Education And Debate

Selling sickness: the pharmaceutical industry and disease mongeringCommentary: Medicalisation of risk factors

BMJ 2002; 324 doi: http://dx.doi.org/10.1136/bmj.324.7342.886 (Published 13 April 2002) Cite this as: BMJ 2002;324:886

Selling sickness: the pharmaceutical industry and disease mongering

  1. Ray Moynihan, journalist (ray_128@hotmail.com)a,
  2. Iona Heath, general practitionerb,
  3. David Henry, professor of clinical pharmacologyc
  1. a Australian Financial Review, GPO Box 506, Sydney, 2201, Australia
  2. b Caversham Group Practice, 4 Peckwater Street, London NW5 2UP
  3. c School of Medical Practice and Population Health, Faculty of Health, University of Newcastle, NSW 2308, Australia
  4. Nordic Cochrane Centre, Rigshospitalet, 2100 Copenhagen Ø, Denmark
  1. Correspondence to: R Moynihan

    A lot of money can be made from healthy people who believe they are sick. Pharmaceutical companies sponsor diseases and promote them to prescribers and consumers. Ray Moynihan, Iona Heath, and David Henry give examples of “disease mongering” and suggest how to prevent the growth of this practice

    There's a lot of money to be made from telling healthy people they're sick. Some forms of medicalising ordinary life may now be better described as disease mongering: widening the boundaries of treatable illness in order to expand markets for those who sell and deliver treatments. 1 2 Pharmaceutical companies are actively involved in sponsoring the definition of diseases and promoting them to both prescribers and consumers. The social construction of illness is being replaced by the corporate construction of disease.

    Whereas some aspects of medicalisation are the subject of ongoing debate, the mechanics of corporate backed disease mongering, and its impact on public consciousness, medical practice, human health, and national budgets, have attracted limited critical scrutiny.

    Within many disease categories informal alliances have emerged, comprising drug company staff, doctors, and consumer groups. Ostensibly engaged in raising public awareness about underdiagnosed and undertreated problems, these alliances tend to promote a view of their particular condition as widespread, serious, and treatable. Because these “disease awareness” campaigns are commonly linked to companies' marketing strategies, they operate to expand markets for new pharmaceutical products. Alternative approaches—emphasising the self limiting or relatively benign natural history of a problem, or the importance of personal coping strategies—are played down or ignored. As the late medical writer Lynn Payer observed, disease mongers “gnaw away at our self-confidence.”2

    Although some sponsored professionals or consumers may act independently and all concerned may have honourable motives, in many cases the formula is the same: groups and/or campaigns are orchestrated, funded, and …

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