Expanding the Market

Once pharmaceutical companies obtained FDA approval for their new psychiatric medications, they naturally wanted to maximize the sale of their products. This meant expanding the pool of potential patients, and to do this, the companies needed the assistance of academic psychiatry and the American Psychiatric Association (APA). From the drug companies’ perspective, the business model to be pursued was obvious: They could provide the financial resources for this task, while academic psychiatry and the APA provided the medical legitimacy. This legitimacy, industry knew, could originate with the DSM: The APA could expand the pool of potential patients by creating new diagnoses or by loosening the diagnostic criteria for existing diagnoses, and then industry could hire academic psychiatrists to conduct studies of the drugs for these new patient populations. Then industry could hire those same psychiatrists, or others in academia, as “key opinion leaders” to speak at professional conferences about the validity of the “illness” and the helpful drug treatment.