Thursday, October 19, 2006

Cymbalta: Flooding the Market

Lilly has been busy pushing duloxetine (Cymbalta) via its "depression hurts" ad campaign as well as (I suspect) drug reps "educating" doctors about its wonders.

I did a brief literature search via PubMed to see what all the hype was about. I found one study that compared paroxetine to duloxetine which found no significant benefit for duloxetine over paroxetine. Link here. I couldn't find anything else comparing it to another medication. Seems like its modest benefits are similar to the rest of its competitors, many of which can be purchased much more inexpensively in generic form.

Then there is the issue of flooding journals with highly similar studies. For example, one study examined the effects of duloxetine on males versus females -- link here. Another examined the effects of duloxetine on Whites versus Blacks -- link here. But wait, there's more -- an article comparing Whites to Hispanics -- link here. All of these include overlapping authors. Do these really warrant separate publications? Couldn't these data, which I bet are from the same database, have been published in one article? None of these articles indicated that gender or race was related to safety or outcomes, so this seems like an obvious attempt to plaster journals with references to duloxetine so that an air of scientific credibility can surround it, resulting in higher prescription rates. When marketing and science collide, duck and cover. Apparently this strategy is working well for Lilly, as Cymablta sales are soaring. In the absence of evidence, just flood journals with unimportant findings in droves and watch the cash flow increase.

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