Merging of marketing and medical science: female sexual dysfunction

doi:10.1136/bmj.c5050

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Ray Moynihan, conjoint lecturer

¹University of Newcastle, Newcastle, Australia

www.raymoynihan.net

Researching his latest book, Ray Moynihan uncovered how drug companies helped construct the scientific building blocks of a new condition. Here he asks whether we need a fresh approach to defining disease

In an article in the BMJ almost 10 years ago I described the making of female sexual dysfunction as the freshest, clearest example of the “corporate sponsored creation of a disease.”1 Looking back over the past decade, it has become clear that drug companies have not simply sponsored the science of this new condition; on occasions they have helped to construct it. Corporate employees have worked with paid key opinion leaders to help develop the disease entity; they have run prevalence surveys to portray it as widespread; and they helped create the measurement and diagnostic instruments to persuade women that their sexual difficulties deserve a medical label and treatment. Drug marketing is merging with medical science in a fascinating and frightening way, raising questions about whether a new approach to defining diseases is warranted.

Expediting the development of a disease

Many of the important scientific gatherings at which this controversial condition has been discussed and debated have been sponsored by drug companies, and in many cases their representatives have taken an active role.1 “During the process of defining the disease,” said Darby Stephens, a former research manager at the drug company Vivus, “we’ve been able to get thought leaders involved in female sexual dysfunction, and really work closely with them to develop this disease entity, so that it makes sense.”2 As sales of sildenafil for men began booming in the early 2000s, companies like Vivus, which was testing a genital cream for women, were keen to pin down erectile dysfunction’s elusive sister condition. “We’re hoping to be able to expedite the process of drug development and of disease development,” said Ms …