In the opening essay, the guest editors, Australian journalist Ray Moynihan and clinical pharmacologist David Henry (Newcastle University, Australia), define disease mongering as "the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments."
New diseases are being defined, they say, by panels of specialists who are often funded by industry. Such diseases are then promoted by industry-sponsored "disease-awareness campaigns," usually designed to sell drugs rather than inform the public about preventing illness or maintaining health.
Eleven articles in the special issue, published to coincide with an international conference at Newcastle University on 11-13 April 2006 (www.diseasemongering.org), describe different forms of disease mongering:
- Aspects of ordinary life, such as sexuality, are being medicalized and turned into illnesses. Joel Lexchin (University of Toronto) argues that Pfizer marketed Viagra not just for treating erectile dysfunction due to medical problems like diabetes, but as a drug that "normal" men could use to enhance their potency.
- Mild problems, such as everyday irritability in children, are portrayed as serious illnesses needing powerful drugs. David Healy (University of Wales) looks at how companies are "selling" bipolar disorder, leading to a surge of diagnoses of bipolar disorder in American children, some as young as two. "Drugs such as Zyprexa and Risperdal are now being used for preschoolers in America with little questioning of this development," he says.
- Health problems are routinely being framed as extremely common. Steven Woloshin and Lisa Schwartz (Dartmouth Medical School) analyze the news coverage of a little-known condition called "restless legs syndrome," a compelling urge to move one's legs. The authors found that the media exaggerated the prevalence of the condition and the need for treatment, and failed to consider the problems of over-diagnosis.
A recent Reuters Business Insight report on so-called lifestyle drugs stated starkly: "the coming years will bear greater witness to the corporate sponsored creation of disease". The special issue, say Moynihan and Henry, is a call for the global health community to challenge this trend. Several articles outline steps that doctors, patients, governments, and the media can take to respond to disease mongering.
"Around the world, there are tentative steps to identify, understand, and combat the threat to human health from the corporate-sponsored selling of sickness," they say. "We trust this theme issue may support and augment these developments."
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TO CONTACT THE GUEST EDITORS OF THE SPECIAL ISSUE:
Ray Moynihan, Journalist and Author, Byron Bay, Australia
Tel: +61 425274836
David Henry, University of Newcastle
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Table of Contents:
1) Moynihan R, Henry D (2006) The fight against disease mongering: Generating knowledge for action. PLoS Med 3(4): e191.
Contact: Ray Moynihan, email: firstname.lastname@example.org
2) Lexchin J (2006) Bigger and better: How Pfizer redefined erectile dysfunction. PLoS Med 3(4): e132.
Contact: Joel Lexchin, email: email@example.com
3) Phillips CB (2006) Medicine goes to school: Teachers as sickness brokers for ADHD. PLoS Med 3(4): e182.
Contact: Christine B. Phillips, email: firstname.lastname@example.org
4) Tiefer L (2006) Female sexual dysfunction: A case study of disease mongering and activist resistance. PLoS Med 3(4): e178.
Contact: Leonore Tiefer, email: email@example.com
5) Healy D (2006) The latest mania: Selling bipolar disorder. PLoS Med 3(4): e185.
Contact: David Healy, email: Healy_Hergest@compuserve.com
6) Applbaum K (2006) Pharmaceutical marketing and the invention of the medical consumer. PLoS Med 3(4): e189.
Contact: Kalman Applbaum, email: firstname.lastname@example.org
7) Heath I (2006) Combating disease mongering: Daunting but nonetheless essential. PLoS Med 3(4): e146.
Contact: Iona Heath, email: email@example.com
8) Woloshin S, Schwartz LM (2006) Giving legs to restless legs: A case study of how the media helps make people sick. PLoS Med 3(4): e170.
Contact: Steven Woloshin, email: firstname.lastname@example.org
9) Maggini M, Vanacore N, Raschetti R (2006) Cholinesterase inhibitors: Drugs looking for a disease? PLoS Med 3(4): e140.
Contact: Marina Maggini, email: email@example.com
10) Mintzes B (2006) Disease mongering in drug promotion: Do governments have a regulatory role? PLoS Med 3(4): e198.
Contact: Barbara Mintzes, email: firstname.lastname@example.org
11) Kumar CJ, Deoker A, Kumar A, Kumar A, Hegde BM (2006) Awareness and attitudes about disease mongering among medical and pharmaceutical students. PLoS Med 3(4): e213.
Contact: C. Jairaj Kumar, email: email@example.com
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PLoS Medicine is an open access, freely available international medical journal. It publishes original research that enhances our understanding of human health and disease, together with commentary and analysis of important global health issues. For more information, visit http://www.plosmedicine.org
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