Selling Sickness

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

Sunday, September 04, 2005

Book Review in the New York Times

SELLING SICKNESS: How the World's Biggest Pharmaceutical Companies Are
Turning Us All Into Patients. By Ray Moynihan and Alan Cassels. (Nation
Books, $25.)

Is menopause a disease? Maybe not, but drug companies encouraged people to think so in order to sell hormone replacement therapy, until the news broke that the hormones increased the risk of heart attacks, strokes and breast cancer. Moynihan and Cassels quote a cheery report by a pharmaceutical analyst in 2003: ''The coming years will bear greater witness to the corporate sponsored creation of disease.''

Case by case, Moynihan and Cassels explain how corporations market disease. They lavish funding on the experts who set the thresholds for conditions like high cholesterol and high blood pressure; the lower the thresholds, the more customers.

The corporations scare the healthy into taking tests of little benefit. They cozen so many ''thought leaders'' in psychiatry with dinners, swag and research dollars that the former editor of The New England Journal of Medicine complained she had trouble finding a qualified reviewer free of drug company money. To throw their corporate voice, they construct patient advocacy groups, such as high cholesterol's Boomer Coalition, or heavily subsidize existing ones. And to skirt F.D.A. ad regulations, they deploy the ultimate corporate weapon: celebrities.

Lauren Hutton praised hormone replacement therapy in 2000 without a word about its emerging dangers, and when running back Ricky Williams gushed about Paxil in 2002, no law obliged him to mention its sci-fi withdrawal symptoms (today's fine print warns of ''electric shock sensations'' and ''abnormal dreams'').

Moynihan and Cassels seem to have written in a hurry, and some of their endnotes are confusing, but they make a compelling case.