Saving lives, or styling them?
The past few years have witnessed the rise of highly publicised “lifestyle” drugs. They are used to alter our appearance, physical and mental capabilities, the effects of aging, and so on. As the availability of a treatment can convert a lifestyle wish into a health need, the pharmaceutical industry becomes a key player in the process of medicalisation, where normal conditions get pathologised.
It appears that when drug therapy is available, physicians are less willing to consider non drug treatments, even when there is no evidence that the former is superior (1). One reason is the pressure from the pharmaceutical industry. One example is the use of Orlistat for treating obesity. Although people taking Orlistat lose a little more weight than those controlling their dietary intake (about 8.9% with pharmaceutical aids vs. 5.6 % with placebo over 1 year), there is no evidence that the drug is any more effective than diet in reducing the morbidity and mortality due to obesity (2). Orlistat is available in India and the prices range from Rs 95 to 390 for 10 tablets. Its reported adverse drug reaction (ADR) varies from mild to severe like oily spotting, increased bowel movements, abdominal pain, headache, rashes and severe liver damage (3).
A number of anti-aging drugs are now available in the market. One of them is Botulinum toxin type A, used for ironing the wrinkles on the face and neck. It can produce paralysis of the small muscles of the face by blocking cholinergic transmission (4).
While there is doubt about the benefits of many modern “lifestyle drugs”, there are also concerns about how the pharmaceutical market operates. Drug development is often driven by potential profitability rather than by public health needs. Once a drug is available, industry campaigns may seek to redefine the illness in the minds of doctors and potential patients, converting wishes into healthcare problems that require treatment.
In India where preventable and treatable diseases like malaria and tuberculosis thrive and kill millions of people and many new diseases emerge without any known treatment, the drug development is skewed towards unimportant “lifestyle drugs”.
The increasing use of “lifestyle drugs” raises, among several others, one pertinent question: are we trying to homogenise society? There is a need to study the concept and impact of these drugs on society particularly in India. India needs to focus more on life saving and essential medicines rather than “lifestyle drugs”. In a free market system, profits may not be the best indication of what drugs we need as a society.
Jeeja MC, Department of Pharmacology, Jayakrishnan T,Department of Community Medicine, Government MedicalCollege, Calicut 673 008 Kerala, INDIA e-mail: [email protected]
- Everitt DE, Avorn J, Baker MW. Clinical decision-making in the evaluation and treatment of insomnia. Am J Med 1990;89:357-62.
- Therapeutic letter. New drugs V [Internet]. Therapeutics initiative. 2000 Apr 13 [cited 2011 Dec 30]. Available from: http://www.ti.ubc.ca/pages/letter34.htm
- US National Library of Medicine. Orlistat: MedlinePlus drug information [cited 2010 Sep 10]. Available from: http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601244.html
- Jeeja MC. Botulinum toxin. Its cosmetic applications. Paper presented during CME on Cosmoceutical pharmacology at Medical College Thrissur. 2009 Oct 23.