In this week’s edition of The Lancet, a medical journal, experts charge that pharmaceutical companies are “medicalizing” problems which were not previously seen as medical conditions. Six essays on the subject of medicalization appear in the issue, which came about as a result of a workshop organized by Dr. Jonathan Metzl, associate professor of psychiatry and women’s studies at the University of Michigan.
In his essay, Metzl explores both the positive and negative effects of direct-to-consumer (DTC) pharmaceutical advertising. For example, TV ads for erectile dysfunction medications such as Cialis, Levitra, and Viagra have altered cultural standards for healthy male sexuality. Ads for antidepressants which are aimed at women tell us that the central problem for depressed women is their inability to function effectively as wives and mothers, ignoring the effects depression has on a woman’s sense of self apart from family obligations.
However, Metzl points out that pharmaceutical ads can prompt patients to discuss problems which they would not normally bring up with their doctors – a positive effect of advertising which should not be overlooked. Ads can also prompt doctors to reexamine society’s assumptions about issues such as gender.
Race is another issue which has been medicalized by drug companies. Troy Duster, professor of sociology at New York University, writes in The Lancet that certain drugs have been developed specifically for African-American patients. He points out that the idea of companies profiting from “racialized drugs” brings up some thorny questions. However, the fact that such drugs exist underscores the need for doctors and researchers to look at social factors, including race, which contribute to diseases like hypertension and cancer.
The effect of DTC advertising is hardly a new issue. The Food and Drug Administration (FDA) conducted 3 surveys between 1999 and 2002, to assess patients’ and physicians’ perceptions of DTC ads. They found that 88 percent of patients who were prompted by an ad to ask their doctors about a specific prescription drug did in fact have the condition the drug treats. This indicated that patients were seeking help for conditions earlier than they might have otherwise — a positive effect of DTC advertising.
Still, some physicians remain troubled by DTC ads. They are concerned that ads may give patients the impression that every problem can and should be solved by medications. Doctors worry that their conversations with patients are too focused on the particular drug the patient wants. They feel that a range of treatment options – which may or may not include prescription drugs — should be explored.
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