A Bitter Pill To Swallow

North Americans are undeniably pill-poppers. As a culture, we’ve grown accustomed to looking for a quick fix or the next “miracle” pill. Not surprisingly, the number of prescriptions sold annually has skyrocketed over the last decade. What has happened over that time to warrant such a spike in sales? Has our collective health deteriorated so dramatically in ten years that a huge increase in prescription sales is warranted? The answer is no. But there are companies out there that would like us to believe that very thing, and they’re achieving this with savvy marketing campaigns. And therein lies the answer.

What has changed in the last decade is that the Food and Drug Administration (FDA) relaxed the regulations surrounding the pharmaceutical companies’ advertising policies. They decided that the companies could advertise directly to the public instead of strictly to medical professionals. The impact was immediate. According to IMS Health Canada, Canadians filled 291 million prescriptions with a price tag of approximately $11 billion in the year 2000. Those numbers average out to about nine prescriptions per person in the country, an increase from just six a decade ago (1). Skyrocketing drug sales are a testament to the success of the various marketing campaigns. With patients demanding prescriptions for drugs they’ve seen on television, we’re becoming a population of pill-poppers. All the more disturbing is that we’re popping pills that we don’t know the first thing about; at least not anything beyond what the drug company wants us to know. The obvious question becomes, how safe and necessary are these drugs?

It was in 1997 that the FDA took steps to relax pharmaceutical companies’ advertising regulations. Immediately, advertisements flooded television and magazines. In the year 2000, companies like Pfizer, Glaxo-Wellcome, Schering-Plough, and Merck, spent nearly $500 million on advertising during primetime on television (2). Today, it is nearly impossible to turn on the television and not be affronted by various ads touting the virtues of: Viagra, Zoloft, Zithromax, Celebrex, Paxil, Differin, Flonase, and Diflucan, to name just a few. The ads have an insidious side, making the consumer believe that these drugs are a necessary part of a long and healthy life. Through the happy and healthy-looking actors in the ads, drug companies perpetuate the myth that drugs are necessary to achieve this kind of life. The message is that we become defined by our illnesses, but we can be rescued from this less-than-ideal life and be empowered if we ingest any one of these drugs. A good example of this is the promotional style used in ads for Pfizer’s allergy medication, Zyrtec. The allergy sufferers in the ads are defined simply by the allergies they suffer from. One woman is a “pollen-mold-dust” and with the help of Zyrtec, she now “enjoys the great indoors” (3). She was able to break through the confines of her allergies with one small pill, and because of it she is a new person, no longer the “pollen-mold-dust,” but a lover of the “great indoors.” It is this kind of freedom that the pharmaceutical companies aim to entice buyers with. They aim to sell a lifestyle, not only a drug.

The pharmaceutical companies’ financial success is a testament to the power of marketing. In the past few years, it is estimated that over 20 million Americans sought medical advice after being exposed to a pharmaceutical company’s marketing campaign (4). On one hand, the ads can be applauded for creating awareness and encouraging people to seek treatment. On the other hand, they create a climate ripe for breeding hypochondriacs, with the result being an overly medicated society. The ads make it easy for someone to see themselves in the symptoms, and, once they do, it is highly likely that they will go to their doctor to ask for treatment — treatment to the tune of whatever drug they saw on the television or in a magazine. The overall proof is in the fact that more and more patients are entering their doctors’ offices with the names of specific drugs that they want prescriptions for. Such actions have to be attributed to the marketing campaigns due to the fact that the average North American is not, in all likelihood, reading medical journals.

Once the big drug companies have cornered all the markets, medicating people with existing conditions, and over-medicating those with mild conditions, where can they expand their business? Their only recourse is to medicalize things that aren’t traditionally treated with prescription medication. PMS, shyness, and even the act of urinating, all have become conditions to be treated with drugs according to the pharmaceutical companies. Their goal is to try to create a false need. They are trying to create a market for their products by inventing a new disorder or condition. Somehow, shyness has morphed into “social anxiety disorder.” The symptoms of this new and highly common disorder include: blushing, shaking, sweating, and a pounding heartbeat. All of the so-called symptoms are fairly banal, and have likely been experienced by everyone at some point in their lives, yet the makers of Paxil are trying to cash in on this by stigmatising these symptoms and making people believe they are serious enough to call for medication. The makers of Sarafem, essentially Prozac with a feminine-sounding name, are trying to cash in on PMS. The only hurdle being that PMS doesn’t sound dire enough to warrant anything other than a Pamprin or an Advil. Sarafem, however, is meant to treat a disorder called “premenstrual dysphoric disorder” or PMDD. Markers for this disorder include intense mood swings and various physical symptoms right before a woman’s period. How this is any different from PMS remains a mystery.

If you don’t suffer from a shyness problem or one related to some form of PMS, don’t be discouraged there is certainly a drug out there for you — perhaps Detrol. The makers of the drug have cornered the overactive bladder market with their new pill. A person may have “overactive bladder syndrome” if they need to urinate more than seven times a day. Is more than seven times truly abnormal, especially if we’re meant to drink eight glasses of water a day? Who gets to decide what is deemed normal? The pharmaceutical companies? Regardless, experts have called the drug “useless” and have found it made “no significant difference when compared to a placebo” (5). Pharmaceutical companies are trying to cash in on invented conditions knowing full well that we, as a culture, will buy into it.

The reality is that companies like Pfizer, Glaxo-Wellcome, Schering-Plough, and Merck, are in the business to make money. With that in mind, consumers must remain realistic and somewhat wary of drug companies’ claims. Most of the studies done on prescription drugs are paid for by the pharmaceutical companies themselves, and as a result are highly biased. If the results of the study are published, often the negative aspects are suppressed or overlooked intentionally, and all the positive aspects are highlighted. Every year the FDA approves between 20 and 50 new drugs (6). In the past, doctors used caution with new drugs, waiting and watching for possible side effects once they were out in the marketplace. Today’s aggressive advertising practices don’t allow for that type of leeway anymore. Patients will inevitably go to their doctors with requests for the latest “miracle” drug.

As a result of shorter FDA trials, skewed studies, and a mass consumption of new drugs, there have been tragedies. A perfect example of this is the situation that arose out of the two diet drugs Fen/Phen and Redux. In 1996, these drugs were touted as “miracle” weight loss pills. They seemed to encapsulate the hopes of overweight America: a quick fix. Sales reflected this hope. Thousands upon thousands of people went to their doctors wanting a prescription for a drug they hoped would change their lives, and sadly it did for many. It is estimated that between 1 million and 5 million people in the United States took one of the two drugs at some point (7). A short year after the drugs were released, they were pulled off the market when evidence surfaced that the drugs had caused damage to the users’ heart valves. There were even a few deaths. Many people’s lives were irreparably changed as a result of being sold a “lifestyle” in a pill. The tragedies aren’t limited to Redux and Fen/Phen; those ones were simply played out in the public eye. The question becomes, as a society how much do we really know about the drugs we are ingesting? Chances are we only know what the drug companies want us to know.

Unfortunately, there is a huge power imbalance in the medical community. The power is tilted very much in favour of the drug companies, and as a result consumers and patients suffer from their lack of knowledge and the abundance of false information. There are no “miracle” drugs, and consumers should be wary of anyone who offers one. North Americans need to educate themselves with information other than the pharmaceutical companies’ brochures or advertisements, as well as learn to ask questions. Overall, they should simply stop opening their mouths and blindly accepting the bitter pill the pharmaceutical companies would have them swallow.

1 Priest, Alicia. (2001). Possible Side Effects. The Georgia Straight, p. 17-21.
2 Bittar, Christine. (2001). Prescription Drugs. Brandweek. (Vol. 42, Issue 17). p. SR22.
3 “Zyrtec.” (2001). Shape. (Vol. 20, Issue 10). p. 49.
4 Bittar, Christine. (2001). Prescription Drugs. Brandweek. (Vol. 42, Issue 17). p. SR22.
5 Priest, Alicia. (2001). Possible Side Effects. The Georgia Straight, p. 17-21.
6 Donatelle, Rebecca J. & Davis, Lorraine G. (2000). Access to Health. (6th ed.). Boston, MA: Allyn and Bacon.
7 Donatelle, Rebecca J. & Davis, Lorraine G. (2000). Access to Health. (6th ed. ). Boston, MA: Allyn and Bacon.

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