It's only fair to share…

One of the best ways to get more business is to increase the size of your potential market. There are various ways of doing this. One can do product line extensions or lever the product into other areas where new markets open up. You see a lot of this in the food and apparel industries.

Surely you would think this does not go on in health? Think again.

Pharmaceutical agents are approved for certain uses. If one can find new uses then new markets will open up. This can be tricky. Indeed the withdrawal some years ago of the drug Vioxx happened when a trial was being conducted on a potential new use for the drug. During this trial was when the risks of heart attack became apparent (some have argued this was known previously) and the rest is history.

A better way is to widen the market for existing use. The best example of this is with cholesterol lowering medications. Over the years the “normal” cut off has been gradually lowered. Every time the cut off is lowered a group of people are reclassified as “needing” drugs when the day before they did not. Similar reclassification of healthy people as those needing treatment occurs when blood pressure targets are lowered.

Nobody dies of cholesterol; it is classed as a risk factor not a disease. Treating risk factors is good business, for the pharmaceutical industry. You are effectively getting life long customers, as “treatment” is long term. Compare this to an antibiotic maker. A person may need a course of an antibiotic but after one or two weeks that is it. You are off the drug.

The other beauty of treating risk factors is that there is no downside. If someone on a cholesterol-lowering drug has a heart attack you cannot blame the drug as it was only lowering risk not treating anything. If you do not the drug maker will claim you as a success in their statistics.

The most commonly used cholesterol lowering medications are the statins. These have been around for 20 years. Some of the early ones are now off patent and Lipitor, the biggest seller will be off patent in a few years. They are huge sellers having generated sales of hundreds of billions of dollars.

So it is with interest that a new market is being opened for another statin drug, Crestor. This market of 6.5 million in the USA do not have raised cholesterol or any sign of heart disease but satisfy three other criteria for “risk” of heart disease, including age.

This new use has FDA approval. Yet the same FDA is cautioning about the side effect of muscle damage with use of simvastain and has previously issued warnings about use of doses greater than 20mg in certain patient groups. A new trial has suggested statin drugs could increase the risk of Type 2 Diabetes.

So what are we to do?

1) Do not get caught up by marketing hype.

2) When you hear claims of 50% reduction in risk look deeper. It may be a drop from 1% to 0.5%. A 0.5% drop doesn’t sound as good as a 50% drop.

3) Be questioning of claims. Look at your own situation rather than be guided by statistics.

There are of course other ways of reducing your chances of having a heart attack, which do not involve taking drugs with side effects.

1) Do regular exercise.

2) Eat mainly real rather than processed food.

3) Maintain a healthy body weight.

Making “patients” out of healthy people is good business if your business is selling pharmaceuticals. Taking pharmaceuticals that you may not need is not good for you or your wallet.