Another key component to medicalization and direct-to-consumer advertising, according to Conrad and Leiter (2004), is that information about off-label uses of drugs can be shared with both doctors and patients. 

Enbrel was approved to treat RA in 1998, Juvenile Arthritis in 1999, Psoriatic Arthritis in 2002, Ankylosing Spondylitis in 2003, and Plaque Psoriasis in 2004. 

Humira was originally discovered to treat RA in 2003, but was then also approved for Psoriatic Arthritis in 2005, and Crohn’s Disease in 2007.  It has also been proven effective in Ankylosing Spondylitis, Ulcertive Colitis, and Juvenile Arthritis. 

As we can see, the uses of these drugs have been expanding over time.  This is not to say that this is a bad thing, it’s just that we have to question if the payoff is more for the patients or more for the pharmaceutical companies. 

A key form of medicalization seen with these drugs is that they are advertised to be prescribed in combination with other drugs, such as Plaquenil and Methotrexate (i.e. Simponi). 

And it’s not just the pharmaceutical companies that have a stake in winning the drug wars.  It gets worse.  It has become clear to me that my insurance company has sold my information.  I am being flooded lately with mail about Benlysta.  Mail that tells me there were be a nurse educator in my area. 

It has all become a bit too big brother for me.

But the interesting thing is that Humira, Enbrel, and Orencia, another biologic for RA, are being plastered all over our TV screens.  This is puzzling to me.  While it is easy to imagine people thinking they may have Restless Leg Syndrome, it’s less believable to me that people are running in droves to their doctors’ offices, thinking that they may have RA.

Fibromyalgia is another story, because if you watch those commercials, it seems that anyone could have it with the symptoms they discuss.

So where does it end?  Where does patient expertise begin and end?  And for that matter, where does the expertise of medical professionals begin and end?

These days, there is a fine line between the two, and there are inherent tensions.  Sure, some doctors are prescription hogs.  They will prescribe anything to anyone.  But how do these commercials play into that?

And are they making our society hyperaware?  Are we all just one commercial away from becoming flaming hypochondriacs? 

On the one hand, these commercials give patients more agency in their health management.  But on the other, these medications are extremely expensive and come with a litany of side-effects, some still unknown. 

This is a bit of a chicken and an egg thing.  Which came first?  The medication or the disease?  In the case of RA, RA definitely came first.  But for some of the other ailments that are treated b RA, one has to wonder.