by Daniel R. Hoffman, Ph.D.
Here are some impressions from the recent American Diabetes Association annual research meeting at the Pennsylvania Convention Center. (See full coverage of the conference.)
- This meeting seemed somewhat smaller than those of past years. That was evident in terms of both the number of booths on the exhibit floor and the opulence of those that were there. That's probably a good thing because it likely means the pharmas at least wanted to tone down the appearance of staging a huge marketing and payoff bazaar.
- A larger proportion of attendees were physicians from outside the U.S. Some exhibitors even cited ADA registration figures that showed 60 percent of attendees at this ADA meeting came from foreign countries. That may be good if it means more physicians are flying in for the scientific sessions. Correspondingly, it would also mean fewer physicians, especially in the U.S., come looking for freebies such as continuing medical education courses that are inevitably biased to favor the products from sponsoring manufacturers. Then again, a higher proportion of foreign physicians may simply mean that manufacturers are targeting more of their marketing efforts to the emerging markets because practitioners there can be swayed more easily and for less money.
- The celebrity perks that pharmas bestow on KOL (key opinion leader) presenters appear less overt. It's probable that the companies still treat big-name investigators with the same sort of wine 'em and dine 'em benefits that defense and homeland security contractors give to military brass, but conditions these days keep it under tighter wraps. Despite the general appearance of less opulence, however, some people overheard a prima donna diabetologist emerging from a parked limo on Arch Street as he berated his sponsor's minder for failing to stock the back seat cooler with the right Pinot Noir.
- A growing number of studies show healthy lifestyle is a more important determinant of longevity and well being than what was previously believed. Another study that came to this conclusion appeared just a few weeks ago. Diabetes is one condition where this finding appears especially relevant, yet pharma's commitment to wellness and prevention still consists mainly of promotions intended to hype their products. As noted in a Sunday Inquirer column, pharma creates a counterproductive attitude among the general public by taking this approach. Instead of encouraging healthy living patterns, the over-medicalization of everyday life fosters the idea that more pills will solve everything. This pills über alles mindset promotes the notion that unhealthy ways of living are themselves medical conditions that require still more pills.
Finally, pharma is by no means the sole or even the major delinquent in the matter of diabetes as a public health problem. News of that appeared outside the ADA in an excellent article published by the UK's Guardian. It shows how the food industry deserves more of the blame for increasing rates of obesity and diabetes. The problem began as far back as the 1970s with the use of corn sugar as a sweetener. At the same time, the U.S. under the Nixon administration adopted the approach of an uncontrolled market as the answer to everything. The administration's Agriculture Department encouraged a more corporatized approach to farming for global customers that resulted in extremely large serving portions.
So in part, the ADA was a distraction from reality where more answers to the public health problem of diabetes depend on an altered political economy instead of results from the lab or the clinic.