Boomers Firing Magic Bullets at Signs of Aging
Rather than rage against the indignities of age, Americans in record numbers are reaching for prescription drugs designed not so much to cure illness as to bolster the quality of life, a trend that has pharmaceutical companies feverishly developing 178 new compounds aimed solely at the symptoms of aging.
From the anti-impotence treatment Viagra to bone-density regulators and baldness remedies, the new drugs capitalize on recent insights into the biology of aging. They promise billions in revenues to buoy corporate profit margins well into the middle of the next century, industry analysts say.
Three weeks after being introduced, Viagra accounted for a remarkable 94% of all new prescriptions dispensed in the United States, according to IMS America, a health care information company that monitors national drug sales.
That kind of demand has at least 91 pharmaceutical companies accelerating research into new anti-aging medicines meant to enhance a sense of well-being, with 46 more prescription drugs in development today than at this time last year.
For the 76 million potential customers of the baby boom generation, who are turning 50 at the rate of one every 10 seconds, the expensive pills and prescription nostrums are the newest weapons in a war on time.
“We are concerned that we may be living longer, but not living better,” said Dr. Gary Small, a psychiatrist who heads the UCLA Center on Aging. “These kinds of medications attempt to push the envelope in quality of life.”
In a sense, for the men and women who elevated scheduling aids such as Filofaxes and electronic PalmPilots to the status of tribal talismans, these new magic bullets aimed at aging are the ultimate form of time management. Certainly, the generation that embraced aerobics and indoor cycling classes to feel the burn is more likely today to feel the backache instead--and the upset stomach from the painkiller taken to relieve it.
In response, drug company researchers are busily testing an entire class of new anti-inflammatory drugs that do not irritate the stomach lining.
Indeed, in their pursuit of anti-aging compounds, the pharmaceutical firms are simply trying to catch up to a generation of affluent self-medicators, who have already embraced a range of herbal remedies and health store palliatives in an effort to hang on to vitality.
Unbidden by any doctor, they take ginkgo biloba to reinvigorate their brains, African tree bark to pump up their libidos, saw palmetto for their prostate--and chase it down with mixtures of chelated minerals and amino acids for energy.
To get their attention, drug companies today spend hundreds of millions of dollars on advertising aimed directly at these health-conscious consumers to ensure that they embrace the new prescription medications.
All of this arises from changing attitudes toward age itself, the ability of medicine to do something to soften the blows of time and the desire to profit from it.
“We are hammering home the idea that if you want quality of life, you really are going to have to pay for it,” said health industry consultant Myron Holubiak, general manager of the Plymouth Group.
Better Living Through Science
That is just the beginning.
“We have medicalized everything” about growing older, treating a natural process as if it were pathological, said Dr. Stanley Korenman, UCLA’s chief of endocrinology and head of its medical ethics program. “We have medicalized the feeling of being irritable. We have medicalized menopause. We have medicalized the feeling of being tired and worn out when you get older.
“There is a physiological basis for everything, and we are getting better and better at doing something about it,” said Korenman, who has studied several of the hormones touted as fountain-of-youth drugs.
No matter how headstrong or well-informed a patient, the doctor still is the one responsible for dispensing any prescription drug. Once a new drug is approved by the FDA, however, doctors may write a prescription for any reason they deem appropriate.
Many doctors bow to patient pressure and overprescribe conventional medications like antibiotics, health care experts said. They may be equally pliable when it comes to the new lifestyle drugs, prescribing them even when there is no pressing clinical need or for purposes not among those approved by the FDA.
Indeed, a new federal law passed in December allows drug companies to promote such unapproved “off-label” uses directly to physicians, as long as there is some medical evidence to back up the claim.
Certainly, many of the new prescription products are aimed at some of the most devastating scourges of age. There is at least $20 billion being spent for research on 400 new drugs to ward off heart ailments, strokes, cancer and other severe conditions attending old age.
For Those Who Think Young
But a growing number of medications blur the line between the treatment of classical clinical conditions and the medical maintenance of an essentially cosmetic, healthy self-image, experts say.
“There is concern for weight, for hair growth, for sexual prowess, for depression,” said Holubiak. And a growing inclination to fix it with a drug.
Anxious about baldness? Rub a little minoxidil on that pate. Or reach for a new $50-a-month prescription remedy called Propecia, which is expected to generate $300 million in sales this year.
A prescription for a new diet pill called Meridia might shrink that middle-aged spread. Renova can help make those wrinkles disappear, while Bristol-Myers Squibb is testing a compound to eliminate those unsightly sunspots.
Meanwhile, there is a new pill to lower cholesterol called Lipitor, which last year accounted for 8.4-million prescriptions and $582.7 million in first-year sales--a record that may soon be broken by Viagra.
Forgetful? Last year, the first significant drug to offset age-related memory loss, called Aricept, came on the market. Seventeen more drugs aimed at alleviating this problem and other symptoms of Alzheimer’s disease are being tested.
Knees and elbows stiffening? Here comes Celebra, expected to be the first significant new arthritis medicine in more than a decade. It is expected to go on sale in a year. Another two dozen medications for this ailment are in development.
In addition, there is Sonata to help speed the sleep that so often eludes the elderly, Evista to control bone loss, and to relieve the embarrassment of the incontinence that can accompany aging, a new drug called Detrol. Six more bladder-control drugs are on the way.
If all this isn’t enough to keep a midlife crisis at bay, there are nine antidepressants in the works, according to a survey by the Pharmaceutical Research and Manufacturers Assn.
And, of course, there is Viagra, at $10 retail for each bright blue pill. Analysts estimate that 36,000 prescriptions were written in the first week it was on the market and 113,000 the second. Worldwide sales may eventually top $4 billion--almost twice the amount spent on the antidepressant Prozac every year.
Like many of the conditions targeted by the new pharmaceuticals, impotence itself is a symptom rather than a disease in its own right. It is associated with heart disease, high blood pressure, diabetes and prostate trouble, in addition to psychological causes.
It also is associated with increasing age. Almost half the men seeking such treatments for sexual dysfunction are 40 to 59, health care analysts say. And the numbers of such patients have been growing about 15% a year, industry surveys show.
The drug’s manufacturer, New York-based Pfizer Inc., and Boston University are conducting studies to see if Viagra can be as effective a restorative for women suffering sexual dysfunction. Four other anti-impotence drugs are in development.
Behind the counter at the Regent Square Pharmacy in Santa Monica, Dick Hepp, who has been filling prescriptions since 1954, has already handled as many as 70 for Viagra and has been turning away people who are “dismayed when they find out they need a prescription, even though there are side effects.” Those range from partial colorblindness to headaches to unusually prolonged erections.
At the boutique Brentwood Pharmacy, Homer Namjo was filling more prescriptions last week for Viagra than for antibiotics.
He sees the new drug as part of a growing number of prescription and over-the-counter treatments aimed at restoring a sense of youthful vigor to aging bodies.
“The number of drugs related to quality-of-life problems has increased tremendously, especially over-the-counter medications,” Namjo said. “They all claim they will improve quality of life, increase energy, reverse aging problems.
“Ten years ago, there were only the antioxidants like vitamin E and vitamin A. Now there seem to be thousands [of quality-of-life treatments]. Every day, a company comes up with a new one,” he said.
Keeping Luster in Golden Years
Some of this simply reflects the graying of America.
Every day, about 6,000 people in the United States celebrate their 65th birthday, with nearly 35 million over 65 today compared to barely a tenth that many at the beginning of the century. By the year 2030, one in five Americans will be over 65.
While life spans are longer, expectations are also higher.
A recent study by Ortho Pharmaceutical Corp. found that three in four baby boomers think they look younger than their age, and eight in 10 say they have fewer signs of facial aging than others their age. Almost three in four say a 50-year-old a generation ago “looked a lot older” than a 50-year-old today.
To ensure that they continue to like what they see in the mirror, these aging boomers are more inclined to take charge of their own medical treatment, prompted partly by the changing economics of medicine, experts say.
“When it comes to health care, baby boomers look after their own self-interest more,” said Daniel C. Robinson, head of the clinical pharmacy department at USC. “They may ask for specific treatment plans and regimens. In previous generations, it might have been left up to the physician.”
Certainly, quality-of-life pharmacology is cause for celebration in many ways, but the new prescription drugs also pose troubling questions for a country already debating how to ration health care, said USC’s Caleb Finch, a leading authority on aging.
Those health benefits administrators being asked to approve coverage of Viagra pills already are debating how much sex is enough, at least for insurance purposes.
Soon, they may be asked to weigh the cost of a sense of well-being.
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Fending Off Old Age
Pharmaceutical companies have 178 new drugs in development to combat the symptoms of aging, according to the most recent industry study. But a growing number blur the line between treating clinical conditions and maintaining a sense of physical well-being.
Ailment: Alzheimer’s disease
Medicines: 17
Ailment: Bladder/kidney disorders
Medicines: 11
Ailment: Depression
Medicines: 9
Ailment: Diabetes
Medicines: 21
Ailment: Eye disorders
Medicines: 8
Ailment: Impotence
Medicines: 4
Ailment: Osteoarthritis
Medicines: 5
Ailment: Osteoporosis
Medicines: 23
Ailment: Paget’s bone disease
Medicines: 2
Ailment: Parkinson’s disease
Medicines: 12
Ailment: Prostate disease
Medicines: 3
Ailment: Respiratory/lung disorders
Medicines: 24
Ailment: Rheumatoid arthritis
Medicines: 24
Ailment: Sepsis
Medicines: 9
Ailment: Skin conditions
Medicines: 11
Ailment: Hair loss and other conditions
Medicines: 13
* Source: PHarmaceutical Research and Manyfacturers Assn.
