Tuesday, October 11, 2005

Drugs Anyone?


Marketing, as a profession, is the art of convincing people that they need things they don't need. A good marketer and advertiser knows how to hit the right emotional buttons to sell everything from cars to make up to weight loss products. Fear -- injected in the right doses -- is the magic trick that gets 'em everytime (just ask Republicans).

The pharmaceutical industry, if judged by sales and profits, has some of the best marketers money can buy. After a commercial I saw the other night, I am now convinced more than ever that the pharmaceutical companies are making up diseases in order to scare the public into popping more pills.

Perhaps I am not the most informed person on the planet, but I had never heard of Restless Legs Syndrome (RLS) until a commercial about the pill that treats it rudely interrupted my enjoyment of Godfather II. So I looked it up. Apparently, RLS sufferers often experience an irresistible urge to move the legs. "Symptoms usually begin during attempts to sleep or relax and interfere with rest. The discomfort sometimes also appears when you are restricted from movement for long periods, such as a car or airplane trip."

This is not just silly to anyone with an ounce of common sense, but it makes me wonder what purpose this is meant to serve. I understand the need for real drugs to cure real diseases. But inventing "disorders" that are nothing more than the side effects of the common ailment called "life" does nothing but make us a society of drug addicts. Instead of exercising and eating better, fat, lazy America just pops a pill to combat high blood pressure or to lose weight. Consumers waste billions of dollars each year on pills they think will make them perfect and ignore the rushed, muffled voice at the end of any commercial that describes the horrible things that may happen to you if you take the pill. You simply replace one ailment with another.

For example, the literature says two types of medications are usually used to treat RLS. Dopamine precursors and agonists. Dopamine precursors are medications that the brain converts to dopamine, a chemical (neurotransmitter) involved in controlling movement.
Side effects that may occur with levodopa, a dopamine precursor, include sudden, jerky, uncontrollable movements (dyskinesias), loss of appetite, nausea and vomiting with or without stomach pain, dry mouth, drooling and difficulty swallowing, headache, dizziness, or fainting, numbness, weakness, and grinding of teeth, insomnia, agitation, anxiety, malaise, fatigue, and euphoria.

Dopamine agonists directly stimulate nerves in the brain that are not naturally being stimulated by dopamine. The most common side effects of dopamine agonists are nausea, constipation, fatigue and fluid retention.

Tough call. Move my legs or nausea, constipation, vomiting, etc.?

Next time you watch a pharmaceutical commercial, think about which you would choose and why. The fact that Americans are choosing pills over affirmative changes to their lifestyles speaks volumes as to the state of our culture and the sad direction in which it is heading.

60 Comments:

At 12:46 PM, October 11, 2005 , Blogger Mr. Wilson said...

there have always been men selling snake oil throughout the centuries and there have always been people too stupid to spot them or too desperate to believe in them against their own better judgment. At least these new drug products go through some kind of FDA approval unlike the tonics of the past like Coca Cola which used to have cocaine in it. You know a fool and his money are soon parted, so if someone doesn't fall for these kinds of marketing campaigns, than it is really only a matter of time until some charlatan takes them for a ride. (and don't get me wrong, we all get taken for a ride every now and then. it is just a hazzard of having disposable income. how many of us pay more money to shop at whole foods and bristol farms or buy organic products even though we never really know what we are really getting versus just going down to Ralph's? Maybe it is worth the extra precaution to us if we have the money, just as it may be worth the money to the restless leg dude to try these pills which probably aren't lethal. By the way, don't you have those ionic air purifiers they sell at sharper image?...i have seen the thirty minute infomerical ads for those things and they are quite pseudoscientific, but whatever...they are selling products to people who feel that its worth it to get the air in their homes a little cleaner.)

But why you gotta dig on the entire marketing profession?

Marketing is also the art of making people aware of the options that they have in using their resources, whether it be their money or time. Even MOSTE has to market itself in order to let the public know that a mentoring program exists...

Lately, I have noiceted that there have been some really sincere marketing campaigns in some industries that have traditionally targeted people in negative ways: selling you stuff that probably doesn't even do what they claim it does by making you fearful, anxious, or insecure, selling products by appealing to your ego and telling you "this is what the rich/cool/smart/cultured people eat/drink/drive/smoke/wear, or just placing their brand next to some large, yet pert breasts. one such marketing campaign is that of Dove? (www.campaignforrealbeauty.com/) I mean its a given that people are going to use soap. although they do not need soap, it does improve the quality of their life so why not buy the product that uses marketing that helps build a sense of well-being too?

I think the most powerful thing we can do personally is to not be swayed by dumb marketing. If you were offended by the ads with Paris Hilton soaping up a Bentley for Carl's Jr., don't buy more Carl''s Jr. burgers. If you don't like that car and clothing labels are marketed to you as exclusive to wealthy people, don't buy those cars and clothing labels. If you don't like people selling you snake oil over the air waves, don't ask your doctor about the snake oil they are pushing. But in a large sense the marketing industry is only going to react to the public. If the public buys more crap based on obviously hyperbolic statements in their ads and/or just seeing tits and ass in close proximity to a beer brand, than all we can expect is more ads of the same ilk. Other than vote with our dollars, there is not much we can do except move to a place where everyone is smart, saavy, and aware of their inherent desirability and sexiness. But I still haven't found my way to Galt's Gulch...

mr. wilson

P.S. Sorry for all of the deletes.. too many errors

 
At 1:48 PM, October 11, 2005 , Blogger Intellectual Insurgent said...

Mr. Wilson,

I don't disagree with anything you said. It is a voluntary choice and a fool and his money, etc. To me, the rise of the pharmaceutical industry is the ultimate statement of the get-rich-quick quick-fix nature of American culture. Rather than eat healthy or exercise, people pop pills. It is the ultimate example of the apathy that had set in as the Roman Empire fell. The success of the pharmaceutical business is the ultimate statement about how disconnected Americans are from themselves. It's sad. Let me know when you find Galt's Gulch.

 
At 7:54 PM, October 11, 2005 , Blogger jj said...

Big Pharma is advertising "new" drugs that in many cases are no better than the old ones. The companies must tell you about the side effects at the end "unless" they do not tell you what the drug is for.

Lunesta is the latest one I have seen the do not make any specific claims and therefor do not have to list the side effects. Personally I would like to see all drug ads removed and let doctors do the job of deciding what you need.

II good post as usual.

 
At 9:22 PM, October 11, 2005 , Blogger chad said...

Alright Insurgent…
You are practically forcing me to leave a 10 page comment by posting on this topic. I agree with most of what you said, except a few points.

I have to take exception to your indictment of Restless Leg Syndrome as an invention of the pharmaceutical industry. RLS is a reasonably well established clinical syndrome (disease, if you will), that had been described decades ago. From what I hear, it can be quite debilitating for not only the sufferer, but the spouse (i.e. bedmate) too. I have to admit, the name does sound a little hokey, but there are plenty of stupid names for diseases (e.g. Redman Syndrome).

While RLS may not be a made-up disease, your charges against the pharmaceutical industry are dead on. Big Pharma is in the business of making money, so the pharmaceutical companies will do anything to sell a drug. The unfortunate thing about drug marketing is that once the medication gets FDA approval they can market it as a cure. With the exception of antibiotics, most drugs do not cure disease (Notice that you never see the pharmaceutical companies pushing antibiotics on television ads…they don’t have to, because antibiotics actually have some value). Most drugs that are marketed on television and print media directly to consumers have very little efficacy, and that’s why they get marketed so heavily. If the drugs really worked, they would sell themselves.

There are a few exceptions to this rule. The ED drugs (e.g. Viagra, Cialis) are actually quite effective, but they are marketed for two reasons: 1) To gain market share since it’s a competitive market with multiple drugs. 2) to increase the market overall by making men think it’s okay to need a little pick me up, so to speak (how smart was it to get a Republican senator form Kansas – Bob Dole – to pitch Viagra, so all those “morally upright” old-ass conservatives with limp wood would feel comfortable using a “performance enhancing” drug.) So even when the drugs work, you can bet the pharmaceutical companies are up to some sneaky stuff when they are selling it on television.

There is a major difference in the ads you see in the mass media (direct to consumer or DTC advertising) versus what you see in the medical journals. The pharmaceutical reps know that physicians care about data much more, so the ads one sees in a medical journal looks totally different from what is in Time or Newsweek.

I have to pause and put my moderate cap on, and note that the Big Pharma does a lot of good too. They are in the business of making money, but that motivation to make money leads to rapid drug development, and we would not have half the HIV medicines and other “miracle” drugs that exist today if it was not for the diligent R&D efforts of the scientists employed by the pharmaceutical companies. The venture capitalist spirit manages to raise funds when a tight-fisted federal government is not willing to appropriate moneys for research endeavors, so I do think we need Big Pharma…we just need more regulation on how they market their drugs.

No where is this problem more obvious than in the field of psychiatric meds. I have seen so many ads that go like this:
“Do you get nervous at parties? Do your palms sweat on job interviews? Do you get butterflies when talking to members of the opposite sex? If so you may have social anxiety disorder”.
These ads are clearly trying to sell people the notion that they have a problem. Actually, they do have a problem, but it’s not really a disease, but just a personality trait. What’s worse, is the treatment does not really work. Sure you’ll be less socially uptight if you take Wellbutrin, Prozac, Paxil, and/or Zoloft but these drugs don’t cure your personality problems. A chill pill might calm you down to the point where you are not nervous at parties, but instead you will just be numbed out and not yourself. It’s these ads for minimally efficacious medications (although, FDA approved) that should be regulated more strictly.

You make a good point Insurgent that the reason these drugs are marketed so heavily is because the minds of America are such fertile ground for suggestion. We do tend to believe that popping pills can solve our problems, and no person is more susceptible to the power of suggestion than the overweight American. On the face of it, the idea of a diet pill is pretty silly. Why not just…hmmm…I don’t know…diet! And God forbid anyone actually get up and do a jumping jack or something. Mr. Wilson makes a good point as well: the reason we have such outlandish marketing is because it works. If our dollars respond to advertising that is clearly not objective, then there will continue to be ads that insult our intelligence, or lack thereof.

Anyway, as far as Big Pharma goes, it comes down to a philosophical problem. The drug companies have a conflict of interest. They have a mission to promote health, but they are in business to make money. When they have a drug that is really good, they are happy to sell it and make revenue from it. It’s a win-win situation. But when they have sunk a fortune into developing a minimally effective drug with a long list of side effects for a pseudo-disease, the drug companies are obligated by the bottom line to market and earn as much money as they can from that drug, too…even if it barely works.
None of this should surprise you, but let me expand the scope of this discussion as I conclude. We all can see that Big Pharma has a major conflict of interest in serving the public, but at least we know we can trust doctors and hospitals, right? Well let’s see…a hospital makes the most money when it’s full and when all of it’s services are being utilized (lab tests, x-rays, operating rooms, etc). Many doctors (especially ones that do procedures…like hmmm’ I don’t know…surgeons maybe) are compensated based on how much they do. So when you go see Dr. Jones and he says you need your gallbladder out, is it because you need your gallbladder out, or because Dr. Jones is trying to pay for his summer home on Martha’s Vineyard. I'm not so callous to suggest that doctors completely make up disease, but their judgement is not anymore immune to personal incentives than the executives at Merck. Health care providers have conflicts of interest too, and there is no way you can be objective when your wallet is tied to your clinical decision making.
If you don’t believe American medicine is conflicted, consider this fact. America has the most capitalistic and privatized health care system in the developed world. We also spend the largest proportion of our gross domestic product on health care. What kind of a return do we get on our investment? You might guess that we have better health than those other developed nations with stingy socialist health care plans, but you’d be wrong. We have higher infant mortality and shorter life span than most of the developed world. Why, you ask. Because we are spending all of our money on expensive tests and therapies that are marginally effective (but very effective in enriching physicians and hospitals), while Canada, England, and Japan are focused on investing more money on preventive medicine, health promotion, and other idiotic programs like gun-control.
Just wanted to leave you with a little taste, but to read more check out what some really smart guys at Dartmouth have been up to for the last 20 years.

Your most trustworthy friend and physician,
chad

“Many a small thing has been made large by the right kind of advertising.”
~Mark Twain

 
At 11:20 AM, October 12, 2005 , Blogger Intellectual Insurgent said...

Chad -

I had no doubt that this post would get you going, but WOW!!! You do not disappoint my trusted friend and physician. Thank you for the very thoughtful and informative comment.

 
At 5:42 AM, October 13, 2005 , Blogger Capt. Fogg said...

Every time I see Bush or Cheney or Rumsfeld on TV I get this restless urge to move my middle finger. Is this Restless Finger Syndrome and if so, is there a pill for it?

 
At 11:35 PM, October 13, 2005 , Anonymous Anonymous said...

Hi,
Its 1am, and I was just searching through the blogs to see if anyone had any new info on Restless Legs Syndrome (RLS). I was very disturbed by your presumption that RLS is a "made up" disease.
I suffer from RLS (and I do mean SUFFER). I understand that RLS has a rather silly name - it assumes that my legs are merely restless, or that I can walk out the pain. Rather, I stay up nights crying in agony, with involuntary spasms running through my legs. Sometimes my legs feel like they have worms crawling through them; at other times, it feels like I have been sitting in car for days, and no amount of walking can relieve my pain. The commercial of which you speak, I agree, does not make RLS sound like a serious disease; this doesn't surprise me in that Glaxo pushes ReQuip to treat RLS, which is a drug with intense side effects, as you cite. However, just taking a pill will not "cure" RLS. Having tried just about every drug to alleviate my pain, I understand your frustration with the pharmaceutical industry.
However, please realize that this is NOT a made up disease. This is a very, very real one. There is no cure for this disease, and the diagnosis and recognition of RLS has been traced back to the 16th century (long before the infiltration of the drug companies). RLS is connected with iron deficiency, Parkinson's Disease, and a number of painful neurological and movement disorders. It is recognized by the AMA, homeopaths and holistic medical professionals. For more information on RLS, and how it has severely affected the lives of sufferers for centuries, check out the book "Sleep Thief" by Virginia Wilson. Thanks, Sarah

 
At 4:13 PM, October 14, 2005 , Blogger Intellectual Insurgent said...

Sarah -

Thanks for your comment. I most certainly stand corrected by both you and Chad. What do you do to alleviate the pain?

 
At 12:09 AM, October 21, 2005 , Blogger pappy said...

The Pharmaceutical Industry is only a part of the problem. Physicians that over prescribe is another. I still get amazed when I admitt a patient on my floor, and I asked them what meds they take, they bring out a plastic bag full of medications. As a patient advocate I try to educate them to be more aggessive in thier health care, by asking appropiate questions and seeking alternatives. But this can be a real hard sell particularly with the elderly.

 
At 2:47 PM, October 23, 2005 , Blogger Intellectual Insurgent said...

Pappy - do you find that people expect all the medication? i.e. do you think they would feel like they weren't getting good care if the doctor wasn't prescribing something?

 
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