It's only fair to share…

When markets reach “maturity” it is normal business practice to look for new markets. If you are selling consumer products there is no problem with this. But what if you are selling pharmaceuticals? Figures from the USA show that adults are now the biggest market for ADHD drugs.

The market for ADHD drugs in adults is growing and more effort is going into that market.

This was reported on Bloomberg about Vyvanse (a huge seller); “We’ve shifted more effort into the adult ADHD market, which is now more than half of the overall market and has the highest growth,” Shire CEO Flemming Ornskov said in a recent conference call with analysts. “It’s growing fast, almost twice as fast as the overall market.”

Whilst healthcare is a market, it is different to other markets. If you want a watch or a shirt or potato chips you buy them. You do not need anyone else to approve it. Prescription pharmaceuticals can only be bought if a doctor has diagnosed you with a condition requiring that pharmaceutical as treatment.

It has been shown many times that the best way to market treatments are to first market conditions. If you can convince someone they have a problem then you have a much better chance of selling them something for this.

In turn doctors are influenced by guidelines and disease definitions. In the case of adult ADHD one now needs as few as four criteria from a possible 22 to be diagnosed. When one considers the vague nature of “symptoms” such as “gets impatient” or “loses things” or “is often restless” the market is potentially everyone.

And therein lies the key. As soon as we reclassify normal behavior as being due to some condition, people start to worry that they have something wrong with them. The fact that I may be restless or have my mind wander is no longer part of being human but a sign of disease. And when the solution is as easy as popping a pill, well why wouldn’t I?

Ray Moynihan wrote in the Saturday Paper about changes to criteria for both ADHD and depression thus; “These newly expanded definitions are not abstract or obscure. They appear in guidelines for doctors, they determine where health resources flow, and they ultimately affect whether your doctor decides to classify you as healthy or sick. And the newly expanded conditions are heavily promoted through a suite of marketing strategies – including the 30,000 pharmaceutical industry-sponsored “educational events” for Australian doctors every year, which happen inside hospitals, hotels and restaurants.”

And here is the key point by Moynihan; “…decisions were made by psychiatric panels on which more than half the members had ties to drug manufacturers selling drugs for ADHD and depression respectively”.

These conflicts of interest are a major problem in medicine. It is wrong that doctors paid by pharmaceutical companies can be involved in decisions regarding their use. It is akin to asking a player on a football team to also umpire the game.

It is either or. You can’t do both!

It is therefore not surprising that sales growth is up.

But the quest for new markets is not over. A study funded by the makers of ADHD drug Vyvanse examined its role in women with “impaired executive function” during and after menopause. Apparently executive function applies to planning and multi tasking.

It may prove incredibly easy to convince people that their inability to do eight things at once is a disease needing treatment.

And of course we have lots of people seeking to turn normal human emotion into a “condition” needing “treatment”. As Jean Goodson (a 14 year old) wrote on spiked that virtually all of her friends have been told they need special help. This is for problems like not liking public speaking or being a bit disorganized.

She notes, “… the wellbeing professionals at our school are telling us that we have serious personal problems…” which in the past would have been seen as normal teenage worry. And concludes”… the professionals in our school are to blame-they are claiming to be solving problems when really they are creating them”.

I have great hope that the next generation will reject this current approach, which makes every normal emotion some type of illness and every small issue a major problem.

Medicalizing life is good for sales. The role of conflicted doctors and academics in this is appalling.

For now, unfortunately the success of this approach is apparent.


Dr Joe Kosterich M.B.B.S is an author, speaker, media presenter and health industry consultant, who wants you to be healthy and get the most out of life. Dr Joe also gives practical, motivational health talks for the general public and organisations where he is known as “An independent doctor who talks about health”.

His latest book “60 minutes to Better Health” is available on Amazon.