The pharmaceutical industry and disease mongering

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7357.216 (Published 27 July 2002) Cite this as: BMJ 2002;325:216

The industry works to develop drugs, not diseases

  1. Richard Tiner, medical director. (rtiner@abpi.org.uk)
  1. Association of the British Pharmaceutical Industry, London SW1A 2DY
  2. National Osteoporosis Society, Bath BA2 0PJ
  3. Dianthus Medical Limited, London SW19 3TZ
  4. Osteoporosis Australia, Forest Lodge NSW 2037, GPO Box 121, Sydney, NSW 2001, Australia
  5. The Surgery, Waddesdon, Aylesbury HP18 0LY
  6. Montefiore Medical Center, Bronx, NY 10458, USA
  7. Public Citizen's Health Research Group, Washington, DC 20009, USA
  8. Consumers' Association, London NW1 4DF
  9. Department of Psychiatry and Behavioural Sciences, London W1N 8AA
  10. Bradford University, Bradford BD7 1BL
  11. Australian Financial Review, GPO Box 506, Sydney, NSW 2201, Australia
  12. Caversham Group Practice, 4 Peckwater Street, London NW5 2UP
  13. School of Medical Practice and Population Health, Faculty of Health, University of Newcastle, NSW 2308, Australia

    EDITOR—It is true that the pharmaceutical industry, with others, is involved in sponsoring the definition of diseases, as suggested by Moynihan et al.1 Both the pharmaceutical industry and regulatory authorities that license new medicines need to develop closely defined definitions so that the safety and efficacy of new medicines can be properly measured.

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    More medicalisation is in fact needed, as indicated by Ebrahim and Bonaccorso and Sturchio. 2 3 The rise of guideline led care around the Western world shows that far too many serious diseases are underdiagnosed and undertreated. Failure to put evidence based medicine into practice is quite legitimately addressed by the pharmaceutical industry. Examples include the underuse of statins in the United Kingdom, the delay in the uptake of thrombolysis during the 1980s, and reliance on old psychotropic drugs when newer agents have a much more favourable profile of side effects.

    Of course, disease awareness campaigns are likely to expand the market for drugs for a given disease, but the market will expand for competitors' products as well as those of the sponsoring company. However, the real value of disease awareness campaigns is exactly what it says: making consumers aware that treatment may be available for their condition. Not infrequently, major disease is detected as a result of a patient seeking medical advice after contact with a disease awareness campaign.

    Moynihan et al imply that preventive medicine is threatening the viability of publicly funded healthcare systems. Yet clearly, it is far better to prevent disease than to treat it when it is established. The benefits of stopping smoking, treating hypertension, reducing raised blood lipid concentrations, etc, are all well established but could not be done without the help of the pharmaceutical industry.

    In choosing the diseases that Moynihan et al detail as sponsored by the pharmaceutical …

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