Marketing Diseases

As this suggests, the pharmaceutical industry sells not only drugs but also diseases to doctors and the public alike. In some cases, drug compa- nies have encouraged doctors and the public to define disease risks (such as high blood pressure) as diseases (such as hypertensive disease). In other cases, drug companies have defined symptoms into new diseases.

One example of this is the disease known as pseudobulbar affect (PBA). PBA refers to uncontrollable laughing or crying unrelated to individuals’ emotional state and can be caused by various disabling neurological conditions (such as head trauma, stroke, and Lou Gehrig’s disease). The concept of PBA was developed by Avanir Pharmaceuticals, which markets the drug Nuedexta as a treatment for it. Although Nuedexta seems to help some patients, its side effects are serious enough that at least one-quarter of users—all of whom already have serious health problems and must take numerous other medications—soon stop taking it. Moreover, equally effective drugs are available at a fraction of the cost.

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To convince doctors that uncontrollable laughing and crying is a disease in itself, Avanir has advertised in medical journals and sponsored continuing education courses, conferences, and a PBA newsletter. Avanir also has marketed the concept of PBA directly to consumers through television advertisements, a website it created focused on PBA, and educational grants to advocacy groups for those living with stroke, multiple sclerosis, and other diseases

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