The profit party is over for Big Pharma except for one category--drugs for autoimmune diseases. Conditions like rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and plaque psoriasis are rare in the adult population but a spate of new ads and self-diagnosing "quizzes" suggest they are Big Pharma's next focus.
Whenever a disease is given initials--rheumatoid arthritis is now "RA," irritable bowel syndrome is "IBS" and ankylosing spondylitis is now "AS"-- watch for it to become a disease du jour, warn Pharma critics, pointing to the marketing of "ED," "RLS," "ADHD" and "GERD." This month, an aggressive broadcast ad campaign broke to scare people into questioning whether their back pain is actually the chronic autoimmune condition ankylosing spondylitis. When the medication is ready, the disease will appear.
Of course, autoimmune diseases exist and need to be treated. But to "grow" the market by selling the diseases under the pretense of "awareness" is unethical--especially because the medications that treat them are so expensive and dangerous. (Plus, if someone has a serious disease do they really need TV ads to make them "aware" of it?) Genetically-modified injected drugs, called TNF blockers and biologics, are highly correlated with rare cancers, TB and life threatening infections and allergic reactions. One popular TNF blocker is even paradoxically linked to a "lupus-like syndrome" and "new or worsening" psoriasis. What? Yet the drugs are increasingly marketed for mild skin and digestive conditions, back pain and even asthma because they make from $10,000 to $200,000 a year for Big Pharma per patient. Ka-ching.
As it did with Vioxx, Meridia, Trovan, Baycol, Vytorin, Avandia, Paxil, Neurontin, Ketek, Prempro and Boniva/Fosamax, Big Pharma is mixing aggressive ad campaigns for TNF-blockers with planted journals articles, a tactic called "if it's worth an ad it's worth an article" in the publishing world. In the top medical journals, ads for new TNF-blockers for RA and about the promise of biologics in general (from Amgen) flank studies and scientific papers that dispel risks and clinicians' objections.
"Among patients with autoimmune diseases, compared with treatment with nonbiologic regimens, initiation of TNF-antagonists was not associated with an increased risk of hospitalizations for serious infections," says one paper. The new expensive RA drugs are not "significantly associated with an increased risk of malignancy," says another. There's "no significant difference in the rate" of major adverse cardiovascular events in patients on TNF-blockers says a third paper. And TNF-blockers do not, repeat not, cause herpes zoster (shingles) says a fourth paper in March 6 issue of the Journal of the American Medical Association (JAMA). Scores of scientific papers that report the opposite.
"Among patients with RA and other inflammatory diseases, those who initiated anti-TNF therapies were not at higher risk of herpes zoster compared with patients who initiated nonbiologic treatment regimens," say the authors, nine of whom report an astounding 46 links to Big Pharma especially biologic makers Amgen and Genentech. Though TNF blockers don't cause herpes zoster, the authors go on to say, outbreaks occur frequently enough in users that trials of anti-shingles vaccines should be initiated. A quick look at the paper's author disclosures shows many financial links to vaccine makers. Oops.
When it comes to expensive drugs that do more harm than good, drugs whose risks only emerge after billions have been made, neither federal regulators or medical journals seem to have learned their lesson. Stay tuned for an epidemic of "chronic autoimmune diseases." END