30 reports of childhood cancer and its links to lymphoma, leukemia and melanoma in children. Yes, lymphoma.

Recently, the TNF-blocker, Xolair, marketed for asthma, was linked to a higher risk of heart attack, mini-stroke, chest pain and blood clots in the lungs and veins and other problems, says the FDA. Seventy-seven people who took Xolair, which carries a warning for severe anaphylaxis, had life-threatening allergic responses in just a year and a half, according to FDA reports. Scientific papers about Xolair's benefits are unabashedly funded by its manufacturer, Novartis and the FDA investigated the facility where its original safety was tested in clinical trials, finding irregularities.

In an attempt to widen the market for TNF-blockers, Big Pharma has marketed them for thinning bones (Prolia), chronic itch (Xolair), and assorted pain and gastrointestinal conditions.

Recently, AbbVie, who makes Humira, rolled out another disease people may have without knowing it. The disease is exocrine pancreatic insufficiency (EPI) and its symptoms include frequent diarrhea, gas and bloating and stomach pain according to the website Identify EPI. While not treated with a TNF-blocker like Humira, EPI is treated with AbbVie's drug Creon, Pancreatic Enzyme Replacement Therapy. The drug may help EPI but it also "may increase your chance of having a rare bowel disorder called fibrosing colonopathy" and may cause "frequent or abnormal bowel movements; bloating." Is this another case of the drug being worse than the disease?

Certainly diseases like exocrine pancreatic insufficiency and ankylosing spondylitis exist as do dry eye and GERD. But Big Pharma's "awareness ads" have created a nation of patients who do not just "ask" their doctors if they have a disease they saw on TV, they often adamantly "tell" the doctor, making a mockery of medical school. Not only do patients "know" the diseases they have and medications they need from watching TV, they even "know" what kind of radiation therapy is best for them thanks to direct-to-consumer ads for proton therapy! Many of the diseases given "awareness" to consumers through advertising lack clear biological markers, like depression, bipolar disorder and attention deficit and boil down to judgment calls. The ads work so well, some medical schools have had to teach doctors "refusal skills."

Many are amused or entertained by direct-to-consumer drug advertising but it is not innocuous. It mass advertises obscure and unlikely conditions like exocrine pancreatic insufficiency and ankylosing spondylitis while ignoring real public health threats like heart disease, cancer and obesity. It creates hypochondriacs who want expensive medications for diseases they may not even have, exposing them to dangerous side effects. Finally, through selling expensive and optional drugs, its raises everyone's health care costs and taxes.

 

Comments

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there must be a good source of information on advertised drugs. I am a biochemist and interested in the biochemistry. Can you direct me?

I make videos youtube [mrphysh]
John
Asheville NC

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