Supersizing Diabetes One Drug at a Time

When I was seven years old, my diet consisted of McDonalds, ice cream and junk food,

surrounding and fulfilling my childlike wishes, these delicious but unhealthy foods were always

at my fingertips. However, that all stopped when my dad received the news. When I was 8 years

old my dad was diagnosed with Diabetes. He had a poor diet and did not work out as often as he

should have, from that, he has forever faced the consequences. Although he wanted to avoid the

drugs, the doctors told him that it was nearly impossible to successfully change your diet and that

people most often fail. Of course like any drug, there was always a side effect. With every

prescription came a different one to help with the side-effects of the first one. This process

became never ending, with every pill came another side effect.

After he was first diagnosed I remember going to countless doctor appointments with him

when there was no one else to watch me. Patiently waiting, I would stare at the magazines on the

coffee table and the colorful pamphlets on the shelves in the reception room, showcasing the

symptoms of various illnesses and ways to treat them. The rooms always had a rather dull beige

theme with abstract coarse gray carpet patterns and carried the bitter smell of some type of

disinfectant. I remember one clinic in particular that seemed to stand out from the rest. The

waiting room of this office had odd shaped furniture and if I didn’t know any better I would have

thought they were types of sculptures, made from warped wood, metal and plastic. The chairs

and couches were comfortable and the large fish tank in the corner was somewhat mesmerizing

especially to a child. On the side of the room with the fish tank the wall was painted an

obnoxiously vibrant green color with two star-stenciled cone light sconces that seemed almost

too bright to look at. There were games and puzzle books on the table along with magazines that

made you almost forget why you were there. As if to comfort or distract the patients from the
real reason that drove them there. I remember standing in my bathroom back at home from the

doctors and seeing a few blood testing strips and injection needles along with at least a couple

pill bottles on the counter every now and then and wondering what they were for.

After being repeatedly given medications and unhappy with his doctors’

recommendations he decided to take a risk and ignore their expert advice and change his diet and

eating habits completely. Ever since I was young my dad has gone a complete 180, from when

he was first diagnosed. Because of what my dad was able to accomplish I have been able to

spend time with him without us having to worry about when the next pill, the next injection or

the next side effect will happen. Because of that, my family and I have become more conscious

with what we eat and what we do. It has been 10 years since my dad was first diagnosed and he

hasn’t touched the medication since. Ten years ago the doctors at the time continuously kept

pushing prescriptions, they never gave him an alternative solution and yet my dad was still able

to take control. He changed his lifestyle and managed to live a happy and healthy life drug free.

Growing up and seeing the major impact of healthy eating I see how crucial it is to

monitor what we put into our bodies and be conscious of the possible consequences. By

watching what struggles my dad faced to find the truth of dealing with one of the most common

illnesses in our nation I’ve developed a stronger fascination with how we handle the major

epidemic of diabetes. Over the years, I have also a developed a special interest in medicine and

find it fascinating what modern medicine can accomplish. But has modern medicine moved the

focus off of what is truly important? Shouldn’t we be worrying about how to prevent illness

rather than worry about the next step of treating and managing these diseases, and what is

stopping this? Since I was little, after watching what my dad has gone through it raised the
question for me: How has marketing affected Type 2 Diabetes and increased pharmaceutical

profits?

The pharmaceutical industry has become very successful through various marketing

techniques including direct-to-consumer advertisements, the media is a major contributor behind

the push of pharmaceutical sales. The information portrayed in pharmaceutical ads can not only

be misleading, but extremely harmful to patients. For many people suffering from this disease,

the idealistic way commercial advertising markets new products can seem too good to be true.

For many severe diabetic seniors, many turn to new drugs because they see no other choice,

“Candidly I don’t know what to believe anymore from all the drug cartel commercial messages

on TV that can remedy every physical problem known and unknown to mankind” said Philip

Arnold, a severe diabetic who has faced many complications due to his disease, including; the

need to amputate a toe, having regular eye injections and suffering from a heart attack. “Not only

might doctors end up passing out inappropriate medications, but also, drug ads could disrupt the

doctor-patient relationship…” (Siegel). When pharmaceutical ads were first introduced on

Television many doctors feared that the trust in their relationship with their patients would

diminish. Today many medication advertisements rarely explain the intended illness the drug is

supposed to treat, instead commercials advertise common symptoms and persuade viewers that

their new product would be right for them.

The marketing techniques of the pharmaceutical industry does not just stop at television

commercials. The most popular and successful way for drugs to reach patients are through the

sells of pharmaceutical representatives, known as detailing. Pharmaceutical representatives are

the face of their product’s company and through detailing, these salesmen can work their way

into popular clinics and persuade physicians to start prescribing their drug. Through the detailing
process, pharmaceutical representatives are well known to be overly charming and generous to

create a bigger bias toward themselves and their product. In detailing Doctors may also receive

gifts such as free meals and samples and vacations (Kacik).This process can be extremely

influential on doctors which make them and their patients more vulnerable to misconceive

information and this can have serious consequences. Marketing new drugs in this fashion makes

the pharmaceutical industry that much more successful, they are profiting off the illness through

the misconceptions of the messages that professionals feed to patients. During a study conducted

at UCLA, Dr. Ian Larkin and Dr. George Loewenstein at Carnegie Mellon University tested the

correlation with doctors and drug corporations by studying the effects of policies on prescription

patterns in many academic medical centers, “They examined prescriptions in 19 academic

medical centers that restricted detailing from January 2006 to June 2012. More than 2,000

doctors were affiliated with the centers”(Wein). During an interview with a current

pharmaceutical representative, John Varellas shed light on the misfortunate way the industry

markets to their patients:

It’s not misleading in that you don’t tell the doctor the wrong thing, or patient the wrong
thing, but what you do is that you don’t tell them everything, you only tell them the good
stuff, you only tell them the stuff they see in commercials. You don’t talk about the side-
effects you don’t talk about the cost...And unfortunately the pharmaceutical industry
treats medications as competition, and they treat them like iPhones...Well whether you
have a Samsung or an iPhone doesn’t dictate whether you live or die, but whether you
have a certain medication or not could dictate whether you live or die. So it’s misleading
in that they treat them like luxury items as opposed to necessities. It sends the wrong
message.

Recently because of the unfair bias that representatives can create in clinics and

academic medical centers, there has been slow progress of bans to end the visitations. Regardless

of the validity of these various medications the pharmaceutical industry is advicaly treating the
sales of their drugs like competition. According to Dr. Alphaeus Wise, a clinic physician whom

is very familiar with Type 2 Diabetes, explained that many doctors prescribe the main first step

basic medications to their patients for Type 2 Diabetes, such as Metformin Januvia, and

Glyburide, all treating the same illness but in different ways. These drugs have been common

prescriptions for patients because of their seniority on the market and the effective results.

Although these drugs have been effective over the years, many of the drug’s messages have

changed over time, affecting how and who the doctors administer them for. From the marketing

experience of Varellas, many representatives like himself started off selling antidiabetic drugs to

clinics and were given very specific instructions: “that the drug was for severe diabetics only”.

Yet after only a few years, the marketing message from the corporations changed to serving all

diabetics, no matter how mild their condition. Marketing new antidiabetic medications to

doctors, pharmaceutical representatives can create an unfair bias for their product, causing

doctors to prescribe medications that may not be perfectly suitable for their patients. For Type 2

Diabetes specifically, the push of drugs on patients who are still classified as pre-diabetics may

see the medications as the only solution. Serious negative effects of constantly consuming anti-

diabetic drugs can also result in anemia, hepatitis, hypoglycemia and forming an insulin

resistance (Vukovic). For others, the constant presence of the drugs can be seen as an easy way

out, but the healthiest most effective way to curing this issue is to push patients change their

lifestyle. The advice marketed by the American Diabetes Association with given portion sizes

and advised carb intake, can actually be extremely harmful (Petersen). Major trusted

corporations that advocate to help the disease are are portraying misinformation, drug advertising

and harmful unhealthy diet plans, the excess of information is too confusing and hard for patients

to know who to trust,and many doctors including Dr. Wise agree. In today’s medical world, there
are numerous ways of treating illnesses and making change and yet the diabetes epidemic is still

a prevalent issue.

Other than the direct marketing by the pharmaceutical industry, the influence of false

advertising of nutritional products has a major impact in a diabetic’s journey towards a healthier

lifestyle. By false advertising diet plans and non-fat options to people that may be struggling

with serious weight issues it can have nothing but negative effects. In turn, marketing these

unhealthy foods as “healthy”, more people with a diabetic problem may turn to the alternative

options, and in result force them to stay on their medication. An example of popular food

misconceptions is the marketing used for Minute Maid. Minute Maid has an "all natural" label on

their Cranberry Apple Cocktail. Yet the product contains added citric acid, and corn syrup,

meaning, according to the FDA it should be prohibited from using the term ‘natural’ in their

juice that it did not occur naturally in the juice but it is not the only food company that

manufactures labels to exaggerate the amount of healthy ingredients (Shapely). Many

corporations are notorious for false advertising and some are more conspicuous than others.

Odwalla Juice for example markets their verified non-GMO, no added sugar juice drinks as

healthy and nutritional when in reality it has almost double the amount of calories and

carbohydrates than sodas, “food systems are not driven to deliver optimal human diets but to

maximize profits”(Stuckler). Thanks to today’s marketing messages many average households in

the U.S., have viewed various types of juice, cereal, and yogurt as a prevalent “healthy” food

choice, which is only increasing the epidemic of Type 2 Diabetes. For severe diabetics this

problem could be detrimental to their life and impair their ability of managing their sugar

consumption. Although most patients rather change to a healthy lifestyle to wean off medication,

thanks to the false nutritional claims of food companies, it makes this task almost impossible to
accomplish. Type 2 Diabetes will be a constant increasing factor, due to the misleading

advertisements of major food corporations and the pharmaceutical industry, patients are being

constantly fed information that can be extremely damaging to their health. “ Food marketing

practices aimed at children...are criticized given that kids are unable to distinguish between truth

and fiction in advertising and that such advertisements stimulate them to eat high-calorie, low-

nutrient food and beverage products”(Elliot). Because of these reckless marketing claims, Type 2

Diabetes will remain a constant threat to Americans, forcing patients to stick to their

prescriptions, and for many this added necessity can be almost detrimental to their health and to

their wallet. With every false advertisement, pharmaceutical profits increase while the health of

millions of Americans are worsening.

Over the last few decades the total revenue of pharmaceutical profits have almost more

than doubled. “Pharmaceutical and biotechnology sales revenue increased about 45%, from $534

billion to $775 billion from 2006 to 2015, according to a recent report from the U.S. Government

Accountability Office” (Kacik). With the increase of sickness of Americans the pharmaceutical

industry is only growing greater and it is all thanks to marketing. The American population is

extremely vulnerable to advertising and it is not always subliminal. To the pharmaceutical

industry diabetes alone contributes about $300 billion dollars, an income that corporations are

not willing to lose. The marketing of false advertisements or misleading information is a major

reason why this disease has been so devastating in our country. It’s also possible that copays or

coinsurance percentages are rising to meet the increased cost of these drugs. Assistant professor

of medicine at Yale, Kasia Lipska, MD, MSH, discovered a new evidence of increasing profits

while looking into out of pocket costs“ her 2014 Journal of the American Medical Association

study...costs of insulin for people with type 2 diabetes, she found that among the commercially
insured population that her team analyzed, out-of-pocket costs for insulin increased by 89

percent from 2000 to 2010”(Tsai). Over the years while more corporations advance in their sales

of insulin drugs have become more expensive and patients have become more dependant. “About

two-thirds of drug companies saw their profit margins increase over that period, averaging

17.=1%. Meanwhile, research and development spending increased just 8%, according to the

report”(Kacik). For a decade diabetic medication has barely progressed in development, and yet

prices and marketing messages have seemed to change dramatically.

Type 2 Diabetes is the seventh leading cause of death in the U.S. affecting about 29.1

million people. The average marginal revenue that Type 2 Diabetes brings to the pharmaceutical

industry is 5-6 million dollars. Most people wonder why the America’s health problem has still

not been resolved but it is rather clear when examining the profits gained by corporations

through marketing. It is not uncommon knowledge that diet needs to change but that is easier

said than done, especially when advertising by major corporations are so relentless in regards to

making money. The pharmaceutical industry has not stopped with their efforts to continue the

push of prescriptions. In today’s society especially it is almost impossible to know who and what

information to trust, when media, corporations, and even well-known doctors are giving

misleading information to patients just for an extra buck. Like any other industry, pharmaceutical

corporations treat their market like a competition. The increase of unhealthy foods are a

complement to the inevitable outcome of increase in prescription profits.With illness, brings an

increase in revenue. Through thorough research and investigation the only answer that can be

certain is it is more important to worry about preventing the disease rather than focusing on how

to treat it. Many of the foods we may see as “healthy” are really the opposite. Not only is Type 2
Diabetes an issue that a major portion of the country is suffering from, it is also a big money

maker.

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Stuckler D, Nestle M. Big food, food systems, and global health. PLoS Med. 2012

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Tsai, Allison. “The Rising Cost of Insulin.” Diabetes Forecast, The Healthy Living

Magazine, Mar. 2016, www.diabetesforecast.org/2016/mar-apr/rising-costs-insulin.html.

Varellas, John, Personal Interview, 28 February 2018

Vukovic, Laurel. "Natural diabetes relief." Natural Health, May 2000, p. 60. Student

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