tag:blogger.com,1999:blog-1732132352927731247.post6178754395567653460..comments2024-03-16T00:27:31.848-07:00Comments on Hooked: Ethics, Medicine, and Pharma: The Next Vioxx? Disease-Mongering "Low T"Howard Brodyhttp://www.blogger.com/profile/00599587504924835039noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-1732132352927731247.post-75433268610477429652013-12-15T06:27:03.838-08:002013-12-15T06:27:03.838-08:00Instead, how about:
The Next Prempro? Disease-Mong...Instead, how about:<br />The Next Prempro? Disease-Mongering “Low T"...So why does "low T" sound like the next Prempro waiting to happen...<br /><br />Another article directed to consumer readers complements the New York Times article:<br /><br />RX for Change: The Low-Down on Low-T (or Menopause for Men)<br />By Charlea Massion and Adriane Fugh-Berman<br />National Women’s Health Network<br />The Women's Health Activist, September/October 2013<br />https://nwhn.org/newsletter/node/1591; accessed Dec. 14, 2013<br /><br />“Does the man in your life have ‘Low-T’ (low testosterone) Syndrome? Oh, wait; make that ‘the men in your life’ — chances are any of the men you know over age 40 qualify for a diagnosis.<br /><br />“The promotion of ‘Low-T’ to consumers eerily parallels the promotion of ‘estrogen deficiency’ to women and prescribers....the benefits of hormones for preventing heart attacks, strokes, dementia, and wrinkles were extolled without scientific proof.... the Women’s Health Initiative (a large, long-term, Federally-funded randomized controlled trial) found that menopause hormone therapy increased the risk of breast cancer, blood clots, dementia, and cardiovascular disease.... <br /><br />“Now, pharmaceutical companies are targeting men, the women who influence them, and health care providers who can prescribe testosterone.”<br /><br />Two JAMA Internal Medicine articles provide additional insight into the disease-mongering of “low-T”.<br /><br />One is Schwartz LM, Woloshin S. Low "T" as in "template": how to sell disease. JAMA Intern Med. 2013 Aug 12;173(15):1460-1462. This article stated, “The Low T campaign provides a template for understanding how disease awareness campaigns work. Like other campaigns (eg, Bipolar Disorder and Restless Legs Syndrome), the Low T campaign uses 3 basic strategies: lower the bar for diagnosis (turning ordinary life experiences into conditions that require medical diagnoses), raise the stakes so that people want to get tested (it is one thing to tell men that Low T can make them grumpy; it is another to say that it can kill them) and spin the evidence about drug benefits and harms.<br /><br />The other article is Braun SR. Promoting "Low T": A Medical Writer's Perspective. JAMA Intern Med. 2013 Aug 12;173(15):1458-1460. The article explains how the author, a medical writer, ghostwrote articles under the name of a well-known endocrinologist for consumer magazines about the “hazards” of low T and the availability of new forms of testosterone replacement therapy (TRT). I found this to be of particular interest, inasmuch as I thought of medical ghostwriting in relation to the concealed role of drug companies in the preparation of medical journal articles under the names of experts.<br /><br />Braun’s article continues to explain how he prepared a patient education booklet carefully spun by a pharmaceutical company manufacturer of a TRT to be blandly accurate and effective at transmitting the company’s core messages. Finally, the article describes development of a consensus statement about TRT from panel meeting all of whose members had received support from by a pharmaceutical company manufacturer of a TRT that in turn was sponsoring the meeting. The workings of such a panel are described in interesting detail.Michael S. Altus, PhD, ELShttp://www.intensivecarecomm.comnoreply@blogger.com