Medicalization of Fibromyalgia
Feb 08, 2009 23:22 Filed in: Work
As many of you know, I work with Fred Wolfe in
running the National Data Bank for Rheumatic
Diseases (we go by NDB and not NDBRD). He
appeared in the AP news today in this story about
Fibromyalgia (FMS).
While it does cover a few of the issues of the problem, it’s weird that there’s only two quotes from Fred, yet says “"I think the purpose of most pharmaceutical company efforts is to do a little disease-mongering and to have people use their drugs," said Dr. Frederick Wolfe, who was lead author of the guidelines defining fibromyalgia in 1990 but has since become one of its leading skeptics.” He wrote a wonderful chapter about FMS in Kelley’s book of Rheumatology that came out last year that covers the topic in greater detail. Plus we’re working with the top FMS doctors in the country in devising a new and updated criteria for diagnosing FMS. Not sure what the AP means by “leading skeptics” and I’m concerned that this will hurt the NDB in our patient participation as FMS patients have zero tolerance for anything that may make them think they aren’t being taken seriously (which is far from the truth - if anything, we’ve done a lot more FMS outcomes research than anyone at UNMC wants us to).
It’s a thorny issue. The pain and problems faced by these patients is real, but the recognition of FMS as a disease by the FDA & ACR hasn’t led to the solution of the problem, but rather to a lot of drugs first approved for other less common problems and then major marketing of them in FMS. There’s the very real concern that the number of patients diagnosed with FMS will increase dramatically after this push by Pharma just like the number increased dramatically after FMS was first named in the 80s (this isn’t coming from Fred, just my own thoughts). Fred was invited to speak at a FMS conference recently, but was uninvited when he said he wanted to talk about medicalization & disease mongering (a talk that he gave to a packed house at UBC in Vancouver last fall - you have less pharma money for such things outside the US).
A fellow rheumatologist and noted opinion-writer, Nortin Hadler, was also quoted in the above AP article. He makes some good points in general, but is often considered to be on the further end of the spectrum on these debates (always interesting, though - his books are thought provoking). Here’s one of his articles now sponsored by abc on heart disease.
While it does cover a few of the issues of the problem, it’s weird that there’s only two quotes from Fred, yet says “"I think the purpose of most pharmaceutical company efforts is to do a little disease-mongering and to have people use their drugs," said Dr. Frederick Wolfe, who was lead author of the guidelines defining fibromyalgia in 1990 but has since become one of its leading skeptics.” He wrote a wonderful chapter about FMS in Kelley’s book of Rheumatology that came out last year that covers the topic in greater detail. Plus we’re working with the top FMS doctors in the country in devising a new and updated criteria for diagnosing FMS. Not sure what the AP means by “leading skeptics” and I’m concerned that this will hurt the NDB in our patient participation as FMS patients have zero tolerance for anything that may make them think they aren’t being taken seriously (which is far from the truth - if anything, we’ve done a lot more FMS outcomes research than anyone at UNMC wants us to).
It’s a thorny issue. The pain and problems faced by these patients is real, but the recognition of FMS as a disease by the FDA & ACR hasn’t led to the solution of the problem, but rather to a lot of drugs first approved for other less common problems and then major marketing of them in FMS. There’s the very real concern that the number of patients diagnosed with FMS will increase dramatically after this push by Pharma just like the number increased dramatically after FMS was first named in the 80s (this isn’t coming from Fred, just my own thoughts). Fred was invited to speak at a FMS conference recently, but was uninvited when he said he wanted to talk about medicalization & disease mongering (a talk that he gave to a packed house at UBC in Vancouver last fall - you have less pharma money for such things outside the US).
A fellow rheumatologist and noted opinion-writer, Nortin Hadler, was also quoted in the above AP article. He makes some good points in general, but is often considered to be on the further end of the spectrum on these debates (always interesting, though - his books are thought provoking). Here’s one of his articles now sponsored by abc on heart disease.
|