Modern technology has its uses from time-to-time, one of the most handy devices being that little gadget you hold in your hand when watching the telly that enables you to zap off the commercials—without all the effort of getting out of your chair!
Those of us who sometimes neglect to operate this self-protective mechanism may have noticed the increasing frequency of medical advertising on the box. We tend to think of TV as being exclusively given over to cars, soap powders, gravy powder and beer, these being usually the most excruciating or, rarely, the opposite—the funniest. But this is not really the case. There has always been a steady stream of non-prescription drug advertising, mostly instantly forgettable because of being so mediocre.
Just lately two drugs arrived on the scene—TAGEMET and ZANTAC. To anyone who has suffered the pains of gastric or duodenal ulcer in the last twenty years or so there is nothing new about these old-timers. But until recently they could only be obtained on prescription and since doctors were only too happy to prescribe by the million, there was never any need to advertise to the public (doctors, of course, have a steady volume of medical advertising pushed through their letterboxes but that is another matter). The difference is that these drugs, formerly only obtainable through your GP are now available to anyone going into a chemists.
Why is this? The reason is that the manufacturers are pushing a lower strength compound, not for the treatment of ulcers, but as a remedy for all those troublesome but less serious problems which afflict so many, the tummy upsets and indigestion formerly the monopoly of Rennies and suchlike. This is a serious attempt to expand a market into competitive fields. Tagemet and Zantac, produced respectively by SmithKline Beecham and Glaxo have been, along with Losec, some of the most lucrative drugs of all time. Zantac, trade name for ranitidine, sells $3.5 billion-worth a year, Losec trade name of omeprazole, $1.6 billion and Tagemet containing cimetidine accounts for $l billion. Looked at from the manufacturer’s viewpoint they were the ideal drug—they relieved the symptoms but never made a cure, meaning that you had to keep taking them for evermore to keep the pain at bay. Although there were never any trials carried out for long-term usage, many doctors issued repeat prescriptions, sometimes for years.
So what has changed this capitalist idyll? It all began in Australia some fifteen years ago when an Australian doctor, curious as to what really happened with stomach ulcers and thinking of himself along good socialist lines, came up with the idea that the real causative agent was a bacterium, named Helicobacter Pylori. Up to this point the consensus of medical opinion was that foreign bacteria could not survive in the stomach and duodenum on account of the presence of gastric acid, and that the main cause of ulcers was over-secretion of acid brought about mainly by stress, alcohol and faulty eating habits. The treatment of choice was our old friends mentioned above, which worked by reducing the amount of gastric acid produced and were known as acid-inhibitors. It is now believed that one of the reasons for excess acid production was the body’s response to infection and the acid was an attempt to kill off H. Pylori, unfortunately making things worse for the sufferer. Anyway whatever the true reasons, maybe our Aussie doctor came up with a solution which worked—a cocktail of antibiotics taken originally for about a month, now reduced to two weeks.
After the customary’ resistance to any change of ideas from the medical profession, this treatment has now become standard practice and in the overwhelming majority of cases permanent relief is obtained after a two or three week treatment. This short medical digression was unfortunately necessary to explain why SmithKline Beecham, Glaxo and Astra are seeking new outlets for their million-dollar products. Needless to say their medical spokesmen conducted a bitter fight to discredit the new thinking, but in the end had to give way.
New markets will have to be found if profits are going to be maintained, but it is unlikely that they will find any niche which hasn’t been cornered by other producers such as Bismuth and the popular antacids. It will be interesting to see what happens—ulcer sufferers will be a lot happier, of course, especially if they ever came across any of the side-effects of the acid-inhibitors such as dizziness, fatigue, headaches, liver dysfunction, blood disorders, confusion, interstitial nephritis, all reported as rare, but nonetheless real.
Cyril Evans
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