The making of a disease: female sexual dysfunction

The corporate sponsored creation of a disease is not a new phenomenon,1 but the making of female sexual dysfunction is the freshest, clearest example we have. A cohort of researchers with close ties to drug companies are working with colleagues in the pharmaceutical industry to develop and define a new category of human illness at meetings heavily sponsored by companies racing to develop new drugs. The most recent gathering, featured Pfizer as chief sponsor and Pfizer-friendly researchers as chief speakers. The venue? The Pfizer Foundation Hall for Humanism in Medicine at New York University Medical School.

Since the launch of sildenafil (Viagra) in 1998, more than 17 million men have had prescriptions written for it as a treatment for erectile dysfunction, with Pfizer reporting sales in 2001 of $1.5bn.2 The emerging competitors, Bayer's vardenafil and Lilly-ICOS's tadalafil, are likewise expected to have annual markets in excess of $1bn each.

To build similar markets for drugs among women, companies first require a clearly defined medical diagnosis with measurable characteristics to facilitate credible clinical trails. Over the past six years the pharmaceutical industry has funded, and its representatives have in some cases attended, a series of meetings to come up with just such a definition (table).