Pushing Western medicine with fear

In fact,they worry Abbott’s marketing campaign may be the bigger threat,scaring healthy people into buying potentially harmful sleeping pills they dont need such as the companys own drug Zolfresh.

They are implying that taking sleeping pills may help you live longer,whereas the data shows that taking sleeping pills is associated with increased mortality, said Dr. Daniel F. Kripke,a psychiatrist at the University of California,San Diego. Industry insiders say the ad points to a bigger problem: According to Benjamin England,an attorney formerly with the US Food and Drug Administration (FDA),drugmakers have lower standards for how they operate in emerging markets like India and China,where government oversight is poor. You already feel like you are in the Wild West, said England,founder of the international consulting firm FDA Imports.com. There is not likely to be anybody who is going to take them to task.

If there is nobody paying that much attention to what people are saying about the product,then theyll push the envelope and say things they would not have gotten away with here, he said. And it doesnt matter that Abbott refrains from mentioning drugs directly,which would have been illegal in India,said another lawyer formerly with the FDA.I would argue that if the company making the claim has a sleep product for sale in India,then this is an implicit ad for the product, the lawyer,who spoke on condition of anonymity,said. In the US,companies cannot put out a scare notice without substantiation simply because they do not mention their product in the communication. With soaring incomes,expanding insurance coverage and more and more chronic disease,India has become a big draw for global drugmakers. According to a McKinsey report last year,the countrys drug market will be worth $55 billion by 2020.

Promoting sleeping pills,a staple of Western medicine,is one way to tap into that potential. Last year US doctors prescribed the drugs nearly 60 million times,with sales exceeding $1.9 billion,according to research firm IMS Health.

In India,a pack of zolpidem the generic form of Abbott’s Zolfresh sells for just a couple of dollars. Despite the low price,getting just a small fraction of the large population to buy sleeping pills could mean a sizable profit for drugmakers. Insomnia is an area where you will find a huge untapped market, said Ram Bala,a marketing expert at the Indian School of Business in Hyderabad,who has consulted for companies like Johnson & Johnson and AstraZeneca.

Bala said drugmakers appear to be stepping up efforts to win over emerging markets,although it’s an uphill battle as many Indians still prefer herbal remedies or are largely unaware of modern medicine. There is a lot of public resistance to treating insomnia,because they don’t think it is such an important condition, Bala said. If you bombard them with enough information about insomnia,may be they may at some point decide,Hey,you know what,there are so many people telling me that insomnia is important,may be I should go to the doctor and check it out.

Indeed,Abbotts ad encourages readers to see their doctor if they can tick off just one of 10 statements,including I feel sleepy during the day and I have a feeling that my sleep is unrefreshing.

“This is so dramatic and ridiculous, said Adriane Fugh-Berman of Georgetown University in Washington,DC,who runs PharmedOut,a think tank that studies drugmakers’ influence on prescribing. It is really advertising,but it is disguised as education, she said. “Industry calls it disease awareness. Those of us who are public health advocates call it disease-mongering making people believe that they are sick when they are normal.

Abbott declined to discuss the purpose of its campaign. But McKinseys India report bolsters Fugh-Bermans point: The acceptability of modern medicine and newer therapies will increase due to aggressive market creation by players, it notes.