Monday, January 28, 2008

Want to delegitimize a disease? Get a drug approved for it!

Concerning Lyrica, the first drug ever FDA approved for the treatment of fibromyalgia, the New York Times has this to say:

For patient advocacy groups and doctors who specialize in fibromyalgia, the Lyrica approval is a milestone. They say they hope Lyrica and two other drugs that may be approved this year will legitimize fibromyalgia…

I’m not so sure. Although occasional experts through the years have been skeptical of the existence of fibromyalgia its status as a disease, by and large, has been secure for decades, well defined by textbooks and professional societies. But that won’t stop the pharmaceutical industry haters from suddenly, after all these years, crying “disease mongering!” “Medicalization!” It’s started already and we can expect it to ramp up substantially as Pfizer’s ad campaign picks up speed and other companies gain approval of their drugs for fibromyalgia. Corporate hatred will be fuelled as the new approvals become cash cows for some companies.

I think the Times has it bass ackwards. Fibromyalgia, a long established disease, will suddenly be questioned simply because drug companies stand to profit by it.


Anonymous said...

I'm sorry, but fibromyalgia is not accepted as a disease by at least a significant majority of the medical community. There is yet no proven pathophysiologic basis for calling it a disease, and much of its acceptance in certain parts of the medical community appears to be more of an acquiescence to loud advocacy groups than science-based thinking. Read some of the articles by Nortin Hadler, M.D. before you join the bandwagon.

R. W. Donnell said...

I realize that if you asked primary care doctors in the trenches whether fibromyalgia exists many of them would say, off the record, that it's bogus while in public would acknowledge that it's a disease, because it's almost politically incorrect nowadays to question its existence. On the other hand pain management specialists and rheumatologists would be more likely to acknowledge it.

Before writing this post I reviewed several sources including UpToDate which has one monograph citing quite a bit of evidence favoring a possible pathophysiologic basis (granted it's unclear).

The point is it has long been established in the literature as a disease (whether you or I think it's legit or not)and therefore is not in need of "medicalization" by the pharmaceutical industry. It was medicalized long before industry got a drug approved to treat it.

R. W. Donnell said...

I might add that Medscape's poll indicates only 27% of readers think fibromyalgia is not a medically recognizable disease.

Stem cells storage said...

Very interesting post.

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