I know that many of you have seen this article by Matthew Perronne since it was picked up by the majority of AP outlets this morning:
Two drugmakers spent hundreds of millions of dollars last year to raise awareness of a murky illness, helping boost sales of pills recently approved as treatments and drowning out unresolved questions — including whether it’s a real disease at all.
Key components of the industry-funded buzz over the pain-and-fatigue ailment fibromyalgia are grants — more than $6 million donated by drugmakers Eli Lilly and Pfizer in the first three quarters of 2008 — to nonprofit groups for medical conferences and educational campaigns, an Associated Press analysis found.
That’s more than they gave for more accepted ailments such as diabetes and Alzheimer’s. Among grants tied to specific diseases, fibromyalgia ranked third for each company, behind only cancer and AIDS for Pfizer and cancer and depression for Lilly.
The physician credited as lead author of the fibromyalgia diagnostic guidelines in 1990, Dr Frederick Wolfe, is now one of the disorder’s most vocal skeptics:
“I think the purpose of most pharmaceutical company efforts is to do a little disease-mongering and to have people use their drugs.”
Wolfe is now with the National Data Bank for Rheumatic Disorders in Wichita, KS.
The best definition I could find for fibromyalagia comes from NIH’s National Institute of Arthritis and Musculoskeletal Disorders (NIAMS):
Fibromyalgia syndrome is a common and chronic disorder characterized by widespread muscle pain, fatigue, and multiple tender points. The word fibromyalgia comes from the Latin term for fibrous tissue (fibro) and the Greek ones for muscle (myo) and pain (algia). Tender points are specific places on the body – on the neck, shoulders, back, hips, and upper and lower extremities – where people with fibromyalgia feel pain in response to slight pressure. . .
. . .Fibromyalgia is a syndrome rather than a disease. Unlike a disease, which is a medical condition with a specific cause or causes and recognizable signs and symptoms, a syndrome is a collection of signs, symptoms, and medical problems that tend to occur together but are not related to a specific, identifiable cause.
Let me state for first time visitors that I am not a physician. Therefore, I lack the specialized knowledge or clinical experience needed to weigh in as to whether fibromyalgia is a disease or disorder or syndrome that is responsive to pharmacotherapy. My unscientific survey of physicians in my community (not rheumatologists) are that people with fibromyalgia are considered hypochondriacs or have depression, arthritis, or sleep disorders that can be treated based upon those defined disorders with clear diagnostic criteria.
Whatever the case, and I encourage clinical colleagues to weigh in down in the comments, I am a strong proponent of the relief of human suffering. However, where I am dismayed is when drug companies begin to support programs that Dr Wolfe describes as “disease-mongering” for the sake of generating drug sales.