It's that time of year again. Hay fever season. Or, viewed another way, the season for high-pressure advertisements and newspaper articles about hayfever. It seems we have an epidemic. Perhaps even a health crisis. Perhaps the entire immune system of the western world has given way under the unremitting assault of environmental toxins, over-hygienic domestic living spaces, processed foods, the agro-industrial buffing up (and soon the genetic modification) of pollens, physical exhaustion and psychic pressure. Kleenex whiteout.
Estimates of the number of Americans suffering from hay fever or allergy symptoms at the height of the season run as high as 50m. About 35m of them are estimated to be afflicted with grass- or pollen-related inflammation.
The Chinese ideogram for "crisis", we are told, is made up of two elements: "danger" and "opportunity". Every epidemic is bad for the population and potentially golden for the pharmaceutical industrty. Big Pharma, as John le Carre has taught us to call it, has invested massively in hay fever remedies. Americans (or their insurers) shell out nearly $5bn a year on allergy medicines. It's low risk, since the medicines are non-toxic and gobbled in vast quantities, over long periods, and typically more in hope than expectation of anything more than mild relief.
I am one of the 50m in America who suffer from summer hay fever. I'm not clear what irritates my poor old conk. I suspect olive tree pollen, though I have sometimes thought that California broom may be the villain. A couple of years ago in America, the allergy/hay fever drug of choice in America was Claritin (spelled Clarityn in the UK). It's marketed by Schering-Plough. Apparently they spent half a billion dollars developing it and got a patent in 1993, which has recently been extended to 2002. These will be profitable years for the company.
The company's adverts claimed you too could be free of all that snot, sneezing and wretchedness. There was one small catch. You had (in America) to get Claritin on prescription from your physician, and the ads instructed you to ask for it by name. Demand it, even.
Claritin is a so-called second generation antihistamine. Unlike the first-generation antihistamines (such as the sniffer's old favourite, Chlor-Trimeton), it blocks inflammation without causing drowsiness. It doesn't cure anything; it just helps you get through the bad months less miserably.
Or does it? In a densely researched article in the New York Times, Stephen S. Hall (a longtime sufferer) suggests that 30-40% of users get relief from Claritin. It is, Hall claimed (choosing his words very carefully - companies that spend half a billion on their product don't stint on lawyers), "a moderately effective medication".
The reason for Claritin's triumph, Hall suggests, is not that it was a miracle drug, but that it was shrewdly marketed and that it was the first such product to take advantage of the FDA's 1994 relaxation of rules on mass-media advertising. Hall's article ends with him in something of an ethical quandary. Last autumn, he was prescribed a month's supply of Claritin-D.
When he went to collect his medicine, there had been a clerical error and he, not his insurance company, was charged. The bill for one month's pills was a whopping $103. This, Hall estimates, is "the consumer's trickle-down tab for the roughly $25m a year in drug development, more than $100m a year in consumer advertising, many millions in closed-door marketing, $20m in lobbying and political contributions and $5m a year for litigation". The question was: "If I had to pay $103 out of my own pocket, would I buy this medicine?" No, he implies, he wouldn't.
Another report, by Jessica Reaves, in the latest issue of Time magazine, goes a step further. Apparently a researcher at Ohio State University, Dr Sheryl Szeinback, studied 265 people taking allergy medicines, costing them, or their insurers, an average of $80 a month. Dr Szeinback discovered that 65% of her sample were actually suffering from transitory colds or short-term mild sinusitus or rhinitis. They didn't need any medicine at all, just a pack of Kleenex.
This finding, if it is true, is particularly relevant to the latest, and smartest, generation of remedies: cortisoid nasal sprays, known as Flonase in the US and Beconase in the UK. I know people who use these and they tell me they are best if applied year-round. Apparently they are prophylactic: ie they don't remove symptoms, they stop them ever happening. But what if (like the 65% of the Ohio sample) you don't really have hay fever at all, just a passing head cold?
All I know is my nose is blocked. I'm in the 35% of genuine sufferers. Claritin doesn't do it for me. Sudafed helps a bit. Looks like I'm going to keep sticking an expensive substance up my nose.
