Drugmakers provide grants for ‘murky’ disease
February 9, 2009
The Associated Press reports that two drugmakers-Eli Lily and Pfizer- spent hundreds of millions of dollars last year to raise awareness of a murky illness-fibromyalgia-helping boost sales of pills approved as treatments and drowning out unresolved questions--including whether it''s a real disease at all. More than $6 million was donated by drugmakers Eli Lilly and Pfizer in the first three quarters of 2008 to nonprofit groups for medical conferences and educational campaigns, an Associated Press analysis found. Fibromyalgia draws skepticism for several reasons. The cause is unknown. There are no tests to confirm a diagnosis. Many patients also fit the criteria for chronic fatigue syndrome and other pain ailments. Experts don''t doubt the patients are in pain. They differ on what to call it and how to treat it. Many doctors and patients say the drugmakers are educating the medical establishment about a misunderstood illness, much as they did with depression in the 1980s. Those with fibromyalgia have often had to fight perceptions that they are hypochondriacs, or even faking their pain. But critics say the companies are hyping fibromyalgia along with their treatments, and that the grantmaking is a textbook example of how drugmakers unduly influence doctors and patients. Whatever the motive, the push has paid off. Between the first quarter of 2007 and the fourth quarter of 2008, sales rose from $395 million to $702 million for Pfizer''s Lyrica, and $442 million to $721 million for Lilly''s antidepressant Cymbalta. The Food and Drug Administration have approved Cymbalta and Lyrica as a treatment for fibromyalgia. The FDA approved the drugs because they''ve been shown to reduce pain in fibromyalgia patients, though it''s not clear how. The drugmakers'' grant making is also plagued by advertisement spending. Eli Lilly spent roughly $128.4 million in the first three quarters of 2008 on ads to promote Cymbalta, according to TNS Media Intelligence. Pfizer Inc. spent more than $125 million advertising Lyrica. But some say the grants'' influence goes much further than dollar figures suggest. Such efforts steer attention to diseases, influencing patients and doctors and making diagnosis more frequent, they say. Many of the grants go to educational programs for doctors that feature seminars on the latest treatments and discoveries. Pfizer says it has no control over which experts are invited to the conferences it sponsors. Skeptics are occasionally asked to attend. The drug industry''s grants also help fill out the budgets of nonprofit disease advocacy groups, which pay for educational programs and patient outreach and also fund some research. Pfizer gave $2.2 million and Lilly gave $3.9 million in grants and donations related to fibromyalgia in the first three quarters of last year, the AP found. Those funds represented 4 percent of Pfizer''s giving and about 9 percent of Eli Lilly''s. Eli Lilly, Pfizer and a handful of other companies began disclosing their grants only in the past two years, after coming under scrutiny from federal lawmakers. The American College of Rheumatology estimates that between 6 million and 12 million people in the U.S. have fibromyalgia, more than 80 percent of them women. People with fibromyalgia experience widespread muscle pain and other symptoms including fatigue, headache and depression.