The Perils of Consumer-Directed Medication Marketing

How often does it come to our attention that things are not exactly what they seem?

Let’s consider the recent launching of a nationwide media campaign to shed light on binge eating disorder (BED). Using well-known and probably well paid spokespeople, such as international tennis star Monica Seles, these public service advertisements are supposedly designed to increase awareness of BED, provide much needed education and help people get the treatment they require.

An informative website has even been established to assist in this effort. Keeping in mind that BED is the fastest growing eating disorder in the United States today, how could this campaign be anything but very positive?

Now, let’s consider the recent and very rapid approval of lisdexamfetamine dimesylate, which goes under the brand name of Vyvanse, to treat BED by the United States Food and Drug Administration (FDA). It is important to note that this drug, a product of Shire, is not new. Historically, it has been used to treat attention deficit hyperactivity disorder (ADHD). In this capacity, it has proved highly lucrative. In 2014 alone, sales of Vyvanse reached 1.5 billion dollars.

Another interesting occurrence is that within days of approval, Monica Seles began visiting medical centers and patient advocacy groups. Allegedly this was to increase awareness of the condition, but in all likelihood based on who is paying her, it was to strongly promote using Vyvanse in the treatment of BED.

Now, let’s look at the relationship between the media campaign and the drug approval. Not only is Shire paying Monica Seles, and other celebrities, but by and large, they are funding the campaign. They are even donating money to popular non-profit eating disorder organizations to get them to jump on the drug bandwagon. The mission of these organizations is to increase awareness and prevention of eating disorders, NOT to promote Shire’s pharmaceutical products.

This is a calculated strategy that the drug company has used in the past, namely with ADHD. First the drug manufacturer embarked on a campaign designed to “help” people who struggled with ADHD by creating awareness, de-stigmatizing the illness and assisting them to get the medication they needed.

Isn’t it intriguing that the medication they would seek and ultimately receive was either Vyvanse or Adderall, a pharmaceutical drug produced by Shire? And what a success this strategy has proven to be. Sales of Adderall remain in the billions.

Shire has been cited and fined by federal officials for inappropriately marketing their products; clearly this hasn’t slowed them down in the least, since this is the strategy currently being used to market Vyvanse. The steps are as follows: awareness of the disorder is created through a widespread media campaign, the drug achieves approval, a consumer direct marketing campaign is launched, and people flock to doctors for a prescription. Additional sales of Vyvanse are expected to reach between 200 and 300 million dollars.

But here is the problem: all obese people do not struggle with BED. In fact, of those who are seeking treatment for obesity, only 7 to 10% meet the clinical criteria for BED. But now, due to the “helpful” website, it is likely that more obese people will get the prescription. This is because they know what to say to receive an appetite-suppressing medication (phen-phen anyone?) Included on the site are the correct questions to ask, and symptoms to discuss, in order to garner the diagnosis of BED. In the time it takes to reach for a prescription pad, the deal is sealed and Vyvanse is on board.

The truth is, drug seeking is not confined to pain killers, benzodiazepines such as Xanax and Ativan, and opiates. Imagine the hardship of being an obese person today, with all the struggles and abuses that go along with living in our culture, which is sick with the thin ideal: health problems, employment discrimination, and societal intolerance. Many frustrated obese people have tried every possible weight loss focused therapies and diet plans without success.

But now, here is this drug, being touted as the first of its kind ever to treat BED. Of course, the reality is that similar to Adderall, phen-phen, and even cocaine, it is actually an appetite suppressant.

This legitimate pharmaceutical will undoubtedly be supported by physicians with little to no eating disorder or addiction training, and little to no success helping obese patients lose weight.

Vyvanse can help people achieve that desired, albeit short-sighted and often unhealthy, treatment outcome. What treatment-seeking obese person would “not” want it? The desire is completely understandable.

What they don’t know is that Vyvanse won’t help them with the emotional and spiritual underpinnings of their eating disorder. And what they probably will not be told by their physician is that it is a stimulant, which carries a significant abuse potential.

The story is not a new one. The drug is taken, it “works,” tolerance and dependence develop, more is taken, and eventually abuse and addiction can result.

Pharmaceuticals can often be a critical component of a treatment plan built to support sustainable recovery. However when drug companies promote products in this fashion, when the exclusive intent is to make huge profits, when the risks and dangers of addictive medications are not communicated, the outcome for patients using the drug can be very poor.

It is no wonder that many Americans hold corporations which operate in this manner in utter contempt. And also why many academic centers, non-profits and treatment centers alike steer clear of receiving monies from big pharmaceutical companies under the auspices of helping to promote disease awareness.

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