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    Disease definitions linked to pharmaceutical companies


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    Disease definitions linked to pharmaceutical companies

    Post by graham64 on Sun Jul 05 2015, 22:35

    Connections between drug companies and panels that define diseases raise questions about who is considered ill and how drug markets are expanded.

    A few weeks ago, ABC Radio aired a frightening item stating one in 10 Australians has “chronic kidney disease”, CKD, and most don’t know they have it. The story prominently featured fear of early death, and the salutary tale of a young man who belatedly discovered advanced kidney disease needing medical attention. What the ABC story didn’t reveal was that the definition of kidney disease has been dramatically and controversially expanded in recent years by experts and organisations with direct links to pharmaceutical companies.

    The broad new CKD definition arose in 2002 from a partnership between the United States National Kidney Foundation and Amgen, a big drug company. Experts arbitrarily set the disease cutoff at half the “normal” kidney function of a young adult – a controversial decision that automatically declared almost half of the elderly as “diseased”, because kidney function changes as we age.

    As it happens, many of the people labelled under this definition of “chronic kidney disease” will – bizarrely – never experience any kidney disease. As one British kidney charity explains, “often CKD is only a very slight abnormality” and many of the elderly people classified as having CKD may have “normal ageing of their kidneys”.

    Despite a decade of criticism of this broad definition of CKD, drug-company-funded organisations have strongly defended it. In 2012, a group of experts reaffirmed it: more than half of them also had financial ties to drug companies or device makers.

    CKD is not an isolated case but an example of a much bigger problem in medicine affecting all of us. Disease definitions are being expanded and diagnostic thresholds lowered so relentlessly that many of us with mild problems or at very low risk of future illness are being unnecessarily labelled as sick, and the rules are often being changed by people with egregious conflicts of interest.

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