Treat “Early and Often” and Other Drug Maker Ruses

I have often reported on the drug maker ruse of “disease mongering” or “selling sickness” –– floating symptoms of scary diseases that you may have right now with convenient online, “symptom quizzes” for you to self-diagnose and verify. Long gone are the days when the medical establishment assured you that you were well (“take two aspirins and call me in the morning”) thanks to direct-to-consumer advertising.

Disease mongering makes patients into de facto drug reps who tell the doctor both the condition they have and the exact med they need –– it makes a mockery of medical school education. A current example of disease mongering is AbbVie’s promotion of the obscure-to-barely-existent condition of “exocrine pancreatic insufficiency” whose ads include voices brazenly leading the witness (or patient) by asking “Could I have EPI?”

Another insidious drug maker ruse, seen currently, is the marketing push for “early treatment.” If you suspect you have an advertised disease (we hope) don’t wait –– treat it now! (Before the symptoms go away says one of my doctor colleagues.)

But, whether for ADHD, asthma, mental conditions, “osteopenia,” cholesterol risks, pre-diabetes or autoimmune conditions, early treatment disallows a patient to find a natural/lifestyle treatment or “outgrow” a condition if they are a child. Instead early treatment creates lifelong drug customers who will never know if they ever even needed a med.

At an America Psychiatric Association annual meeting I attended, a doctor who directed outpatient psychiatry at Rhode Island Hospital suggested that precisely because mental illnesses can be lifelong, a wait and see approach should be adopted rather than early treatment. (He also noted a correlation between unconfirmed and over-diagnosed cases of bipolar disorder and disability payments.)

This week Janssen Scientific Affairs (part of Johnson and Johnson) announced that according to its own data, “early initiation of long-acting injectable antipsychotics (LAIs) was associated with fewer inpatient stays” and emergency room visits in Medicaid patients with schizophrenia. Though a drug maker saying its own drug works on the basis of its own research is essentially an ad, medical media are treating it like news.

By citing fewer inpatient stays and ER visits, Janssen implies that early treatment lowers medical costs but its recently FDA-approved LAI, called INVEGA HAFYERA™ which costs between $11,760.28 and $17,640.05, shows it is really just cost shifting –– to Janssen.

Private health insurers won’t pay such prices so it is no wonder Janssen wants to heist Medicaid and government program dollars. Hepatitis C drug makers (whose meds cost $84,000 for 12 weeks) also looted Medicaid, almost bankrupting some states.

Another drug maker press release disguised as news this week announces that a long-acting antipsychotic containing risperidone will delay time “to relapse” in patients with schizophrenia. Does risperidone ring a bell? The Department of Veterans Affairs spent $717 million on five million prescriptions of Risperdal (risperidone) to treat posttraumatic stress disorder in troops deployed to Afghanistan and Iraq only to discover after nine years that the drug worked no better than a placebo reported the Journal of the American Medical Association (JAMA) in 2011. Can taxpayers have their money back?

How and why have meds become injectables and priced so high that Congress has investigated? When drug makers’ pill profit party ended –– the blockbusters Lipitor, Seroquel, Zyprexa, Singular, Concerta, Cymbalta and Abilify went off patent –– they rolled out injected (biologic) drugs which are more lucrative and resistant to generic competition. Drug makers specifically pursued “specialty drugs” for obscure diseases whose prices reflect their life-or-death value but don’t answer the needs of the general public. (Where, for example, are antibiotics for resistant bacteria and non-opioid painkillers?)

Finally, the schizophrenia “space” itself (as drug makers and marketers call it) supports shameless profiteering, as we are seeing this week

Martha Rosenberg is an investigative health reporter. She is the author of  Born With A Junk Food Deficiency: How Flaks, Quacks and Hacks Pimp The Public Health (Prometheus).