Lifestyle drugs: New avenues

The unbound desire of human being for betterment of life shall continue to bring about innovations in lifestyle drugs, say Kole P L, Bhusari Sachin, Thakurdesai P A, Nagappa A N

Lifestyle drugs are the drugs with the diverse group of pharmaceuticals that treat the symptoms of chronic non-life-threatening conditions - symptoms that are also the by-products of natural ageing. Lifestyle drugs are the one that meet the following criteria: They are attractive to the popular media; they enhance quality of life; often address problems of a social or cosmetic nature; and are not conducive to reimbursement. Lifestyle drugs treat conditions attend on ageing and so they will take advantage of the increasing longevity of human life.

Evolution of lifestyle drugs
Prevalence of lifestyle conditions is being driven by increased disease and treatment awareness, as well as by increased baseline prevalence. Many campaigns in other countries such as ‘Shape up America’ have helped to raise awareness of the seriousness of lifestyle complaints such as obesity. This also increased the number of diagnosed sufferers and, therefore, the commercial potential of the market.

The massive global media attention to Viagra, for example, has brought thousands of erectile dysfunction sufferers into physicians’ offices. This movement is being fuelled in the USA by Direct-to-Consumer (DTC) marketing and in Europe by government health campaigns. Absolute prevalence in most lifestyle conditions is being driven by the ageing of the population in the developed world. Lifestyle conditions may be considered to be less serious than other conditions, but in epidemiological terms they may be significant.

The redefinition of an individual or social problem as disease inevitably leads to quest for an appropriate treatment. Because of high demand of lifestyle drugs, it can be profitable and more and more research is being focused in this area. However, the life style drugs may be discovered as a chance or serendipity as in case of finasteride
xnow being used for diminishing hair loss and promoting hair growth.

Present status
At present, worldwide expenditure on pharmaceuticals is running at an enormous rate. At times, many people lay out a considerable amount of money on cable television, they are likely to pay as much for a lifestyle drug. Such enormous spending could double the size of the drug industry over the next five years, sending ripple effects through the entire economy.
The appeal of lifestyle drugs to large segments of population is attracting pharma companies. Life style drugs have attracted a large population, with equal distribution attracting all segments with a little or no concern for real need. For instance, in case of Viagra a big part of market is normally potent men who are looking for enhanced sexual performance. What gives vast appeal to life style drugs is their ability to enhance the lives of people with less severe symptoms. And also to mention that Direct-To-Consumer advertising fuels the demand for life style drugs.

Evaluation and patient satisfaction
A lot needs to be done to establish an accurate cost versus benefit data for life style drugs through pharmacoeconomic studies. Nevertheless, it is difficult to measure the economic aspects of patient satisfaction. For example, an individual is taking an anabolic steroid to pump up his muscles; he has physique and personality that is more satisfying. Now how much that translates into his self-betterment appears to be relative.

The collective values of many constituencies in a society define the healthcare priorities and status of life style drugs in that hierarchy. A few countries, however, have given stress on healthcare priorities through identifying and coding the national values. New Zealand has successfully systematized healthcare decisions by focusing on care of patients deemed to receive “substantial health benefit” through major healthcare reforms. The criteria for these healthcare reforms being benefits of health services in relation to value for money, fairness and consistency with community values and priorities.

Given the elusive relationship of patient satisfaction and quality of life to improved work productivity and tangible economic benefit, the cost effectiveness of life style drugs may be particularly difficult to prove.

Future trends
The unbound desire of human being for betterment of its life continues to bring about the innovations like life style drugs. Ironically, the life style drugs were discovered more by serendipity than fancy chemistry in the past.

However, where once it took some 15 years to develop a new drug, advances in technology allows chemists to test thousands of drug candidates in one day. The investment that is needed to be spent blockbuster to bring new life style drugs will spawn dramatic changes in the industry.

(The authors are with Pharmacy Group, Birla Institute of Technology and Science, Pilani)