How a medical condition was invented as a way to sell more drugs

A 'disease' that went right from a PowerPoint to your doctor's office

You might think that new drugs are created to treat diseases.

But more and more Big Pharma creates a disease to sell its drugs.

It’s a case of what I call OPM, or “overactive pharma marketing.” And OPM is very contagious.

You might wake up one morning feeling fine only to find out you suddenly have a disease. That’s what happened to over 46 million Americans who suddenly learned they had come down with “OAB” — overactive bladder.

Now maybe that sounds like a real medical issue. But, in fact, overactive bladder came right off the PowerPoint presentation of a drug company VP. It was designed and marketed as creatively as a new iPhone or Kindle is.

And because of that, OAB is now a very important disease. The market is so big that new drugs are being approved to treat it all the time.

Now, a dozen years after someone invented OAB, we’re learning that those drugs don’t work very well and can cause “life-threatening harm.”

You’ve seen the commercials with the girl who walks around putting giant numbers in her purse showing how many times she has to “go” during a night on the town. And that’s from the National Women’s Health Resource Center — it’s a public service announcement!

So this must be an important medical condition, right?

Well, no…overactive bladder came directly from the brilliant marketing mind of a man named Neil Wolf. He was the VP of Pharmacia, a drug company that has since been purchased by Pfizer.

Wolf was working hard to expand a condition called “urge incontinence” to sell more of his company’s drug, Detrol. The market for people who had this problem of accidently “peeing in their pants” wasn’t big enough to sell millions of pills.

And, it’s also kind of embarrassing. People weren’t telling their doctors about it often enough to get big Rx sales.

So Wolf’s idea was to make the market bigger. He rebranded the condition to include those who just had a strong urge to make lots of trips to the bathroom. And he wasn’t shy about what he was doing either.

In 2002 he presented his strategy called “Positioning Detrol: Creating a Disease.”

Wolf became the Don Draper of the pharma world.

One of his slides is called “Critical success factors.” And it lays out what needs to be done. Things like, “establish OAB as a serious medical condition with profound negative impact on people’s quality of life.”

Another part of the plan was called simply “Creating OAB.” And that slide shows a star with the points touching each group needed to make this new disease a success. One part of the star said “regulators,” meaning the FDA.

That part of the plan has worked really, really well. So well, in fact, that the FDA has continued to approve drugs for OAB all these years. Even ones that its own experts say are only a teeny bit better than a placebo!

In 2012 it gave the green light for Myrbetriq to hit the pharmacy shelf. Now this Rx for OAB has a whole bunch of side effects that are pretty serious, like heart problems, cancer, liver damage, UTIs, high blood pressure, and…”trouble emptying your bladder.” Talk about going from bad to worse.

And when the FDA got together its advisory committee meeting to review this drug, most of the talk was about the fact that it doesn’t do much for people with OAB. That’s right! All those risks for a drug whose benefits were called “almost as marginal as is possible.”

But the FDA approved it anyway! Neil Wolf should be very proud of himself.

The committee did spend lots of time commending the drug company for doing a really good job in putting all the studies, facts and figures together. And many made a point of saying how well placebo seemed to work on this condition.

But then, as one doctor said, “we’re not licensing placebo.”

Actually, I think that sounds like it would have been a much better idea.

After all, when you’re dealing with a made-up condition, licensing placebo for it makes perfect sense.

Sources:
“Create a disease to market a new drug” Carl Elliott, KevinMD, kevinmd.com

“Overactive bladder: ‘Pharmacia instrumental in creating new disease’ says former VP” Pharma Marketing Blog, pharmamkting.blogspot.com