Disease mongering is now part of the global health debate
Two years ago, Ray Moynihan and David Henry at the University of Newcastle in Australia helped organize the world’s first international conference on disease mongering, the process of widening the boundaries of illness in order to grow markets for those who sell and deliver treatments. The conference coincided with a special theme issue of PLoS Medicine on the same subject (http://collections.plos.org/plosmedicine/diseasemongering-2006.php). Now, in an Essay in this week's PLoS Medicine, Moynihan and colleagues look back over the last two years to ask what kind of impact the conference and theme issue have had. There are reliable signs, they say, that disease mongering is now part of the global health debate: "Within the media, consumer movements, and the professional and research communities, increasing numbers of people are formulating ways to confront the problem, in some cases forcing the pharmaceutical industry to respond."
For example, high-profile articles on disease mongering have emerged in the mainstream media recently. In covering a new drug called Requip—for “restless legs syndrome”—The Wall Street Journal headlined the story “How Glaxo Marketed a Malady to Sell a Drug." Similarly, The New York Times recently ran a story about a new medicine called Lyrica—for “fibromyalgia”—under the headline “Drug Approved. Is Disease Real"”
In November 2007, disease mongering was a key subject of debate at the annual congress of Consumers International, an organization involving 220 member groups in over 100 countries. Responding to the issue at that conference, the head of the International Federation of Pharmaceutical Manufacturers and Associations, Harvey Bale, conceded that there were examples of “egregious over-promotion”, though he defended the industry’s capacity to ethically market medicines.
"While we have noted some signs of media, consumer, and academic debate and action about the problem of disease mongering," say Moynihan and colleagues, "we are not aware of a similar increase in policy interest or action. In fact, to the contrary, there is some evidence of complacency about disease mongering on the part of regulators." The US Food and Drug Administration’s recent proposal to relax restrictions on off-label marketing of drugs, they argue, risks setting the conditions for disease mongering to flourish.
"Unnecessary medicalisation and medication may be wasting many precious health resources, with obvious opportunity costs for private and public health insurers alike. Producing credible estimates of the magnitude of those costs is a future direction that should be urgently pursued."