Healthy Skepticism Library item: 6238

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Publication type: news

Pollard R.
TV ads shove drugs down our throats
Sydney Morning Herald 2006 Oct 78

Full text:

WE HAVE pills to get rid of headaches, pills to get to sleep, pills to
get it up, pills to get over depression and now pills to get rid of
excess weight.

Under the guise of “consumers taking control of their health”, the vast
and growing self-medication industry – involving pharmacies,
complementary therapies and over-the-counter drugs – is pushing people
toward a life where they chose which drug to take for whatever ailment
they have self-diagnosed.

The problem: they are not experienced clinicians, and conditions
written
off as trivial may indeed be serious. Drugs considered helpful could
have serious side effects or interact badly with other medications.

The margin for error is enormous, and without careful consideration,
lives will be at risk.

A new element has just been added to the mix.

Australians, previously protected from direct-to-consumer advertising
of most medications, are now being exposed to ads pushing the anti-obesity
drug Xenical, which was recently reclassified to allow the drug company
to bypass doctors and target potential patients.

The next pill up for reclassification is the migraine drug sumatriptan,
which is made by GlaxoSmithKline.

It is only available on prescription but next week the National Drugs
and Poisons Schedule Committee will consider the drug company’s second
application to have the product rescheduled as an over-the-counter
medication.

It is a potent vasoconstrictor that helps to constrict blood vessels
that become enlarged during a migraine – yet people with heart disease
or high blood pressure may experience serious side effects from the
drug, particularly if those conditions are undiagnosed.

Naming a drug on television has a powerful effect – a pharmacists’
email list has lit up in the past two weeks with examples of people of normal
weight trying to access the anti-obesity drug.

Xenical, according to the guidelines, should only be given to people
with a body mass index of over 30, or over 27 if they have other
conditions, such as heart disease or high blood pressure.

It works by preventing the body absorbing fat. The downside? That means
a person literally expels that fat, often in the form of oily
diarrhoea. Many find the side effects intolerable.

“The incidence of almost stick-thin overseas tourists … asking for
Xenical by name has rocketed,” one pharmacist wrote.

Still another commented that pharmacists will spend “a lot of time
sorting out the few people for whom Xenical might be useful from the
many who decide they want it, following promotion direct to consumer”.

The deputy chairman of the Greater Metropolitan Clinical Taskforce,
John Dwyer, said the move toward consumers taking more control of their
health must be accompanied by a shift in the way health care is
delivered.

“The concept of people taking more responsibility for their own health
is important, but to do that they need to be educated … especially
when you are talking about complicated issues such as weight loss,
migraine headaches or depression “ he said.

The Australian Self-Medication Industry represents pharmaceutical
companies, complementary medicine distributors, pharmacies and other
health-care organisations.

Last year it launched its agenda: “Self-care is a personal choice; it
is the extent to which an individual, family or community engages in any
activity with the intention of improving or maintaining health,
preventing disease, managing conditions, and restoring health.”

Its scientific director, Deon Schoombie, said self-care was not just
about medication, but also lifestyle management.

“When it comes to medication, when it is needed and necessary, there
should be appropriate levels of access,” Dr Schoombie said.

So how does one work out whether medication is needed in the world of
self-care?

“It may be necessary for certain conditions to be diagnosed first by a
GP or specialist … but then further care can be provided by a
pharmacist, for example.”

A health economist, Paul Gross, believes that higher levels of
self-care could provide cost relief for governments providing health care to an
ageing population.

He said studies in Europe showed that switching 5 to 10 per cent of
prescription medicines to over-the-counter status had reduced the use
of doctors and cut total payments from government.

The problem lay in the lack of information available to health
consumers and of an organised way of monitoring people’s health, said Mr Gross,
the director of the Institute of Health Economics and Technology
Assessment.

“At the moment, I cannot get this information from my health fund, from
Medicare or my doctor – I cannot get the information I need for
consumer-directed health care.”