Much of modern Western medicine revolves around the prescription pad, and Big Pharma exerts impressive influence on the practice of medicine. Part of the culture is that we prescribe medicines for specific illnesses, not just because they help people do better. People get Prozac because they have Major Depressive Disorder, not just because they’re sad and lethargic and Prozac will probably help.
So what happens when Pharma produces a potential blockbuster drug to treat some element of the human condition that doesn’t have an ICD-10 code as a specific disease? Why, then we have to create the disease, of course. Think Erectile Dysfunction or Obesity. And then the young, fit, smartly-dressed pharmaceutical company sales representatives will call on physicians, often bearing Starbucks lattes or Panera lunches and distribute literature that teaches those doctors how to recognize and treat these newly defined and popularized conditions. The ICD-10 code will make sure that the insurance company will cover the treatment and everyone is happy.
What would happen should someone discover a medication that careful clinical studies proved simply added a few years to the life of most of the people who took it? The side effects (there are always side effects) were rare and/or mild.
The mechanism of action of this life-extending drug might not actually be known. Aspirin was first sold commercially in 1899 but its mechanism of action wasn’t elucidated until 1971.
What would we do with such a drug? It seems that there would probably be a lot of demand, but doctors probably wouldn’t want to prescribe it “just because it will make you live longer” and, even if they did, insurance companies probably wouldn’t pay for it. You can be sure it would be expensive, at least until the patents ran out. So would we create a disease called “Mortality” so that we could prescribe the drug to delay the onset of the symptoms of Mortality (death)?
—2p