Greed is one of our most destructive traits and no one is more prone to fall prey to its grip than the shareholders of pharmaceutical companies, especially of late. The expectation for, and dependance on, easy money has been created and pharma companies are now expected to provide for this insatiable and growing demand for ever increasing payouts and dividends.
Managing disease has become the well trodden path to providing those profits.
To paint pharma as the only black sheep in the healthcare family would however be grossly unfair, as insurers and other Shylock’s have smelled the blood in the water and have been circling and feeding for decades. If we however, as patients, represent the fish in the water, pharma is guilty of providing the worms industry bait their hooks with.
How many people reading this article can open their medicine cabinet and produce one or more drug they have been prescribed in the last decade that comes with a repeat prescription – for life! I’d hazard it would be more than half the readers. Healthcare is no longer trying cure you, and probably stopped trying decades ago. Right around the time the penny dropped.
A healthy, cured cow is no longer a cash cow. Long term management became the new catchphrase of medicine.
A change in tack
The mechanics that underpin this shift in care are incredibly transparent and from a physiological point of view, also simpler to manage. It is far easier interfering on a daily basis with the production of, say, excess stomach acid in someone who suffers from gastritis, than it is to address and correct the underlying cause of the excess acid. I should know, I take a daily dose of Omeprazole for exactly this.
While the package insert suggests the medication should not be used for longer than 10 days (covering the manufacturer) some doctors prescribe these for life. Who, I wonder, when the dust settles in the industry, will be held legally liable for off-label use. I’d suggest to the prescribing doctors that it wont be the manufacturers.
Almost every drug we now manufacture falls prey to off-label use or use way beyond its intended, approved and clinically trialed, prescribed use.
Aspirin is ingested daily by millions around the globe in the hopes it will offer some form of protection against cardiac events and clotting. Statins are prescribed for life, to control bad cholesterol and soften your arteries. Ozempic, a drug containing semaglutide to manage insulin in diabetics is now being used off-label for weight management. To keep the weight off, you’re obliged to use it for life.
How does Ozempic affect a healthy patient population that does not suffer with diabetes? No one knows, as the long term use of the drug has not been tested in this patient population. Why would you bother? To be clear, the doctor signing your script doesn’t have a clue either. In the cold light of day, he is taking an unethical medical risk prescribing an off-label drug to you, one you may very well require for life.
We know, and your doctor is all to well aware of this, that exercise and a healthy diet can potentially replace most of the drugs you pay for each month. Drugs that are supposed to buy you the time to implement healthy changes in your lifestyle are now being used to chain you to the wheel of never ending “health” dependency.
An expensive habit, with drugs like Ozempic retailing for around $1500 a shot. The price has skyrocketed as vanity has boosted demand for the drug, leaving patients with actual diabetes, who have a real need for the medicine, unable to find or afford it.
So ingrained has this “continued use” policy become, in both the minds of healthcare and patients, that even the vaccines we now manufacture, are subject to it. Booster shot after booster shot.
There are of course multiple and often serious consequences of practicing medicine this way, a few of which are outlined in brief below;
- Off-label use in medications are very rarely subjected to clinical trial, so even the prescribing doctor is unsure of how your continued use of a particular medicine is going to impact your health.
- You place organs like your kidneys and liver at increased risk by taking large amounts of medication.
- Patients are often prescribed additional medication to counter the effects of existing medication. This additional medication, is, of course, also for life. Patients can end up with shelves of pills.
- Often expensive, these medications can, and do, drain the savings of many elderly patients.
- This pill mill places unnecessary demands on healthcare insurers who drive up premiums, an action that has a direct knock-on effect on the cost of care.
The topic is far too complex for a short article like this to explore in any depth, and I would highly recommend reading this series by Stephen Schimpff, Md on Future of Health. The ten articles examine the issues in far more depth.
Stemming the tide
The problem of creating a medication dependent population can only be affectively addressed at its point of origin. The doctors consulting room. While doctors themselves are not to blame for the “management mentality” that pervades healthcare, they do act as the point of origin. They are also, much like they patients they treat, victims of the system.
Ridiculous time constraints and pressures brought to bear on doctors by insurers and the healthcare system they are obliged to operate within, all lead to one inevitable result. Quick in – quick out, with patients receiving only cursory care. Diagnosis suffers as a result. Patients are also conditioned to expect that leaving the consultation without a prescription in hand equates to poor treatment.
Both doctors and patients need to be re-educated on the primary goal of healthcare. It is to deliver care that prevents or cures disease and manages health. Drugs, in most instances, are temporary fixes to allow for healthy lifestyle choices to restore wellbeing. Our bodies are capable of reinvigorating themselves if the damage is identified early and the causes addressed.
Medicating someone up the yazoo and essentially turning them into prescription junkies does not improve quality of life. In point of fact, it often worsens it. As long as we continue to accept the current healthcare status quo, our health as a global population will continue to decline.