Selling Sickness

How the World's Biggest Pharmaceutical Companies are Turning us All into Patients

Monday, August 01, 2005

Book Review: Philadelphia Inquirer

Selling Sickness
How the World's Biggest Pharmaceutical Companies Are Turning Us All into Patients
By Ray Moynihan and Alan Cassels

Nation Books. 254 pp. $25

Reviewed by Sherry Jacobson

Ray Moynihan and Alan Cassels, coauthors of Selling Sickness: How the World's Biggest Pharmaceutical Companies Are Turning Us All Into Patients, make a strong case against the pill-popping habits of many Americans. Specifically, their book takes aim at our habit of using pills to control such conditions as high cholesterol, high blood pressure, osteoporosis and menopause.

Both authors are outsiders to the U.S. health care system. Moynihan is an Australian journalist who has covered the business of health care for nearly a decade, including prize-winning reports in the British Medical Journal. Cassels is a Canadian health policy researcher in British Columbia.

As someone who has written about medical problems for years, I've got to admit that the book makes a pretty convincing argument that the public is being manipulated. Americans are forking over a fortune in hopes of avoiding severe illnesses, and drug companies are getting richer in the process.

But the authors make their strongest case by dissecting pharmaceutical claims that a certain medication can prevent a certain disease. Take high blood pressure, for example.

U.S. medical guidelines indicate that more than 40 million Americans suffer from high blood pressure or hypertension, a condition that increases the risk of suffering a heart attack or stroke. One medication purports to cut the risk by a third. So why not take it?

The authors want you to examine the numbers more closely. If you have elevated blood pressure but no other health complications, your risk of suffering a heart attack or stroke could be about 3 percent during the next five years. When medication cuts that risk by a third, your risk drops by a mere percentage point.

The authors also theorize that drug companies pressure government regulators, particularly the U.S. Food and Drug Administration, to create new disease categories. They wonder whether these new categories - including premenstrual dysphoric disorder, social anxiety disorder, irritable bowl syndrome, and female sexual dysfunction - even exist but for the drugs that have been invented to tackle them.

The book also criticizes doctors for promoting the benefits of medication without revealing their own financial connections to the drug's manufacturer, as well as Hollywood celebrities who market their personal health problems on talk shows without mentioning that drug companies are paying them.

And the news media, of course, take a major hit for not blowing the whistle on the entire charade.

What's a conscientious health-care consumer supposed to do?

The authors urge consumers to employ a "healthy skepticism" whenever they hear claims of a new, but rampant, disorder and, of course, to be wary of the perfect remedy that would combat it.

But consumers also need to be smart enough to know when they're sick enough to need the medication. The authors wisely conclude: "Sometimes, of course, diseases are real, painful and deadly, and treatment with the latest and most expensive drug or other medical technology or procedure is highly desirable."

The trouble is, you have to know the difference.

This review appeared originally in the Dallas Morning News.