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Healthy Skepticism International News

June 2005

Book Review: Selling Sickness


Review of ‘Selling Sickness : How the drug companies are turning us all into patients’.
Moynihan R and Cassels A, published by Allen and Unwin, 2005.

Ray Moynihan is an internationally known medical journalist based in Australia and Alan Cassels is a Canadian researcher and writer who works on drug policy issues.

The central argument of ‘Selling Sickness’ is that comparatively uncommon or mild medical conditions are being redefined and promoted at the instigation of an influential pharmaceutical industry and with the assistance of an obliging medical profession in order to suggest that they are much more widespread and severe than was formerly believed.
This is done for the purposes of marketing drugs which are alleged to be therapeutic in treating those conditions, though many of the participants in the process claim that they are simply involved in ‘educational campaigns’.

The authors develop this theme in relation to a series of conditions and their matching drugs, devoting a separate chapter to each condition.-

Chapter 1: high cholesterol->statins
Chapter 2: depression -> SSRIs
Chapter 3: menopause-> HRT
Chapter 5: ADD/ADHD -> Ritalin/amphetamines etc
Chapter 6: ‘Pre-menstrual Dysphoric Disorder’ -> SSRIs
Chapter 7: Social Anxiety Disorder -> SSRIs
chapter 8: Osteoporosis -> biphosphonates
Chapter 9: Irritable Bowel Syndrome -> Lotronex/Zelnorm
Chapter 10: Female Sexual Dysfunction -> Viagra/Testosterone patches

Along the way, we learn about the complex, clever and comprehensive strategies utilised by pharmaceutical companies to influence the medical profession, ‘thought leaders’, patient advocacy groups, researchers, guideline writers, regulatory agencies, political decision makers and the general public. We also learn about those who are trying to resist the disease mongering juggernaut. Ethical independent thinkers, operating with miniscule resources in a David-and-Goliath struggle against the massive financial resources of the pharmaceutical industry and its supporters(speaking of which, Healthy Skepticism gets a mention on page 102).

Selling Sickness is easy reading and will be an absorbing but hair-raising excursion into the world of pharmaceutical advertising and disease promotion for both the health professional and general reader alike. The book has a recurring polemical element as it attempts to convince us of the wrongness of most of what it describes, which may be unnecessary in view of the horrifying nature of the material which speaks eloquently enough for itself.

The principle focus of the book is on the ‘Anglo’ countries of the USA, UK, Canada and Australia though one suspects that the same processes are being played out in every country where the public have enough disposable income to be able to afford these diseases.

This book will be of interest to anyone concerned about their personal health and/or the health of their community. It raises important questions about the nature of health and disease, and who gets to define when a symptom is bad enough to be classified as a disorder. Who is in control of this process and what are their motives? They might not be as objective as we tend to naively imagine.

Read this book and a ‘Disease Awareness Campaign’ advertisement on TV will never look the same again.

Selling Sickness is highly recommended as an eye-opener for the general public and should be compulsory reading for all health professionals and health science students.



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