Prescriptions for Health – or Profits?

Posted by on Jan 29, 2013 in Blog | 1 comment

Perhaps you have heard some reports about the pharmaceutical companies trying to influence doctors to prescribe more drugs, for their benefit rather than the patient’s.  Well, now even the medical journals are looking at the situation.  The Annals of Family Medicine reported a study done by some anthropologists from Michigan State University.  The authors noted that spending on prescription drugs in the United States has risen nearly 6-fold since 1990.  The study focused on how medical doctors managed type two diabetes and hypertension, two of the most common chronic health conditions.

What they found was a significantly lowered diagnostic threshold for these diseases.  Which means, it has gotten easier to be diagnosed with them.  In 1998, the fasting glucose level that meant “diabetic” was lowered from 140 to 126.  This resulted in an additional 10.3 million people being defined as diabetics.  The definition of “pre-diabetes” was changed from 110 to 100.  These changes meant that those millions of people would now be put on prescription drugs.

In 1993, the blood pressure definition for hypertension was lowered from 160/95 to 140/90 (in non-diabetic patients).  In 1998, hypertension for diabetics was set at 130/80.  These changes resulted in about 22 million additional hypertension diagnoses – and prescriptions.

Now, is this a bad thing?  The committees and organizations that set these standards have substantial pharmaceutical industry ties.  Doctors are monitored and evaluated on if they treat by these standards.  The important question is if these lower standards benefit patients or just make profits go up for drug companies.  If medical doctors were treating diabetes and hypertension by encouraging patients to eat healthier diets, exercise more, and take nutritional supplements, it would probably be a good thing.  But they are treating with drugs which have side effects and risks.  Two- thirds of patients report symptoms from their diabetic and hypertension medications.  Furthermore, 89% of these patients are taking multiple drugs, averaging 4 or 5 drugs which they are told to take “permanently”.

The authors of this study found that drug companies setting the standards by which their products are sold is not in the best interest of patients. They urged that organizations with financial conflicts of interest be banned from guideline writing panels.  And they called for physicians to be discouraged from seeing drug representatives.

The worst part of this story is that the biggest money makers for the drug industry do not fix the problem.  They “manage” a chronic condition.  And diabetes and hypertension are both treatable by lifestyle changes!  So by only offering patients a prescription, doctors are actually keeping people sick when they should be working with them to make them well.  You hear a lot in the news about how these problems keep worsening, and about the social and economic costs involved.  But maybe the blame lies with a system in which medicine is run by a multi-billion dollar drug industry.

One Comment

  1. Your are pointing out a significant situation. I personally was told by my doctor some years ago to take a blood pressure drug, but I decided not to. I think we all have to apply some degree of skepticism to any prescription that we are given. Of course, sometimes a drug is genuinely needed, so it is possible to go too far in the direction of skepticism.

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