Open-access journal PLoS Medicine has a special on disease mongering – the practice of promoting medical conditions in an effort to boost drug sales.
Drugs are, of course, incredibly useful in treating suffering and disease, but their reality doesn’t always match the marketing of either the compound or the diagnosis.
For example, the definition of many psychiatric conditions is often based on fuzzy criteria on what constitutes a mental disorder and what constitutes normal human suffering or impairment.
The official acceptance of a diagnosis can involve intensely political decisions because if a group of experiences are defined as a mental disorder, the government or insurance companies can be called on to provide care for the affected people.
If a drug company can get their medication licensed as an ‘approved’ part of the care package, they can obviously make a huge amount of money.
This has led to drug companies funding pressure groups both to get a condition recognised with an ‘official’ diagnosis or to raise awareness of certain diagnoses (which has the effect of increasing the rates of diagnoses, and, of course, prescriptions).
This is not to deny that people may genuinely be suffering, but whether that suffering is best treated by a particular drug is another matter.
Here is where science is supposed to settle the matter, except for the fact that drug companies have been known to suppress drug trials that find no effect, and ghost-write scientific papers to which respected scientists add their names (and prestige).
Individual doctors are persuaded to prescribe certain drugs by free gifts, meals, air tickets to visit conferences, and large-scale sponsorship of academic meetings.
It’s all very murky and quite insidious. The PLoS Medicine collection has articles that point out some of the marketing practices that support this process.
The issue coincides with a conference currently being held on the same topic in Australia.