In January the U.S. Food and Drug Administration approved the amphetamine Vyvanse as the first drug for binge-eating disorder (BED). Four days later former tennis star Monica Seles appeared on Good Morning America to discuss her long-time struggle with BED, and public service announcements (PSAs) began to run on national television to raise awareness about the disorder, urging concerned viewers to talk to their doctors. It soon came to light that Seles was a paid spokesperson for Shire, the drug company that makes Vyvanse, and that the company had also sponsored the television PSAs. “Shire was clearly aware that recommending doctor visits would increase prescriptions for the drug,” says Jeffery Lacasse, a mental health researcher at Florida State University.
This is not the first time a pharmaceutical company has tried to educate the public about a condition for which it sells a treatment. “Promoting diseases to sell drugs is a common and venerable practice among drug companies,” explains Marcia Angell, a senior lecturer on social medicine at Harvard Medical School and former editor in chief of the New England Journal of Medicine. “They try to expand the size of the market by implying that nearly everyone has the condition.” Although some people may legitimately suffer from a particular disorder and require drug treatment, others might be diagnosed with a disorder they do not actually have or start taking medications that might not ultimately benefit them. As a drug-selling tactic, awareness campaigns are tried and true. Below are some other notable examples—and ways you can use this information as a consumer.
Drug companies help to spread the word about attention-deficit/hyperactivity disorder—and the treatments they sell for it—by funding its high-profile patient advocacy group, Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). From 1991 to 1994 Ciba-Geigy, the company that then manufactured Ritalin (it subsequently merged with Sandoz to become Novartis), gave $748,000 to the patient organization, prompting the U.S. Drug Enforcement Administration to note that “the relationship between Ciba-Geigy and CHADD raises serious concerns about CHADD's motive in proselytizing the use of Ritalin.” Yet the tradition continues: in 2014 CHADD received $345,000 in grants from drug companies.
Social anxiety disorder
In 1999 posters featuring pictures of glum individuals began appearing in U.S. bus stops and other public locations featuring the slogan “Imagine you are allergic to people.” The posters were designed to raise awareness about social anxiety disorder, a condition characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations, which the drug Paxil, then made by SmithKline Beecham (which would later merge into GlaxoSmithKline), had just been approved to treat. As reported in Mother Jones in 2002, the posters were sponsored by the Social Anxiety Disorder Coalition, a partnership between several nonprofit advocacy groups and SmithKline Beecham. The coalition also sponsored studies discussing the importance of “building public awareness” to improve “treatment access,” according to one study author, and it sent press releases to journalists to inspire media coverage.
In 2002 a series of TV advertisements aired to raise awareness about bipolar disorder, a condition that causes cyclic swings in mood and energy. The ads, which did not mention any drugs, urged viewers to log onto a Web site called the Bipolar Help Center and take a questionnaire that would help them track variations in their moods. Viewers were also told to bring the results of the questionnaire to their doctor because “getting a correct diagnosis is the first step in treating bipolar disorder. Help your doctor to help you.” The ads were sponsored by Lilly, which had just been licensed to market its drug Zyprexa for mania. In the journal PLOS Medicine, David Healy, now at Bangor University in Wales, argued that these types of ads “reach beyond those suffering from a mood disorder to others who will as a consequence be more likely to see aspects of their personal experiences in a new way that will lead to medical consultations.”
Restless legs syndrome
GlaxoSmithKline made restless legs syndrome—a disorder characterized in part by the urge to move one's legs at night—a household term in 2003, when it ran a vigorous awareness campaign for the disorder. The company began by issuing press releases about presentations given at the 2003 annual meeting for the American Academy of Neurology, a professional society representing neurologists and neuroscientists. Two months later it distributed another press release, for a company-funded, as yet unpublished study, entitled “New Survey Reveals Common Yet Under Recognized Disorder—Restless Legs Syndrome—Is Keeping Americans Awake at Night.” The press releases led to a slew of media coverage of the disorder; according to an analysis in 2006, one fifth of all articles written about it referred readers to the nonprofit Restless Legs Syndrome Foundation for more information, an organization that was then heavily subsidized by GlaxoSmithKline.*
*Editor's Note (10/22/15): The original sentence from the magazine article was edited after it was posted online. The original erroneously stated the Restless Legs Syndrome Foundation is currently subsidized by GlaxoSmithKline—it is not.
Awareness campaigns may help some people get useful support and treatment, but they might also prompt healthy people to start taking drugs they do not need. “Drug company sponsorship doesn't mean the information is bogus—but it does raise a red flag because companies do stand to benefit from increasing diagnoses, which leads to more treatment,” says Steve Woloshin, a researcher at the Dartmouth College Institute for Health Policy and Clinical Practice. It can be difficult for consumers to know if a condition they are hearing about is part of a drug company awareness campaign—TV ads and Web sites do not always disclose company sponsorship—but consumers can look out for phrases such as “the disease your doctor has never heard of,” which can be red flags. Most important, before starting a new treatment, is to always talk to your doctor about risks and benefits. “The key questions to ask about treatment are ‘What is likely to happen to me if I am not treated? What is likely to happen to me if I am—including side effects?’” Woloshin says. —M.W.M.