If someone told us that in 2010 the citizens of the planet are going to spend 40,000 million euros in buying medicines that do not cure anything , we may think that our interlocutor has gone crazy. But if our interlocutor wields nothing more and nothing less than the latest report on trends in the pharmaceutical market presented by Deutsche Bank a few months ago, we will begin to think that it is the world that has gone crazy.
One thing or another. This is nothing more than evidence of a new trend that is beginning to become a stellar phenomenon in the drug market: the rise of so-called “lifestyle pills”, of medical products designed to combat conditions, discomfort or characteristics. functional that, in themselves, do not pose any threat to the patient’s health, but which affect their sense of quality of life.
Baldness, impotence, bags under the eyes, jet lag , hangover or bad mood cannot be considered illnesses, they are not serious, they do not cause sick leave or threaten anyone’s life, but they have become a mine of new pills, creams, treatments and therapies dedicated to them.
At first it does not seem at all strange that a person wants to be better than well, who wants to get rid of those small physical, physiological or emotional imperfections that bother him. We want to erase acne from the face, overcome our shyness, improve our sexual performance or hide the lack of hair. The problem arises when, as the expert in Bioethics Carl Elliott has warned, “social behavior begins to medicalize”, that is, when desires and needs that have always belonged to the individual’s socialization environment – such as their ability to relate to others, their job success or love relationships – are resolved at the pharmacy on call.
Is there anything wrong with that? For the director of the Clinical Pharmacology service of the University Clinic of Navarra, Jesús Honorato, “the rise of these drugs is a reflection of the prevailing hedonism in the society we live in and of our good economic availability. All this leads to an exaggerated cult of the medicine , on which responsibilities are deposited that one is not capable of assuming “.
But there are other causes that may explain the rise of this type of drug. According to the United Nations, in Spain 22 percent of the population is over 60 years old and the percentage will double by 2050. It is evident that the signs of the passing of the years are not always assumed with natural resignation by those who experience them and that pharmaceutical companies have an ideal breeding ground to encourage the temptation to fight them.
Some experts consider that, far from being harmful, this trend is an example of the maturity of societies. This is the case of Rafael García, general director of the Association for Self-care of Health, who has stated that “citizens want to be managers of their well-being and this forces the pharmacy to stop being a center solely for the dispensing of prescribed drugs “.
The problem lies in determining whether the rise of these therapies is caused by a genuine demand for self-management of quality of life or is due to the simple pressure of pharmaceutical marketing. It should be borne in mind that the drug market has few avenues of rapid growth. Most of the treatments for serious diseases are subject to the restrictions of the health management policies of each country and their profitability depends on the financing of the public health system. In Spain, for example, anti-obesity drugs such as Xenical are not among those paid for by Social Security, but they are in the United Kingdom. Lifestyle therapies offer an interesting extension of the market.
Many of these “wellness pills” do indeed show effective results at certain levels of use. For example, there are molecules that stop hair loss or that help you lose weight. The problem is the excessively attractive presentation of its properties. A classic example is that of a new tranquilizer that the Sandoz company began to market in the late 1960s. In its advertising campaign, it was assured that the drug would help “the newcomer who cannot make friends, the executive who cannot resign himself to retirement, the mother-in-law who cannot stand her daughter-in-law.” The health authorities withdrew the ad because they considered that an illegitimate chemical alternative to social problems was being offered. Obviously the situations described in the advertisement produce anxiety and anxiety can be treated with tranquilizers. But is it ethical to link the use of tranquilizers to the resolution of individual conflicts, to success in society?
New lifestyle products turn the pharmacist into a kind of personal advisor. Not only can it provide guidance on aspects of cosmetics and beauty, on the prevention of wrinkles or elimination of bad breath but, taken the trend to its extreme extremes, it could serve as an advisor to the next job interview or as a conscience reliever for the boss who just laid off ten employees.
“What is clear – says Dr. Honorato – is that today the doctor and pharmacist have a lot of work ahead of them to avoid allowing health ignorance to lead many people to take substances that are not effective and, therefore, are dangerous.”
Faced with this effort, market pressure continues to arise. It is estimated that the market for treatments against impotence, smoking and wrinkles will grow between 10 and 30 percent before 2010. Contraceptives, antidepressants and therapies against alopecia follow.
Many of these drugs are supported by studies that confirm their effectiveness in certain cases, such as the use of sildenafil against erectile dysfunction. But some specialists fear that excessive frivolity when presenting their results in advertising will produce an undesirable effect: the user may lose confidence in the doctor or pharmacist who prescribes them.
What leaves no doubt is that we will consume more and more drugs for healthy people.
Increased longevity, loss of interpersonal communication, sedentary lifestyle, and the need to maintain a well-groomed and youthful image help the trend. As Jesús Honorato recalls, “some conditions such as being overweight can be treated by improving hygiene-dietary habits” and it is not necessary to resort to miracle pills. In other cases, such as new molecules to enhance memory, the aim is to improve even more functions that are not impaired. Has the border between health and disease been definitively erased?
WHEN POOR HEALTH SELLS
The United States is the only industrialized country that allows direct-to-consumer advertising of prescription drugs . In the European Union, legislation limits this type of advertisement to magazines for health professionals. But the Health Ministries of some countries, including Spain, have begun to raise the possibility of easing these restrictions. The type of advertising that is made of medicines is vital to analyze the functioning of the health system. In the US, for example, it so happens that the best-selling prescription drugs are precisely the most advertised. In theory, the prescription of a drug should depend only on the doctor’s decision based on evidence. But the advertising market is very succulent and influential. For example, in the US, Merck laboratories invested more in promoting an anti-inflammatory than what Pepsi spends on advertising.
Jorge Mayor
