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Jun 2016

Pushing the New Pill with Lower Medical Thresholds

I knew the pharmaceutical industry had taken over the country when late one night, as I was watching a talk show, I saw a commercial, and after just 15 seconds of watching, I began wondering if I indeed had restless leg syndrome.

It didn’t stop there.

Does a slow left-lane driver send you to brink of road rage? Well, you might be one of 16 million Americans suffering from “intermittent explosive disorder.”

Are you like my late pop who could polish off a bag of Doritos while watching Steve Martin’s My Blue Heaven on TV? Well, that is a sure sign of “binge-eating disorder,” which is said to trouble 7 million Americans.

You cannot turn a sports magazine page without reading about 14 million men who are said to have clinically low testosterone. I am sure if I read those women’s magazines at the supermarket checkout line, I would learn that 9 million women are suffering from low sexual desire while millions more are struggling with bladders that are too active or have blood sugar that is a tad too high. Once upon a time, that blood sugar level was considered to be normal. Today, you are borderline diabetic, which makes a person a candidate for expensive medication.

In the early 1990s, none of these conditions were on any American’s radar. Now, we are a nation overrun by these new treatable disorders.

Many independent physicians are skeptical, saying the new conditions are the product of a system. Medical groups get pharmaceutical industry funding with researchers looking to advance their careers. Of course, drug companies are aiming to broaden the market for expensive new products. The canvas of television air provides ample opportunity to learn not only of our maladies, but also the ample amount of pharmaceutical side effects in less than 10 seconds.

A Milwaukee Journal Sentinel investigation found one common denominator in this medical condition growth. The newspaper’s examination of eight common new conditions found the changes all went in the same direction, which was expanding the population that could be treated with expensive drugs.

A great example of this new condition abuse is pre-diabetes. According to a USA Today article, twice in the past 13 years (2003 and 2010), the American Diabetes Association (ADA) lowered the threshold for blood sugar levels used to define “pre-diabetes.” Independent physicians without ties to the pharmaceutical industry noted that pre-diabetes is an unnecessary label. Pressuring the public that pre-diabetes is a serious condition can lead to the overtreatment of patients with drugs, which exposes them to risks without any real proof of benefits.

So what did doctors do prior to the pill push?

A 2002 published study found that a combination of diet and exercise reduced the odds of pre-diabetes becoming diabetes by 58 percent. Shockingly, the use of the drug metformin only reduced the diabetic odds by 31 percent.

But the two ADA threshold adjustments grew the pre-diabetic pool from 17 million to 87 million. Hello? That is a going from a backyard pool to Lake Tahoe. Earlier this year, a UCLA Center for Health Policy Research report estimated that 46 percent of all Californians (13 million people) are now considered pre-diabetic.

How does this happen?

The ADA has long received financial support from drug companies, including more than $7 million from current donors, according to USA Today. The actual dollar amount may well be higher. The ADA website only lists donors by minimum amounts.

New medical definitions or lowered thresholds mean millions more people instantly become potential customers, as they now fit the criteria for having treatable disorders. Critics say the changes mean more patients may end up being treated with drugs that may be risky.

So what pills are being pushed today?

Well, there’s one for female sexual interest/arousal disorder (low sex drive in women) and adult ADHD (a lack of focus). There’s overactive bladder disorder (you have to pee quite often), and premenstrual dysphoric disorder (a severe form of premenstrual symptoms).

These conditions, along with low testosterone and pre-diabetes, now affect more than 180 million Americans, which is roughly 77 percent of the adult population in the United States.


Not surprisingly, there is a playbook for selling disease to the public, Carl Elliott, a professor of bioethics at the University of Minnesota Medical School, told USA Today.

“You destigmatize the condition. Broaden it to include a much larger patient population, rebrand it, or give it a name that is less embarrassing to people,” he said. “People would rather have overactive bladder than be called incontinent. Then you’re all set for selling your treatment.”

It was in the late 1990s when wholesome actress June Allyson sold incontinence or “unstable bladder” condition on TV commercials, albeit for adult diapers, with the softer-sounding “overactive bladder.” With just a simple name change by the International Continence Society, the new condition suddenly affected 33 million people in the United States alone.

For drug companies, bigger numbers mean larger markets, and they can put more pressure on the U.S. Food and Drug Administration to approve new products. For advocacy groups and medical societies, many of which get drug company funding, having more people with a condition can make it seem more mainstream and lead to more financial support.

So there’s the rub. The only question is simple. When is the next medical condition I never knew I had coming?

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