Influence of Pharmaceutical Ads on Healthcare

A study appearing in the October 2012 issue of the Annals of Family Medicine explores the question of how drug companies are influencing both the practice of medicine and the health of patients who seek care from medical providers.

The authors note "Spending on prescription drugs in the Unites States has risen nearly 6-fold since 1990, reflecting substantial increases in treatment of chronic conditions and subsequent polypharmacy (multiple prescriptions). As many as 45% of Americans have at least 1 diagnosed chronic condition, and 60% of the most prescribed medications were for hypertension, high cholesterol levels and diabetes. The Centers for Disease Control and Prevention estimates that 11% of the US population and 40% of people older than age 60 take 5 medications or more." 

The authors focused their review on management of type II diabetes and hypertension, two of the most common chronic health conditions.  The study examined the overwhelming prevalence of prescription drug use in managing these two conditions and focused on the influencing factors more closely.

Factors recognized: 

 

Lower diagnostic thresholds – This mean that more people are diagnosed with a disease they didn't previously have.   

The lowering of fasting glucose (blood sugar) levels from 140 to 126 in 1998 resulted in an additional 10.3 million people being medically defined as diabetics.  Pre diabetes glucose levels were lowered to 100 in 2003 from the previous levels of 110, creating more pre diabetic cases.  

The definition for hypertension (high blood pressure) was lowered in 1993 from a pressure of 160/95 to 140/90 in non-diabetic patients. In 1998, the hypertension level for diabetics was set at 130/80, lower than that of non-diabetics. These two changes created an estimated 22 million additional hypertension diagnoses. The pre hypertension level was also established in 1998 at 120/80. 

Clinician Incentives - Medical doctors are often rewarded for keeping their patients below certain standards based on established guidelines.  

"The committees and organizations setting the standards often have substantial pharmaceutical industry support and include many individuals with industry ties." According to the authors, "many insurance companies assess individual clinicians on the basis of whether their patients meet these standards, often paying substantial bonuses that encourage clinicians to respond to marginal test results with aggressive use of pharmaceuticals."   

The Prescribing Cascade – As most people know, prescription drugs can have adverse impacts on patients.  They can produce symptoms that prompt the prescribing of additional drugs to combat the side effects of the first. 

Two-thirds of patients with diabetes and hypertension reported symptoms which they attributed to their medications, with several patients hospitalized because of symptoms, prompting a medication change.  This study found 89% of the patients "reported taking multiple medications, averaging 4.8 prescriptions with more than half (51%) taking 5 or more." The sad fact is that many of the patients were expected to continue taking these medications "permanently."   

What to Do? 

The authors call for a reform on how much influence the pharmaceutical industry has on the practice of medicine: "At a minimum, we urge policies excluding individuals or organizations with financial conflicts of interest from involvement with guideline-writing panels. They also suggest that physicians "be discouraged from seeing drug representatives."  

So what is the take home from this information? 

We see that chronic illnesses are experienced by 45% of the population.  

These numbers are tremendously high, considering that almost all chronic diseases are due to lifestyle.  Without the proper lifestyle changes, drugs will have little effect on these conditions other than suppressing the symptoms and creating even more problems.  Are we starting to see where part of the problem with our rising healthcare costs are coming from? 

Drug manufacturing is a business, run for profits.  The public is persuaded to believe that these companies have only altruistic intentions; to help the masses be “healthier”.   This is often the furthest thing from the truth.  As we saw in the above study, guideline criteria are often modified to increase the “market pool” for the drugs.

The pharmaceutical industry was a $325 Billion business in the US in 2012.  For years the most profitable business in the U.S. has been the pharmaceutical corporations, which routinely top the annual fortune 500 list. 

An essential part of the pharmaceutical industry’s overwhelming ‘success’ lays in the liaison between the corporations and the ‘symptoms management’ health care industry: The pharmaceutical representative. The men and women we see meeting with physicians, walking into offices with gifts of lunch for the staff, meeting with the doctor while you wait for your appointment.   These individuals are working for their paycheck, not your health. 

As concerned individuals we must take it upon ourselves to regain and maintain our health and well being.  This is the goal at David City Chiropractic; to coach and empower or patients to live healthier and more wellness oriented lives by modifying lifestyle habits from simple postural correction to nutritionally enhancing the body for optimal immunity and hormonal health.  If this sounds interesting to you, contact our office for more information. 

The answer to the nation’s healthcare crisis is not more drugs and technology to treat sick people but fewer people getting sick.

Yours For Better Health,

Dr. Heller