GSK ‘Selling’ Social Anxiety Disorder, Washington Post Reports
A marketing campaign that greatly increased the visibility and sales of the social anxiety drug Paxil has some mental health advocates and researchers concerned that drug makers, "traditionally in the business of finding new drugs for existing disorders, are increasingly in the business of seeking new disorders for existing drugs," the Washington Post reports. In 1999, SmithKline Beecham, now GlaxoSmithKline, hired the New York public relations firm Cohn & Wolfe to "coordinat[e]" an advertising campaign for Paxil that included "testimonials" from advocacy groups, such as the American Psychiatric Association and the Anxiety Disorders Association of America, and doctors who said that "social anxiety was America's third most common mental disorder with more than 10 million sufferers." The campaign was so successful that according to the marketing newsletter PR News, the number of media accounts about social anxiety disorder rose from 50 stories in 1997 and 1998 to more than 1 billion references in 1999, with 96% of those indicating that "Paxil is the first and only FDA-approved medication for the treatment of social anxiety disorder." Paxil sales, which had "lagg[ed]" behind those of Zoloft and Prozac, rose 18% last year, and according to GSK's 2000 annual shareholder report, Paxil "became number one in the U.S. selective serotonin reuptake inhibitor market for new retail prescriptions in 2000."
Many mental health experts, however, believe that campaigns such as the one for Paxil "blu[r] the line between normal personality variation and real psychiatric conditions" and can "trivialize serious mental illnesses." Rex Cowdry, medical director of the National Alliance for the Mentally Ill, said, "Some marketing seems to imply that huge proportions of the population need pharmaceutical intervention for relatively common problems, and in the long run, I am concerned that may undermine the credibility of the concept of serious mental illness." For instance, while commercials for Paxil said that more than 10 million Americans suffer from social anxiety disorder and that 13% of Americans are affected by the disorder, the National Institute of Mental Health has placed that figure at 3.7% of the population. In addition, while the campaign "mentioned" a psychological treatment for social anxiety disorder known as cognitive behavior therapy, it "did not stress that the therapy is as effective as medication, has no side effects, such as sexual problems and fatigue, and does not require patients to stay on treatment indefinitely," the Post reports.
Finally, many psychiatrists say there is "probably little difference" between Paxil and other similar medications like Prozac and Zoloft. Carl Elliott, a bioethicist at the University of Minnesota, said, "Pharmaceutical companies who are marketing psychopharmacological treatments have gotten into the business of selling psychiatric illness. ... If you are [GSK] and you are the only manufacturer who has the drug for social anxiety disorder, it's in your interest to broaden the category as far as possible and make the borders as fuzzy as possible."
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The physicians and advocacy groups who worked on the Paxil campaign, however, "defended the efforts," saying that they helped "thousands" of people with social anxiety disorder. The advocacy organizations, stating that the "only way for [not-for-profit] groups to get out a potent public health message is to team up" with a drug maker, said that they "demanded and received full control over the editorial content" of the campaign. And University of California-San Diego Psychiatry Professor Murray Stein, responding to criticism that the Paxil campaign has led to unnecessary medications for those who do not really suffer from social anxiety disorder, said, "Would somebody who is not having problems take a medicine that is costly and has side effects? I don't think too many people would do that. The idea that this is cosmetic psychopharmacology I find offensive" (Vedantam, Washington Post, 7/16).