(Self-)Diagnosis and (Self-)Medicating in a Digital Age

Posted: 8/11/2016 3:31:14 PM by Katie Sessa

Playing Doctor
In an age where the average American spends between two and three hours on the internet per day, it should come as no surprise that at least one of those hours per week is usually spent looking for health information. When websites such as WebMD or the Mayo Clinic provide descriptions of common symptoms for various diseases and conditions, Americans have decided that there is no longer any need for a medical degree to be able to diagnose them, they can play doctor themselves through a quick Google search.

The Pew Research Center released results from their Internet and American Life Project study indicating that 35% of patients researching their symptoms on the internet did not follow up with a medical professional afterwards, and another 18% found that their medical “conclusion” differed from the diagnosis they eventually received by an actual medical professional1. Interestingly, those with a college degree were more likely to resort to the internet to look up their symptoms.
Bad Practice?
In the United States, where health care spending consumes 18% of the national GDP and an aging population will soon face shortages in nurses and general practitioners, self-diagnosis of minor ailments through the aid of the internet offers a promising possibility to control costs and ease the burden on medical professionals2. On the other hand, a study conducted at Harvard Medical School revealed that in only a mere 34% of cases did the online symptom checker list the correct diagnosis3. Along the same vein, Microsoft performed a study regarding online health searches, and found that there was equal likelihood between an online diagnosis of “brain tumor” and “caffeine withdrawal” in response to a search for “headache”. Note that allergies or the common cold, which constitute the most likely medical causes of a headache were a search result of lower probability as compared to “brain tumor” and “caffeine withdrawal”4. This discrepancy is due to the fact that websites order the pages that come up in response to searches in order of popularity, as opposed to relevance. In other words, web searches, by nature, make critical diagnoses more prevalent than relatively benign conditions.
Industry Trends in Response to Self-Diagnosis
The accessibility of medical information over the internet has sparked a trend in the pharmaceutical industry: increased migration of drugs from prescription (Rx) to over-the-counter (OTC). Regardless of whether or not a patient ultimately finds out if their self-diagnosis is correct, the fact of the matter is people are seeing less cause to go to the doctor. With patients as their own doctors, pharmaceutical companies would be losing money if they continued to churn out Rx-only drugs. If you suffered from allergies prior to 2002, you would visit the doctor to obtain a prescription for Claritin. But in 2002, Schering-Plough moved Claritin to OTC, just as its patent was running out and inexpensive generics were threatening its profit margin. Other antihistamines followed suit, namely Zyrtec in 2007 and Allegra in 20115.  

Another notable example of Rx to OTC migration is Flonase. The prevalence of allergic rhinitis amounts roughly to 50 million Americans. In 2010 alone, it was reported that Americans lost a combined total of more than 6 million work days, visited the doctor more than 16 million times, and spent roughly $17.5 billion dollars in an attempt to alleviate the side effects of their nasal allergies. Seeing the need for an OTC drug, GlaxoSmithKline seized the opportunity in 2014 to move Flonase, which was previously a prescription-only intranasal corticosteroid, out to the pharmacy shelves. After the first sixteen weeks as an OTC agent, Flonase generated almost $100 million dollars in sales6, more than double the sales of its closest competitor Nasacort7. As demonstrated by these figures, there is a market for convenience in the eyes of the consumer.

With numerous antihistamine, allergic rhinitis and acid reflux therapies leading the charge, new waves of statins, erectile dysfunction, and migraine drugs are now on the watch list for an Rx to OTC transition8,9. MedPanel has helped companies contemplating this transition by message testing direct-to-consumer advertising in a diverse demographic spread of patients.