Saturday, February 13, 2010


Once again antidepressants are in the news.

There was a January Newsweek story ( about how little affect antidepressants really have on depression. I really encourage people to read the Newsweek article.

There continues to be more research showing that placebos (sugar pills) are as effective as antidepressants. So, with all of this data why are antidepressants becoming more and more popular? And with no true data to support the effectiveness of antidepressants, why are pharmaceutical companies continuing to create more antidepressants?

Well, let's look at it this way...

If you were running a pharmaceutical company and could choose one of the following areas to pursue, which would you? Here is a very simple analysis:

Area 1 - Serious psychological illnesses like schizophrenia.

Characteristics: easy to diagnose when someone suffers from it - easy to tell when someone improves from treatment.
Market size: very small percentage of the population, but the patient must take the medication the remainder of his/her life. Good long term sales but low volume.

Area 2 - Bacterial infections.

Characteristics: easy to diagnose the condition - also easy to tell when someone improves.
Market size: Potentially large, anyone can get an infection. One big downside, you only take the medication until the infection is healed. All sales are short term. Sales are great when there is a major outbreak of infections though.

Area 3 - Depression

Characteristics: not easy to diagnose clearly - a very wide range of levels of depression. Although there are outward symptoms a great deal of the diagnosis is based on patient self report...much like pain.
Market size: The entire population, virtually everyone displays some of the symptoms of depression at some time (as the Zoloft commercial says we all feel a little down at times.) Plus, the patient, once on antidepressants must take them the rest of his/her life. Excellent potential volume and long term sales.

So, strictly from a profit standpoint, which drug makes the most sense to pursue? Ones that have clear symptoms and limited markets or a drug for a condition that is hard to determine with a huge market...with a lifetime of use?

Hmmmm. So, you make the choice...

Of course, one would hope that someone at a pharmaceutical company might be more concerned about ethics and health, than just profits...but then maybe I am just a dreamer.

How does the saying go, "Just follow the money..."

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