Drugs, Pharmaceutical Companies, Marketing and Quote of the Week (James le Fanu on Zantac)

Psychiatrists talk about the phenomenon of “perception filter”- no sooner has your attention been drawn to a particular fact or word, than you become aware of this item/subject everywhere. No sooner had I got [this short article] published on the role of marketing in the pharmaceutical industry, than the subject seemed to be everywhere I looked.

The idea that drugs may be promoted inappropriately is not a new subject -one of the allegations that has dogged the “antidepressant industry”, doctors and patients alike has long been that antidepressants are being prescribed inappropriately (over-prescribed). In the case of antidepressants, this “debate” seems to date pretty much from the advent of SSRIs, such as Prozac, over twenty years ago. None the less, the role of drug-company-marketing on prescription and disease diagnosis rates is probably being discussed a little more in the media of late. The context to this may or may not be the release of the book “Sex Lies and Pharmaceuticals” by Ray Moynihan last month. In any case, quote of the week this week is one comment on the topic that has slipped through my current “drug-marketing” perception filter-

“Manhattan-based advertising executive Vince Parry describes how childhood Christmases were always marred by an uncle’s withering pessimism about the whole business.... Then, in the Eighties, psychiatrists described the now well known Seasonal Affective Disorder (SAD) as a depressive illness associated with shorter winter days and treatable with antidepressants or light exposure. “My uncle was thus transformed from a curmudgeon into a sympathetic victim by the coining of a simple phrase”....Parry has since become one of the most influential people in contemporary medicine by working closely with the pharmaceutical industry to persuade doctors that common symptoms are in fact due to some potentially serious but under-recognised condition – hence treatment with some costly drug...”

- Dr James le Fanu writing in The Sunday Telegraph 31st Oct 2010, page L21 (“Life” section).

le Fanu concludes his piece by relating the phenomenon of “blockbuster” drugs (those which have sales exceeding $1 billion per year), noting that the first of these- Zantac- was for indigestion. This may be a little unexpected, not least since treating indigestion is certainly not one of the most obvious ways to make a fortune, but there are a further 27 drugs with similar (or greater) sales. Some of these treat serious and unmistakable conditions, such as Enoxaparin for thrombosis, Quetiapine for schizophrenia, Metoprolol for high blood pressure and Budesonide for asthma, but the list includes other anti-indigestion medicines, such as Omeprazole (aka "Losec" or "Prilosec") and Esomeprazole.