BMJ 2002;324:867 ( 13 April )
Ray Moynihan, Sydney
A senior pharmaceutical company executive says estimates of the prevalence of diseases are often exaggerated.
Using the example of his company's promotion of "social phobia," Fred Nadjarian, managing director of Roche in Australia, said: "The marketing people always beat [hype] these things up. It's just natural enthusiasm."
The candid comments come as the pharmaceutical industry intensifies its push to loosen European regulations on direct-to-consumer promotions involving both "disease awareness campaigns" and straight advertisements for drugs.
In the late 1990s Roche planned to market its antidepressant moclobemide (marketed as Aurorix in Australia and as Manerix in the United Kingdom) for the treatment of social phobia. A media release sponsored by Roche claimed at the time that more than one million Australians suffered a "soul destroying" psychiatric disorder called "social phobia," which could be treated with behavioural therapy and drugs.
In an interview last month Mr Nadjarian said he now feels he was somewhat "taken in" by the estimates that were presented to him of the prevalence of social phobia. "I thought there might be a big market. But when we tried to recruit [for clinical trials] we just weren't able to," he said.
While not disputing the existence of legitimate illness, Mr Nadjarian said the extent of social phobia was much smaller than was initially thought.
He argues that his experience with that one condition highlights a much wider problem: "If you added up all the statistics, we all must have about 20 diseases. A lot of these things are blown out of all proportion," he said.
The comments add weight to fears that pharmaceutical companies may be systematically seeking to portray certain health conditions in ways that maximise their size and seriousnesspartly to help build markets for new products.
Acknowledging the obvious potential for conflicts of interest when drug
companies sponsor publicity about diseases, Mr Nadjarian said: "Behind
every statistic there is a vested interest." He added that while the vested
interests of a company official are clear, other people such as professors
who appear independent may also have a vested interest in exaggerating
estimates of a disease's prevalenceso as to attract attention to an area
of research. "There's a natural human tendency to exaggerate," he said.
(See p 886.)
© BMJ 2002