Parading ailments to sell pills

Since 1997, when the US first allowed TV ads that tout the latest drugs, Americans have had to watch a parade of ailments they knew little about. Selling sickness is now a multibillion-dollar business. Some critics joke that drug companies may soon sell a pill for the mass hypochondria their ads seem to create.

Pushing prescription drugs directly at consumers is still a big experiment in the US. (The only other developed nation to allow it is New Zealand.) Many critics say the disadvantages outweigh the advantages. Among the problems is that the advertisements bear little relationship to the bulk of the country's health needs.

Tighter regulations of the ads are needed by the Food and Drug Administration to prevent abuses, and new FDA rules for the industry are expected soon.

Most important, the FDA should focus on ways to prevent an increasing overuse of drugs caused by the ads and help counter their effects of turning people away from nondrug treatments, or even nonmedical ones.

Some in the medical community are pushing back against the selling of drugs to treat mild conditions that are rarely serious or the attempts to recategorize common aspects of life, such as shyness, as medical conditions. By doing so, drugmakers can expand or even create markets for their products. Sometimes they even invent new conditions, such as "pre-hypertension," and then offer a drug for it.

"There's a lot of money to be made from telling healthy people they're sick," concludes an article in the April 13 edition of BMJ, a British medical journal, titled "Selling sickness: the pharmaceutical industry and disease mongering."

The article quotes the late medical writer Lynn Payer as saying that disease-mongers "gnaw away at our self-confidence" by pushing drug-based solutions to life's problems and exploiting fears of disease and death. One leaked memo from a public relations firm, the article reports, told of how its "medical education" campaign would turn "irritable bowel syndrome" into a "credible, common, and concrete disease" requiring drugs.

Americans have grown more skeptical toward the TV drug ads since 1997, according to polls. Still, the FDA must help TV viewers guard against subtle manipulation by these commercials. One ad for a new drug plays on teenage fears of skin problems and offers free music downloads if teens persuade their parents to take them to a doctor for a prescription.

Disease-mongering, of course, is nothing new. The founder of this paper, Mary Baker Eddy, wrote more than a century ago: "Looking over the newspapers of the day, one naturally reflects that it is dangerous to live, so loaded with disease seems the very air." (This newspaper does not accept medical advertising.)

Senate majority leader Bill Frist, who's also a heart surgeon, said in a recent speech: "Drug advertisements ... cause more people to take prescription drugs. They create an artificial demand."

And just as the medical industry now recognizes that one's thinking can improve health, it must also know that regular images and suggestions of ailments are not in the public interest.

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