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Profitably Inventing New Diseases PUBLIC CITIZEN HEALTH RESEARCH GROUP SIDNEY M. WOLFE, M.D., EDITOR August 2003 +VOL. 19, N0.8 Profitably Inventing New Diseases ecent article in Medical and change its name to "halitosis," Developing a new condition to Marketing and Media (May thereby creating "awareness - and build recognition for an unmet Al 003), aimed at the marketing anxiety - around a serious-sound­ market need." departments of the pharmaceutical ing medical condition." Halitosis, in industry, provides an extraordinary ads, was made responsible for prob­ An example of the second sugges­ view of this industry of which the lems ranging from lack of career tion is Pfizer's marketing strategy that public, unfortunately, remains advancement to divorce, and within turned Viagra into an acronym for unaware. Vince Parry, the "Chief six years, sales increased from erectile dysfunction. Branding Officer" for a company $100,000 to $4 million. Drug companies are now masters of called "InChord," tells his pharma­ Today, healthcare marketers are suggestion number three - develop­ ceutical company readers - and much more imaginative: they take ing a new condition - spectacularly potential clients - how to increase their pharmaceutical product and so in the field of mental health. Parry sales by combining the "creation" of add in "external thought leaders advises, "No therapeutic category is a disease with a drug to treat it. [usually physicians who vouch for more accepting of condition branding There is no dispute that the phar­ the drug's worthiness], support than the field of anxiety and depres­ maceutical industry, first and fore­ groups and consumers." Parry lists sion." The manual used to describe most, is an industry needing and three principal strategies that can be mental disorders, the Diagnostic and seeking ways to increase profits for used to create a new condition: Statistical Manual of Mental Disorders its shareholders and that larger prof­ (DSM), is compiled by the American its require a continuing increase in "Elevating the importance of an Psychiatric Association, an organiza­ sales, a feat orchestrated by market­ existing condition tion heavily funded by the pharma­ ing departments. But in the past, Redefining an existing condi­ ceutical industry. simply letting the public know the tion to reduce a stigma continued on page 3 uses for a drug too often failed to generate the robust growth in sales CONTENTS desired. The solution, as described by Parry, is something called "condi­ Secret No More tion branding" in which a company Medicare investigation results now fair game .................................. .. 2 defines a new condition (along with its worry-provoking symptoms) to Bad Medicine convince physicians and patients Why Bush's malpractice policy will only help insurers ......................3 that they must treat the condition and use one particular drug. Product Recalls From sunscreen to extension cords: watch out! ................................ .. 6 Parry begins with an early exam­ ple: Warner-Lambert's desire to Do Not Use Finasteride For Preventing Prostate Cancer expand its market for Listerine, Study shows benefits may not outweigh risks ................................... .. 9 which in the 1920s had multiple uses but lacked sales growth. Warner­ Outrage of the Month Lambert's strategy was to take a Taxol: How the NIH gave away the store ................................... n ..... 12 harmless concept, unpleasant breath, VISIT HEALTH RESEARCH GROUP'S WEB SITE AT WWW.CITIZEN .ORG/HRG/ Secret No More: Medicare Investigation Results Now Fair Game This article was written by Several months after he requested an purpose of overseeing Medicare serv­ Amanda Frost, the Public Citizen investigation, the government sent ices. QIOs are groups of independent attorney who successfully litigated Mr. Shipp a letter informing him that doctors charged with the responsibili­ this case. the investigation had been complet­ ty of ensuring that doctors provide ed, but that he would not be Medicare patients with adequate care. he government is not allowed informed of the results because the Anyone on Medicare, or their repre­ to keep secret the results of its doctors he had complained about sentative (such as a family member), T investigations into complaints had refused to allow him to obtain may file a complaint with their local by Medicare beneficiaries, the United that information. QIO about the medical care received States Court of Appeals for the D.C. In its lawsuit, Public Citizen through Medicare. The QIO is Circuit ruled on June 20, 2003. The argued that the government's policy required by federal law to investigate decision handed a victory to Public violated the Peer Review all complaints and - as a result of the Citizen in its lawsuit against the Organization Act because it did not recent legal victory in the D.C. Circuit Department of Health and Human provide a meaningful response for - to provide the results of those Services (HHS), in which Public Medicare beneficiaries who investigations to the complaining Citizen challenged HHS' policy of complain about the quality of party. keeping secret the results of its medical services they received. The A directory of the names and tele­ investigations into complaints by D.C. Circuit, affirming the district phone numbers for QIOs all over Medicare beneficiaries when the court, agreed with Public Citizen on the country is located at doctor under investigation refused to all counts, and ordered HHS to begin www.cms.hhs.gov/qio/default.asp. consent to disclosure. As a result of disclosing the results of its investiga­ Information about Medicare benefits that policy, Public Citizen members, tions to any Medicare beneficiary, or more generally can be found at along with many other Medicare representative of a beneficiary, who www.cms.hhs.gov/medicare. If you beneficiaries and their families, have complains about the quality of have questions or concerns about the been denied access to the results of Medicare services. quality of Medicare services that you investigations into their complaints Public Citizen hopes the litigation or a close relative have received, you about sub-standard medical care. will help raise public awareness should write your local QIO and ask The case arose from Public Citizen about the rights of Medicare benefici­ them to investigate. If you have ques­ member David Shipp's request that aries to challenge the quality of tions about the process of filing a the government review whether his medical care provided under complaint with a QIO or obtaining the wife received appropriate care while Medicare. Few Medicare beneficiaries results of a QIO investigation, you being treated for cancer. Mr. Shipp's realize that the government has should write to Amanda Frost, Public wife, Doris Shipp, had been diag­ established Quality Improvement Citizen, 1600 20th Street, NW nosed with cancer in December Organizations (QIOs, formerly called Washington, D.C. 20009. 1998, and she died six months later. Peer Review Organizations) for the THE PUBLIC CITIZI!N JIEAl.TH R.ESI!ARC}l GROUP Edltor .................................. Sidney M. Wolfe, MD The Health Research Group was co-founded Managing Edltor ............................. Lynn Miller in 1971 by Ralph Nader and Sidney Wolfe in Hutltl1l~ttcr Washington, D.C. to fight for the public's Staff Researchers. .... ........................ .... ................... health, and to give consumers more control Peter Lurie, MD, MPH over decisions that affect their health. Larry Saslch, PharmD, MPH Copyright © Health Letter, 2003 Elizabeth Barbehenn, PhD Published Monthly by Material in the Health Letter may not be Amanda Frost, ]D Public Citizen Health Research Group re-printed without permission from the Editor. Send letters and requests to HEALTH LETTER, Information Specialist..... john Paul Fawcett All rights reserved. ISSN 0882-598X Editor, 1600 20th St., NW, Washington, D.C., Production Mgr. ...................... Kristy Ljackson 20009. Annual subscription price is $18.00 (12 is­ sues). Mail subscriptions and address changes Presldent ................................... joan Claybrook to Health Letter, Circulation Department, 1600 20th St., NW, Washington, D.C., 20009. Founder ........................................... Ralph Nader Our Web site address is www.citizen.org/hrg. 2 +August 2003 Bad Medicine Why Bush's Malpractice Policy Will Only Help Insurers The following article by Sasha cases. Karl Rove must be thrilled. reimbursements declining and Polakow-Suransky is reprinted from For an administration determined to malpractice premiums rising, trial The American Prospect val. 14 no. 7, deplete the coffers of Democratic lawyers are the physicians' new july 3, 2003. trial-lawyer donors - and damage target. presidential hopeful Sen. John President Bush's AMA-backed or the third time in as many Edwards CD-N.C.) in the process - proposal to cap pain and suffering decades, doctors across the malpractice reform is a godsend. damages at $250,000 will satisfy the Fcountry are protesting rising It is also a powerful wedge issue AMA's desire to shield doctors from medical malpractice insurance with the potential to alienate doctors liability while curtailing maimed premiums. The American Medical from Democrats after their recent patients' rights to sue. But in the end Association (AMA) is promoting its collaboration on the Patients' Bill of it is more likely to line the pockets of longstanding goal of medical liability Rights. Just one year ago, the AMA insurance
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