Big Pharma Seeks Little Patients
While children have always had asthma and allergies, there are two changes since the legalization of direct-to-consumer advertising in the late 1990s: They are prescribing allergy drugs at younger ages—often as young as 1—and the medications are more dangerous.
The FDA now warns that the heavily advertised Serevent, Foradil, Advair, and Symbicort shouldn’t be used if an inhaled corticosteroid (like Flovent) is already working to control asthma and shouldn’t be used at all without an inhaled corticosteroid.
These drugs, called long-acting beta agonists or LABAs, were billed as add-on drugs to “control asthma” but sometimes worsen asthma and cause asthma-related intubation and death. (Yes, exactly what they were supposed to prevent!) And who are at the highest risk for harm and death from the drugs? Children 4 to 11 years old, according to the FDA.
Singulair is another allergy-asthma drug marketed to kids for symptoms that could just as easily be treated with over-the-counter antihistamines.
In addition to FDA warnings about psychiatric side effects and published suicides of children on the drug, Singulair is believed linked to the aggression, hostility, irritability, and other behavioral symptoms that are diagnosed as ADHD, says Fox News. Of course once a child is diagnosed with ADHD, more dangerous drugs are probably around the corner.
Still, pharma’s most-insidious war on children is probably trying to get babies on GERD medicines.
Even though the approximately 71 times a day that babies spit up is considered perfectly normal and does not damage the esophagus, the number of GERD prescriptions for babies has recently quadrupled, writes pediatrician Darshak Sanghavi.
The drugs don’t treat baby reflux, but they “may increase brain bleeds and gut damage in preterm infants as well as the risk of food allergies in older infants,” says Dr. Sanghavi, author of the bestselling “A Map of the Child.”
Since the pricey heartburn drug “purple pill” Prilosec debuted over a decade ago, followed by Nexium, proton pump inhibitor drugs (PPIs) that switch off stomach-acid- producing cells, have become veritable “purple crack,” say U.S. doctors.
Even though heartburn is not a valid indicator of GERD—it can exist without esophageal damage and vice versa—PPIs are often prescribed for intestinal-tract pain where no hydrochloric acid even exists.
Half of all hospital inpatients are now put on PPIs, writes Dr. Sanghavi. (The head of Medicaid and Medicare admonished AMA doctors in 2003: “You should be embarrassed if you prescribe Nexium, because it increases costs with no medical benefits.”)
Like asthma drugs, PPIs can cause exactly what they are supposed to prevent when patients try to quit: heartburn and reflux. They increase the risk of bone fractures in women by 25 percent, angioplasty-related deaths, and intestinal infections
In kids, PPIs can cause headache, abdominal pain, nausea, constipation, diarrhea, and increased risk of community-acquired pneumonia.
Why is pharma picking on the child-patient?
“Children are known to be compliant patients, and that makes them a highly desirable market for drugs,” says former pharma rep Gwen Olsen, author of “Confessions of an Rx Drug Pusher.”
“Children are forced by school personnel to take their drugs, they are forced by their parents to take their drugs, and they are forced by their doctors to take their drugs. So children are the ideal patient-type because they represent refilled prescription compliance and ‘longevity.’ In other words, they will be lifelong patients and repeat customers for pharma.”
There is also “clinical laziness,” says Dr. Sanghavi. “Nexium is over-prescribed for the most banal of reasons: It’s less work to write a prescription and pretend the problem is solved.”
Martha Rosenberg is a journalist who lives in Chicago.