Thursday, April 20, 2006

Disease Awareness or "Disease Mongering?"

[Also see results of this survey: "Disease Mongering: Real or Fantasy?"]

Recently, some pharmaceutical companies have stepped up their use of unbranded DTC ads whose messages focus only on the medical condition -- e,g., erectile dysfunction (ED) -- that the branded product treats with no mention of the brand. The industry calls these "disease awareness" ads. Some industry critics, however, call it "disease mongering."
"[Disease Mongering"] is exemplified mostly explicitly by many pharmaceutical industry-funded disease awareness campaigns - more often designed to sell drugs than to illuminate or to inform or educate about the prevention of illness or the maintenance of health." [Public Library of Science Medicine report]
I first heard the term "disease mongering" mentioned in a post by Peter Rost ("Pharma's Black Knight") in his blog over at the Huffington Post conglomerate (the Wall Mart of Blogs) -- see "Convincing Men That They Can't Perform."
[I'm jealous! According to Peter, "Several of the Huffington Post readers have asked me to take my clothes off and show some naughty pictures..." Finally, a blogger has achieved the real goal of all us nerdy bloggers -- sex appeal! He offers up some beefcake press conference photo opps. I am sure Peter will appear in movies (eg, Michael Moore's "Sicko" -- see "Michael Moore Seeks Sickos") and perhaps even star in the first ever Pharma Reality Show -- where contestants compete to overcome their lifestyle inadequacies like ED within the budgets of their consumer-directed, high deductible insurance plans. But I digress...]
What is "Disease Mongering"? "Disease mongering" -- according to a paper written on the subject in the PLoS Report mentioned above -- is "the effort by pharmaceutical companies (or others with similar financial interests) to enlarge the market for a treatment by convincing people that they are sick and need medical intervention."

Some "diseases" that the authors of the report consider "mongered" include:

  • Restless leg syndrome - Prevalence of rare condition exaggerated
  • Irritable bowel syndrome - Promoted as a serious illness needing therapy, when usually a mild problem
  • Menopause - Too often medicalised as a disorder when really a normal part of life
One of the authors -- Ray Moyniham, visiting editor and contributor to the British Medical Journal -- is also co-author of the book "Selling Sickness: How the World's Biggest Pharmaceutical Companies are Turning Us All into Patients."

Legitimate Awareness vs. Mongering

Although I hadn't heard the term "Disease Mongering" before, I have written on the subject in the past, most frequently in the area of ED. See, for example, "Indication Bloat - The Next DTC Issue" and "ED Drug Sales Limp", in which I suggest that sales goals for Viagra et al are not being met because pharma marketers were drinking their own Kool Aid regarding the high estimated prevalence of the condition.

ED: It's A Little Problem After All!
Pfizer, for example, says that "over half of all men over 40 have ED to some degree" (see "What you should know about erectile dysfunction (ED)"). A long time ago, I pointed out how ridiculous and misleading this statement is (see "Why are ED drug sales falling?"). According to an article in the New York Times, "What is not generally spelled out is that about 80 percent of those classified as having erectile dysfunction in the study were categorized as having only a moderate or minimal problem."
Recently, there have been a spate of ED disease awareness ads that talk about the potential causes of ED: high blood pressure, diabetes, and high cholesterol. On the one hand, I applaud this as truly educational (see "Pfizer Tries Unbranded ED DTC Ads"). For many years the branded ads said zip about the causes of ED. On the other hand, these ads may be an attempt to widen the potential market for ED drugs -- to all men with high blood pressure, high cholesterol, and/or diabetes; not just men who want to please their wives (like that poor guy in HBO's "Big Love"!).

The marketers of ED drugs -- especially the laggards in the market -- must be pretty desperate to engage in unbranded disease awareness advertising since it is a well-known axiom that disease awareness ads benefit the market leader (ie, Viagra in the ED market) most. In this case, however, "disease mongering" -- or, if you prefer, "disease awareness" -- efforts are a rising tide that will float all ED drug ships.


  1. Anonymous9:12 AM

    here's another blog entry on disease mongering:

  2. Very good post, as usual.

  3. Anonymous1:15 PM

    I'm really interested in this discussion. We all know the Europeans can only engage in disease awareness campaigns and that branded links to patients are not allowed. Perhaps we can learn from their efforts. I have worked on global women's health campaigns and believe that in subjects that are difficult to discuss and women are being just told to "cope" that our industry can actually do quite a bit of good. I am not sure in general that menopause is disease mongering, for example. Would like to continue this discussion as I think we can advance the industry and do good here, too.

  4. I’ve seen ads on TV for Caduet. It has two ingredients. One is Amlodipine and the other is Atorvastatin. With my RxDrugCard I can get 30 tablets of Amlodipine for $9 and 30 tablets of Simvastatin for $9. I’ll bet they are charging more than $18 for this new drug! The unthinking public is going to pressure their doctors into giving them something just because it’s new, when something old or generic would do the job for cheaper.


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