The latest issue of the Public Library of Science Medicine is devoted to disease mongering: creating diseases that turn healthy people into patients. The editors and contributors to the issue describe how widespread disease mongering has become and how it is the result of a complex stew driven by a pharmaceutical industry that enlists directly or indirectly public relations companies, researchers, professional organizations, and patient advocacy groups.
Disease mongering not only includes campaigns to create diseases where none existed before, like cardiovascular disease and metabolic syndrome, but the elevation of conditions suffered by a few into epidemics, such as attention deficit hyperactivity disorder.
The articles describe how pharmaceutical companies drive this ship based on the need to maintain sales. In some cases, this includes “repurposing” drugs from one condition to another. Statins are notorious for this having research shift from anti-cholesterol to anti-inflammation to anti-cancer. In what was news to me, Prozac has now been re-purposed and named Sarafem to treat the hitherto unknown disease “premenstrual dysphoric disorder.”
But disease mongering isn’t just about Big Pharma marketing to consumers. Or even about a pharmaceutical company promoting concern for a condition for which they coincidentally have the perfect drug. Researchers get financial support for investigating the seriousness of these conditions. Medical professionals who specialize in the condition have a mixture of professional and financial interest in expanding the attention paid to the condition. Don’t forget that only 10% of Big Pharma marketing is directed at consumers—the other 90% is directed at medical professionals.
Finally, there are patient advocacy groups that join in promoting a condition. Take for example the American Diabetes Association. The ADA is heavily supported by the pharmaceutical companies that sell anti-diabetes drugs. The supposed diabetes epidemic and the ensuing drive to get people into treatment as early as possible is a direct consequence. Leave aside the negative effects of anti-diabetes drugs, if you look at the statistics for this epidemic you discover that it’s not everywhere—the increases are principally among African-Americans. For me, that tells a different story than “More drugs!”
A recent report intended for pharmaceutical industry leaders discussed “lifestyle drugs.” The report emphasized that “the coming years will bear greater witness to the corporate sponsored creation of disease.” We don’t need a conspiracy theory. They’re telling us what they’re going to do.
Which brings me to Medicare Part D. This is the alleged prescription drug benefit created by the Bush administration. It would more accurate to call it “The Medicare Part That Transfers Income from Taxpayers to Drug Companies.” The core question for consumers is how much coverage they need: the plan seems to work for those with few drug needs and for those with huge drug needs, but not for those in between.
In the age of disease mongering, Medicare recipients contemplating Part D and the rest of us for that matter should ask whether we need the drugs at all.
The issues in this article are developed (with references) in issue #4 of the Progressive Health Observer in a review article titled “Fit to Print? A review of The Truth About the Drug Companies and Critical Condition.”
Related resources are available on the Health Politics page.
