Dear Editor: As my first reaction, I thought; yes, pharmaceutical companies are inventing syndromes. [See “Are Drug Firms Disease-Mongering?” MM June, page 10.] However, after some reflection I believe that they are merely looking at different disease states or conditions that their products may help to alleviate. The real questions are: How important is the condition, disease, or syndrome to the affected individual? Does mass communication; i.e., television and print campaigns, actually create a well-informed public or does it increase demand for the product unnecessarily?

Physicians with fee-for-service-based practices are often caught in a Catch-22 scenario that the mass communication creates. Nexium (as an example) may now be overprescribed to patients who do not actually suffer from acid reflux — rather it will be used as the “latest and greatest” solution for heartburn. If the physician recommends to their patient Mylanta or Tums instead of Nexium, the patient may believe that the physician is not current regarding medications available, and therefore is possibly less competent that some of the doctor's peers. This influences some physicians' prescribing habits.

An additional influential factor is the lack of time for true patient-physician consultation. Society and marketers are suggesting that consumers should be more demanding and achieve results immediately. The lack of time that a physician has during the patient visit limits the ability of the physician to help educate the patient regarding the best approach to managing his or her health.

The truth of the matter is that pharmaceutical companies are in the business of selling pills. There is nothing wrong with that. Line extensions such as Nexium, Propecia, and others offer the companies and their shareholders a return on their investment (“Build a better mouse trap…”). The issue is: What will it take to have better-educated health care consumers and health care providers?
Peter Epstein