The Multi-Billion Dollar Depression Treatment Industry
What is the Business Model behind Depression Treatment?
Or is there even a slight amount of money to be made by Health Care Companies / Hospitals / Doctors by Depression Treatment?
No! This is not some crappy health tips post! This is the BADA-BAAP / Grandfather of all the business models examples that you could ever have heard or read about. So Grab a cup of coffee/beer and sit with your reading glasses on, because this is gonna be one hell of a read that you have had lately (and 30 minutes long read as well).
About Depression, Founders, Funders and Facts
I finished my last read which was an awesome business strategy book named Understanding Michael Porter, the tools required for the understanding of the industry that this book gave was fabulous! A must read! So post this I was looking for my next read for which I needed something that gives me a broader perspective of the HIDDEN business value in an industry (something I call in my own train of thought patterns as BASTARDIZATION of the Business Model, more explanation later in this post as well) and this is when I uncovered a truly Unique, Ruthless & powerful, even more than the Prostitution & Begging Industry, Business Model……
Yes, You did get that right!
It’s the Depression Treatment Industry! Let’s get on to its business model now.
When was depression discovered? Well, there isn’t really one time that I can point to in the past but I can very well say that this has been around for centuries! No One person who can be credited as the first person for discovering it. Since Depression has been known since the beginning of the human race it becomes difficult to track who did actually discover it.
The earliest recorded accounts of what we now know as “Depression” appeared in the second millennium B.C. in Mesopotamia. In these works, depression was discussed as being a spiritual rather than physical condition, with it, as well as other mental illnesses, being thought of as being caused by demonic possession. As such, it was dealt with by priests rather than physicians.
The idea of depression as being caused by demons and evil spirits has existed in many cultures, including the ancient Greeks, Romans, Babylonians, Chinese and Egyptians, and was often treated with such methods as beatings, physical restraint and starvation in an attempt to drive the demons out. The ancient Greeks and Romans, however, were of two minds on the matter, with many doctors also considering it to be a biological and psychological illness.
Depression Founders: A Greek physician named Hippocrates is credited with the idea that depression, or melancholia as it was known then, was caused by an imbalance in four body fluids: yellow bile, black bile (melan=black, khole=bile/fluid i.e. melancholia), phlegm, and blood. Specifically, melancholia was attributed to an excess of black bile in the spleen. Poor chap, could not even see his idea getting FUNDED! 🙂
Depression Funders: Well, this list a never ending one, everyone from Leading Pharmaceutical Majors, Doctors, Family Physicians, Schools, Medicine Stores, Alcohol Companies, Drug Majors, Actors/Actresses, Cosmetic Companies, Insurance companies etc. etc. etc. Again, more on why all of these people have been included in the list are mentioned in the section of stakeholders below.
Before you move any further, you can try googling out whatever you can on this topic and you will find nothing but ZERO. That is so because this is a very sensitive topic and religious groups, activists and other anti-profiteering groups want to stay in the good books of the funders for some unknown gains, I feel. Having said this, if you are currently on meds (related to depression) and if you feel anything otherwise after reading this, please consult your doctor before taking any decision with regards to the same, and if you are continuing beyond this point of the article, you are deemed indemnifying the author and the blog for any consequences/liabilities you may face on altering your dosage or any other decision likewise.
Depression Treatment Business Model
Before we dig deeper into who is doing what here to take advantage of the multi-billion dollar depression industry, we must first understand the backdrop of why health care institutions do what they do! The why is really important.
A pharma company exists because “Diseases EXIST” – without the diseases (and thus an affected living being) there is no room for pharma companies. Which leads to the next argument i.e. For pharma companies to compete in a crowded market (one world, one market) they need
multiple (read newer) avenues (revenue lines, markets) to make money from. This leads to my final argument that you need to create a new market for your growing hunger of money ( 🙂 ) and Babammmm! They created an entire market just on the basis of SADNESS (human emotion) and are now trying to make money out of it from every corner!
The OVER Medicalisation of Sadness: In his controversial book, Limits to Medicine – Medical Nemesis, Ivan Illich, the author states that the ‘medical establishments have become a major threat to health’. Written in 1975 he warned against the over-medicalisation of life situations like Mental Status, Immunity Programs etc. For e.g. The stupidest DISORDER of obesity which can be treated with exercise, is being considered as AN Epidemic and is being purposely treated with medical treatments (costing 1000’s of dollars on a recurring basis) & multiple doctors, physiotherapists, shrinks (psychiatrists as they prefer to call themselves) appointments (on a monthly, bi-monthly basis).
The entire Health Business Community has medicalised Sadness (a pertinent human emotion) clubbed it with heavy marketing dollars and treating normal human emotional states as illness. There is a growing trend to medicalise modern problems (easier to let go of the pain momentarily rather than exercise and get rid of it forever in a few weeks), people are medicating themselves more than ever to cope with everyday living, thereby blaming factors outside their control for the way they are.
Since the 1990’s the sadness emotion is lost and is replaced by some or the other type of depression and is spreading like an epidemic and has exploded the sales of antidepressants which have become the top selling prescription drug since 2001. This increase in antidepressants sales has been reached by extending the boundaries of the term depression to encompass everyday situations that cause anxiety, disappointment or sadness. Using the actual word ‘depression’ can, therefore, be misleading and unhelpful, because what is a normal human response to a difficult life experience is increasingly being confused as mental illness.
I even got some stupid shrink telling my cousin (who flunked 10th board exams and got everyone in the family depressed – ROFL, LOL whatever) aged 16 years that his constant acidity attacks (because of constantly eating junk food, which also caused farting) were an early sign of depression! 😀 (Seriously? I mean now farting is also an earlier sign of depression followed by acidity).
The Science behind Depression
Picture Courtesy: YouTube/Screenshot
Before moving on, it is important to know how Depression works or the science behind Depression. Important to note that there are various schools of thought about why depression occurs and a lot of research still going on as to how it occurs so that it can be treated, no conclusive so far (if you get a conclusive one, please contact me). I am outlining the school of thought that major scientists have agreed to and is being used in developing drugs to cure the same. This is part of a large scam of pharma companies and research is still on! A few important definitions or terms to know:
- Hippocampus: Part of the brain where memories are stored
- Amygdala: Part of the brain where emotions are conceived
- Neuro-Transmitter: A special molecule that transfers signals between the various neurons.
- Serotonin: A neurotransmitter, also called as the happy hormone
- SSRIs: Selective Serotonin Reuptake Inhibitors – a group of drugs that came out during the 1980s and sold like wildfire for curing depression
The human brain is a marvelous piece of meat! It can create its own worlds and universes for the parasite (you are the parasite that is feeding off of it) for it to feel relaxed, composed etc. It is that fighter which fights for you as the first resort. Now the brain fights in its own ways, by releasing certain chemicals (hormones, amines etc) that can elevate or depreciate the emotion behind the certain state of mind that your body is in. Thus during the depressed state of mind as well, the brain stimulates certain hormones to be produced in excess to fight off anything unwanted in your mind! Yes, it is only a mind game.
Your brain is fully equipped to trick you into believing anything that you want or don’t want to believe in.
Depression is nothing but elevated sadness and when you’re sad the happy hormone (serotonin) gets sucked up (dried up) to fight it and you start feeling low after it dried up (not being happy because happy signals from hippocampus can’t pass in absence of happy hormone) and as this bout prevails, the more and more serotonin gets sucked up leading to a long downward spiral of depression. This school of thought was treated with inducing the brain to secrete more of serotonin or to consume less of what is already there: so that the brain can relax and keep the happy mood on – This is where the SSRIs did their part of the work and treated depression to some extent. But the majority of the cases it only led to the deterioration of the brain quality (thus over-reliant on the SSRIs by the patient) and led to a new school of thought as follows.
This school of thought was treated with inducing the brain to secrete more of serotonin or to consume less of what is already there: so that the brain can relax and keep the happy mood on – This is where the SSRIs did their part of the work and treated depression to some extent. But the majority of the cases it only led to the deterioration of the brain quality (thus over-reliant on the SSRIs by the patient) and led to a new school of thought as follows.
Another school of thought says, depression is caused due to a reduction in the size of the hippocampus (the memory palace) and the amygdala (emotion center) – thus the person suffering from depression literally becomes a zombie after these two parts of the brain are affected after over consumption of the SSRIs. The new type of drugs actually stimulate growth (neuro-generation) of these parts (or rather prevent them from deteriorating) and treat depression.
Amazing! Isn’t it?
Depression Treatment Industry Size
Before your brain gets overheated reading my arguments about this, cool it down with this amazing example that I give to all my clients on increasing efficiency! Consider the example of a MAID. If you’re not noticing the regular amount of work that she has, she will gradually start complaining about having too much work around the house and that you should increase her wages, but the day you start noticing her on the total work that she is doing – SHE WILL CREATE WORK for HERSELF, by spilling stuff somewhere, cleaning pre-cleaned utensils, scrubbing clean corners and trying to push you out of the kitchen (so that you can’t watch her) etc.
Did you get it?
Big Pharma Companies are CREATING NEW (Read FICTITIOUS) DISEASES (and funding the R&D about those diseases from the tax payers money by grants etc.) which can be cured by TAKING MIRACLE DRUGs (Mostly tricking your brain into thinking this is a miracle drug whereas, in reality, this is just a sugar pill, this phenomenon is called PLACEBOs) which are also CREATED by THEM or THEIR SUBSIDIARIES. This is how you create your market.
The industry is comprised of two major components:
- The drug sale (Anti-Depressants): The market for antidepressants has been segmented based on the various classes of drugs that are generally used for the treatment of these psychiatric conditions. Various drug classes considered while estimating the overall market are selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tetracyclic antidepressants (TeCAs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), benzodiazepines, beta-blockers, atypical antipsychotics, and anticonvulsants. These drug classes cover major depressive disorder (MDD), obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD) and panic disorder (PD) – The major players in the category are sertraline (Zoloft), fluoxetine (Prozac, Sarafem), citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil, Pexeva, Brisdelle), fluvoxamine (Luvox), trazodone (Oleptro)
- Psychiatry and related services (Bastardization): Includes, counselors, support groups, hypnotist con artists, psychiatrists, cosmetic surgeons etc.
In 2016, the total global sales of just the drugs (SSRIs) including branded and generics was close to $13.2 billion and is expected to cross $19 billion by 2020.
But there is an interesting trend here, since 2008/9 when the majority of the drug companies concluded their patents, generics came into force and reduced the overall share of the companies like Eli Lilly (Prozac), Pfizer (Zoloft) etc.
According to a WHO (2017) estimate, there are 350 million reported cases of Depression Globally (please note the reported) and according to another study, less than 50% of the reported people get treated for depression. Now consider this maths magic, 350 million affected * 50% treated * 150$ (Avg cost of the treatment including counselling, medicines etc. per month) * 12 months = 315,000,00,00,00 USD.
Need help figuring that out?
This is equivalent to 315 Billion Dollars Globally Per YEAR. And all of this goes to select pharmaceutical companies and depression treatment professionals.
Depression Industry Bastardization
The best business model according to me is the one that needs only a push (of money and marketing) in the initial stages and reaps benefits (unknowingly to the consumer) from the consumers at a later stage for a prolonged period of time.
Depression Treatment is one such business model.
Bastardization means to CORRUPT! For e.g. the business model of facebook (the biggest cause of the social depression btw) can be bastardized with selling data publicly.
The depression industry has really been corrupted by vague researches that prove that SSRIs help in curing depression and blah blah. They have thrown money at marketing & building up of this myth that depression is curable with their medicines and have bastardized an entire ecosystem of money hungry professionals that are making money left right and center from this industry. I feel the entire depression treatment business model has been corrupted with the presence of VESTED INTEREST parties like the following.
Depression Treatment Key Stakeholders
- Pharma companies,
- & Their paid pawns (movie stars who suddenly have started coming out of the closet that they are or were suffering from depression),
- Research companies,
- Marketing companies,
- Healthcare professionals (OB-GYNs, Cosmetologists, General Physicians etc.) who communicate to the distressed that they are depressed, and consulting is paying lesser money as compared to the commissions that medical professionals receive if they prescribe a particular drug, so professionals are also not looking to really consult the patient but putting them straight on meds.
- Self-help writers etc.
- Civic Health Departments (Because they get their share of revenue in form of Taxes and fund their R&D with grants out of the common tax payers money)
- All of these people put together have built a goliath that is raging with speed towards the ultimate goal of putting everyone under some or the other form of depression.
Here marketing has played a big role in filling the coffers of these companies with money. They have marketed Depression as something that can affect your and your loved one’s lives drastically and that “THEY CAN HELP”. What people are not realizing is that it is killing their life day by day as they consume more and more of these medicines.
Just think of why a renowned movie actress in India just came out of the closet stating that she was/is depressed and the television is suddenly being thronged with ads surrounding depression? Does it ring any bells?
They are not realizing that the majority of the effects that the medicines are doing for the depression treatment are not doing so by their virtue, it is because of their own brain fighting it out!
There have been cases when extreme doses of SSRIs also have not helped people coping with depression and where the patient ultimately took a life-altering step in that direction.
A research states that possibly 1,000 to 2,000 people taking an SSRI drug commit suicide each year in the US who would not have done so were they not on the drug. Then there’s the issue of generational harm. Birth defects, miscarriages (as many as 20,000 per year), and voluntary abortions due to the baby being diagnosed with a birth defect are other devastating side effects that get little if any attention.
Key Drivers of Multi-Billion Dollar Depression Treatment Industry
What these smart pharmaceutical companies have done is they have opened up new avenues to market their useless drugs now that generics have taken over the total sales volumes, they are finding out newer channels to inject their drugs in the healthcare system.
Newer avenues like:
- Depression in Children (less than 12 years old): Are you seriously kidding me? Someone who doesn’t even understand the meaning of life is affected by depression? Basically, any child sadder than the average child of their age is considered Depressed!
- Depression in New-Born Mothers (Dads as well): (Post Partum Depression) – Again are you freaking kidding me? The joy that arrives in newborn parents is far greater than any stupid thought of depression that is in the minds of parents.
- Depression in Young Adults: Because of looks, social acceptance etc. YAs start feeling insecurity and inferiority – which is termed as depression.
Newer Markets like for sale of drugs:
- USA, UK, Canada etc. as markets are exhausted to the core with depression drugs and services being offered, pharma companies exploit newer markets like Asia, Africa etc (under-developed) and start pumping their drugs in these markets : A reputed Indian Pharma company who makes generics similar to Prozac has just increased their revenue 5 times (2016 last quarter) on the back of rising awareness of Depression in India (where 10 lac people are assumed to be depressed) – It does not make sense that depression is more common in places like Canada, Australia or the United States. How can depression be centralized this way? So these companies are looking to explore virgin territories to exploit now.
- Pet Depression Markets: Have you guys totally lost it? A pet needs love, that’s it, they don’t require material things, they can not get depressed, even if they are sad, they can be immediately turned into happy beings by a small bout of play with them.
Top Types of
Shit Depression Reasons (according to Doctors)
- Generally Feeling Low: Just feeling low on some account or incident happened in the past (really old past)
- Under Achievement (of Life Goals whatever): In overall walks of life
- Post-Partum Depression: Stress on Mother/Father post delivery of their child
- Chronic Pain related: People suffering from chronic pains (knee/back etc.)
- Fatal / Life Altering Injury related: People who’ve met with an accident which has altered their life in some way
- Stressed Work-Life Balance
- Relationship Issues: Unhappy Sex life etc.
- Parenting Issues: Comparison between siblings
- Child Abuse: Children who have been abused or young adults who have been abused in the past
- Family Problems (Child going through a Parental-Divorce phase)
- Employer Induced (Overwork, Office Politics, Performance Pressure etc.)
- Money Induced
- Religion Induced
- Inferiority Induced: Mostly based on Looks of the person
In conclusion, I would only say that Depression Treatment is just a state of mind and that it has been exploited for long by the pharmaceutical companies. A lot of you would love me for penning this down, you guys can get me a coffee 🙂 – Others can show their disgust in the comments below and I promise no comments deleted :-).
Disclaimer: Depression Industry Business Model and Depression Treatment arguments were given to highlight the personal views of the Author and have no reference to any person, institution or body. You agree to indemnify the author and the blog against all the liabilities arising out of the usage of the information on your own.