How the Drug Companies Want Us to Be Sick

You see a TV show or a commercial featuring medical problems, and you start feeling the symptoms yourself: a twinge in the leg or maybe a moment of doubt about your emotional stability.

If so, you, like millions of Americans, could be suffering from a serious condition known as telechondria. But help is here, with new Advertil(R) in the green-and-yellow caplet. Ask your doctor …

No, wait, don't really ask. Telechondriacs have not yet been recognized by science. Pharmacists are not dispensing drugs like "Advertil," and they probably never will. The last chemical that pharmaceutical executives would want to sell you is one that makes it harder for them to convince you that you're sick and need their products.

Drug corporations and their "awareness" groups, as we're all painfully aware, have defined and redefined a host of medical conditions -- including female sexual dysfunction, erectile dysfunction, restless legs, sleeplessness, bipolar disorder, attention deficit disorder, social anxiety disorder and irritable bowel syndrome -- to include larger and larger segments of the population in the United States and other Western nations.

Accepting for a moment the industry's claims about the numbers of people suffering from the eight diseases listed above, we could do some simple calculations showing that up to 93 percent of adult women and men in the United States suffer from at least one of them. Throw in a few more conditions like depression, bone density loss and premenstrual dysphoric disorder, and industry figures make it appear that virtually every American has a disease in need of a treatment.

Last year, Ray Moynihan and Alan Cassels called attention to the epidemic of disease marketing in their book "Selling Sickness." Last month, health professionals, academics, journalists and consumers gathered in Newcastle, Australia, for the Inaugural Conference on Disease Mongering. A set of papers from that meeting was published free by the online journal PLoS Medicine. Also last month, the Prescription Access Litigation Project (PALP) in Boston announced its "2006 Bitter Pill Awards," recognizing drug companies that engaged in the year's worst "overzealous and questionable marketing practices."

These and other recent activities make it all too clear that the profitable practices exposed in Lynn Payer's 1992 book "Disease Mongers: How Doctors, Drug Companies, and Insurers Are Making You Feel Sick" have been refined and amplified in recent years, with the apparent goal of medicating an entire population.

Unruly body parts

The evolution of "restless legs syndrome," documented by Steven Woloshin and Lisa Schwartz in a paper from the Disease Mongering Conference, is a case study in how a pharmaceutical company, with help from the media, can turn what is a serious problem for some people into a contrived medical condition for millions more.

Woloshin and Schwartz analyzed media coverage in the interval between 2003, when GlaxoSmithKline Inc. first issued press releases about trials of its drug Requip for relief of restless legs syndrome, and 2005, when the U.S. Food and Drug Administration (FDA) approved that use.

Of 187 major newspaper articles published during those two years, 64 percent relayed without comment the industry's claims that millions of Americans -- as many as "1 in 10 adults" -- suffer restless leg. Forty-five percent of the articles stressed that many people may be unaware they're sick, even though, according to 73 percent of the articles, the syndrome can have extreme physical, social and emotional consequences. Reports of the relief provided by drug treatment used "miracle language" 34 percent of the time, while 93 percent of articles failed to quantify Requip's side effects.

Yet the relief people get from Requip appears to be anything but miraculous. In one trial, 73 percent of subjects saw improvement -- compared with 57 percent whose symptoms improved with a placebo! Side effects that occurred in clinical trials at least twice as often with Requip as with a placebo included nausea (40 percent of subjects), vomiting (11 percent), somnolence (12 percent), dizziness (11 percent) and fatigue (8 percent).