Debunking the Conspiracy Theory that Drug Companies Keep Us Sick

I’ve never been a proponent of conspiracy theories in general. They play out well in movie and television dramas, where the hero has uncovered a renegade government plot to dupe or destroy the beloved institutions and suffering innocent citizens of America. It’s an intriguing fiction aptly supported with rock-solid evidence, but it doesn’t translate well into real life, for the simple reason that there doesn’t seem to be one group of American business or political power-mongers that could ever all agree on and smoothly execute a radical and gargantuan plot.

But maybe Big Pharma is an entirely different animal and our growing reliance on medication is the result of a more complex web of misdirection. Natasha Deonarain, MD, MBA, argues that drug companies medicate us for mostly preventable diseases and cites cancer treatment as the biggest waste of spending, claiming that obesity and lack of exercise cause most cancers. Health care dollars, she concludes, should be spent on aggressive programs that promote better lifestyles that include healthy eating and activity, thereby preventing cancer. Researchers that raise the hope that cancer can be cured are, according to Deonarain, spreading “…a wonderful lie that tugs at our hearts, opens our purses and perpetuates our reliance on drugs instead of funneling billions into the provision of health practices and education first.” Although her assessment of how we can avoid disease simply by eating better and being more active is rather reductive, her claim that health insurance and health providers are inadequate in covering and promoting preventative programs has some validity.

In an Atlantic 2012 article, John-Manuel Andriote attacks drug companies’ direct-to-consumer marketing via television commercials as collusion between drug manufacturers, doctors and insurers to convince healthy people that they are ill and slightly sick people that they are even sicker. One technique used to accomplish this, Andriote writes, is to change the metrics for diagnosing disease. For example, the numbers for diagnosing hypertension has dropped. What used to be considered a normal BP—120/80—is now called pre-hypertension, which motivates doctors to prescribe hypertension drugs to essentially healthy patients who don’t really need them.  While Andriote makes some very strong points, the argument felt simplistic and limited, and made me think first of multiple sclerosis. When I developed the disease back in 1999 but was given no diagnosis, I could only start taking a DMD after getting a diagnosis—which occurred six years later. But now, patients diagnosed with CIS, who show all the signs of MS but have had only one attack, can start a DMD. That change was made based on the fact that drug intervention works best to delay progression in the early stages of the disease. It is hard for me to believe that this was just a ploy to get more people on these very expensive drugs.

David Shaywitz, MD, PhD, offers an entirely different take on why drug companies offer mostly incremental therapies and very few cures. Shaywitz writes: “The unfortunate truth is that drug companies really want to cure disease, but rarely know how. Medical science simply isn’t up to the challenge. Most diseases aren’t well enough understood to enable the rational development of truly transformative treatments.” He goes on to explain that when Phase III trials fail, as they did in a recent one for Alzheimer’s disease, they are characterized as a failure and a waste of research money. And though that may be true, the failure lay in not knowing enough about the disease pathophysiology.

Shaywitz also won’t dismiss the value of incremental therapies. Two examples I can think of would be Biogen coming up with the Avonex pen and Teva developing a version of Copaxone that can be injected only three days a week instead of daily. Although they aren’t revolutionary advances, we have all read positive patient testimonials on health forums claiming this new tweak made disease management a little easier for them.

Conspiracy theorists often claim that drug companies would lose money if they developed a cure for diseases. That scenario doesn’t at all translate into reality. A cure would have enormous value and Big Pharma would make plenty from it. What’s more, a cure is not a preventative. New cases would develop and that drug would be in constant demand. Big Pharma would be just as wealthy in such a scenario. And even if a company developed a cure and a vaccine to prevent new cases, that’s just one disease among thousands.

Whether you wax cynical about drug companies or feel that you mostly benefit from its therapies, there will always be an unease concerning our growing reliance on prescription drugs. As MS patients, we must continue to weigh the risks and benefits of our medications and make informed decisions as best we can.

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