Saturday, November 13, 2004

Drugs Firms Accused of Scaring People for Profit

Drugs firms 'are scaring people for profit'
London Telegraph | Nov 12 2004

A senior member of the Royal College of General Practitioners told MPs yesterday that health scares over osteoporosis and high blood pressure were created largely by pharmaceutical companies intent on selling their drugs.
Dr Iona Heath, the outgoing chairman of the college's committee on medical ethics, said people's bones became thinner naturally as they became older, but there was no correlation between bone density and fracture rates.
"It is a continuum," she said. "I would not dispute that at the end of the continuum there are people whose bones cause problems. But there is no cut-off point where someone has good bones and someone has bad bones."
She suggested women over 50 should stamp on the floor instead of taking drugs to prevent their bones thinning.
Dr Heath told the Commons health select committee that pharmaceutical companies were "disease-mongering" and creating "disease creep" where more and more people were told that there was something wrong with them.
In the case of osteoporosis, she said that when older women had their bone density measured it was compared with the bone density of a young woman, even though this was bound to show up a problem. "The same thing is happening with high blood pressure," she said. "We are only just beginning to understand the health effects of making people worried about their health.
"It's a huge problem for the future. People feel that their body is somehow sabotaging them. If someone is told that they have high blood pressure, they think about it, on average, seven times a day. This introspective health surveillance is the absolute antithesis of health."
Dr Heath, who received the CBE in 2000 for her work in the medical profession, was one of the latest batch of witnesses to appear before the committee's inquiry into the influence of the pharmaceutical industry on the health service.
She was responding to a question from David Hinchcliffe, who heads the committee, about so-called "disease awareness campaigns", which are the only way in which pharmaceutical companies are allowed to promote their products.
Because the companies are not allowed to promote their own drug for a particular condition, they may attempt to raise patient awareness of that condition through advertising, which may lead to more prescriptions being written for the company's drugs.
Dr Heath said: "We GPs regard part of our role as defending patients against the pharmaceutical industry".
She said that, because of the industry's campaigns, she was seeing large numbers of patients who were "inappropriately worried" about their health, and that this had "huge personal and social implications for them, and huge financial implications for society".
She also cited the large numbers of rich patients who are unnecessarily worried about their cholesterol level, saying that plans to make some cholesterol-lowering statins available over the counter without prescription would only exacerbate the problem. "The fittest, wellest people spend the most time worrying about cholesterol," she said, adding that people with poorer diets who might benefit from the drugs did not have time to worry about their cholesterol levels.
Osteoporosis is a very common condition, strongly linked to ageing and affecting one woman in three and one man in 12 over the age of 50.
It is a natural condition in which bones lose density and fracture more easily. Bone density reaches its peak when men and women are in their thirties and declines after that. But not everyone who has osteoporosis will sustain a fracture.
An estimated 70,000 hip fractures, 50,000 wrist fractures and 120,000 spine fractures are caused by the condition each year.
In women, osteoporosis is associated with the drop in levels of the hormone oestrogen after the menopause. Men with osteoporosis are sometimes treated with the male hormone testosterone.
Dr Heath's argument that there is no correlation between bone density and the rate of fractures in osteoporosis opposes accepted medical thinking. A spokesman for the National Osteoporosis Society said yesterday: "For every 10 per cent drop in bone density below average, the risk of fracture doubles.
"This risk increases as people get older, because the risk of falling is greater," she said.
With a very large potential market the drugs industry has been active in recent years in producing drugs for osteoporosis. They include bisphosphonates, non-hormonal drugs that help to maintain bone density and Serms.
Serms, selective estrogen receptor modulators, act in a similar way to oestrogen in bone, again helping to maintain density.