The enthusiasm with which news outlets uncritically reported the spoof disease motivational deficit disorder and the drug indolebant took their creators by surprise (BMJ 2006;332:745, 1 Apr).
David Henry, the convenor of a conference on disease mongering held last week in Newcastle, New South Wales, said the media coverage showed “that it is relatively easy to get [out] the concept of a disease that doesn't exist and a treatment that doesn't exist.”
Dr Henry, who is clinical pharmacologist at the University of Newcastle, said the explanation for such gullibility was that “when it comes to health, people suspend the scepticism they use in other areas of their life.”
Martin Palin, the founder of the Sydney based medical public relations company Palin Communications, disputed the suggestion that public relations companies “created” new diseases for drug companies. Public relations people, he argued, “do not dictate news”—instead it is determined by others, such as news editors.
David Healy, from Cardiff University's Department of Psychological Medicine, told the conference that “it is easy to sell the good kind of message about pills, but it is awfully hard to say there may be risks [with them].”
Professor Healey disputed the claims of drug industry funded patients' groups that people who use “mood stabiliser” drugs are better off than those who don't.
And popularising medical conditions, he warned, can go to extraordinary lengths. Professor Healey quoted from Brandon the Bipolar Bear, a children's book aimed at 4 to 11 year olds that was published in the United States in 2001. A doctor in the story tells a child: “There are good medicines to help people with bipolar disorder, you can start taking one right away … I also want you to promise, Brandon, to take your medicine when your mother tells you to.”
The effect of advertising directly to consumers and attempts to restrict it were also discussed at the conference. Such advertising is currently being reviewed in New Zealand, with the deadline for submissions closing at the end of April.
Barbara Mintzes, from the University of British Columbia, expressed concern at the challenges to regulations on drug advertising. She said, “I see an alarming trend in Canada towards what is called ‘smart regulation’; in Britain it is ‘better regulation,’ which is the idea that you basically avoid regulating.
“Any time I have seen anyone presenting an argument in favour of expanding direct to consumer advertising they never say the ‘A’ word for advertising—they only refer to ‘information.’ You never see any reference to any of the research on the content analyses of direct to consumer advertising.”
In Canada the media conglomerate CanWest MediaWorks launched a legal action last December alleging that the Canadian government's ban on direct to consumer advertising was an infringement of its right to freedom of expression.
In the concluding presentation at the conference the London based GP Iona Heath argued that the first step to countering “disease mongering” lay with the medical profession. “The first step has to be a genuine disentanglement of the medical profession from the pharmaceutical industry. There is no such thing as a free lunch … Doctors can only provide appropriately independent and authentic advice to patients and indeed to politicians if they are seen to be completely independent of other powerful interests,” she said.