A new report in the Public Library of Science Medicine has again accused the pharmaceutical industry of unethical behaviour, this time by “disease-mongering” and “lifestyle” treatments for minor problems.
This comes at a time when AstraZeneca, Shire Pharmaceuticals, GSK and others are reporting strong profit growth.
The problem for the report is that it seems to ignore the pattern of history of medicine.
As society has become more affluent, and as medical progress has continued, each generation has tended to think of illness in a new way. Issues that were considered just the inconveniences of life in previous decades now become treatable conditions which people are wanting help with.
I often talk of above the line and below the line: above is medical, below is performance or lifestyle – but the line keeps falling.
IVF – was below the line in the UK, a fact of life if you are infertile. But now has become a treatable condition under the NHS.
Cosmetic surgery was entirely below the line except when dealing with injuries, but in today’s NHS even a total sex change operation is now above the line, as is just about any kind of cosmetic surgery if a strong enough case can be made about the psychological damage being caused.
Hair loss in women – above the line.
Hair loss in men – below the line.
Impotence – definitely now above the line.
Mental enhancement drugs in older people with memory loss – above the line.
Mental enhancement drugs in older people without memory loss – below the line.
The big issue for the future of the pharmacueutical industry is to get accurate predictions about how that line is likely to move in the next 5-15 years – but that in turn also depends on what new options become available.