Expanding the market for me-too drugs

In an effort to make the most money from “me-too” drugs, drug companies look for target markets with the following characteristics, as outlined by Dr. Marcia Angell, former editor of the New England Journal of Medicine:  

1.      Be large enough to accommodate a number of drugs that are all competing for the same market. Such markets generally consist of people with health conditions that are both common and chronic, such as arthritis, hay fever, or depression—ailments that don’t go away. This type of market is far more lucrative than those that target transient conditions, such as acute infections, or lethal conditions, which kill the customer.

2.      Consist of customers who can afford the drugs. As Dr. Angell says, “the pharmaceutical industry is supremely uninterested in finding drugs to treat tropical diseases, like malaria or sleeping sickness or schistosomiasis. Although these disease are widespread, they are not important to the industry, since those who suffer from them are in countries too poor to buy drugs.”

3.      Be highly elastic, so it can expand. The most common way to expand the market is to create new medical conditions, such as “pre-hypertension” (BP between 120 over 80 and 140 over 90), or to lower the cutoff point for high cholesterol from 280 milligrams per deciliter to 200. By lowering the thresholds for illness, you increase the sales of drugs.

Companies can also expand their markets by promoting “diseases” to fit their drugs. For example, at one time, “acid reflux disease” was called “heartburn,” and you dealt with it by drinking a glass of milk or an over-the-counter antacid. Now it is marketed as a serious esophageal disease, which it usually is not. Other examples are premenstrual tension, now called “premenstrual dysphoric disorder;” or impotence, now called “erectile dysfunction.” 

There’s also “social anxiety disorder,” a disease created for the drug Paxil. (Because few psychiatric disorders have objective criteria for diagnoses, they are easier to expand than most physical illnesses.) As Paxil’s product director told Advertising Age, “Every marketer’s dream is to find an unidentified or unknown market and develop it. That’s what we were able to do with social anxiety disorder.” Not feeling anxious? Just tune into a commercial for Paxil, which showed the World Trade Center towers collapsing.

Recently, a company expanded their market for Vyvanse, a type of amphetamine used to treat attention deficit hyperactive disorder. It's now promoted as a treatment for binge eating. Plenty of customers there.

Next week: Passing off ghost-written articles as the work of academics

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