Selling Sickness: How the World's Biggest Pharmaceutical Companies Are Turning Us All Into Patients [Paperback]

Ray Moynihan (Author), Alan Cassels (Author)

Book Description

ISBN-10: 156025856X | ISBN-13: 978-1560258568 | Publication Date: June 23, 2006 | Edition: 1

Thirty years ago, Henry Gadsden, the head of Merck, one of the world's largest drug companies, told Fortune magazine that he wanted Merck to be more like chewing gum maker Wrigley's. It had long been his dream to make drugs for healthy people so that Merck could "sell to everyone." Gadsden's dream now drives the marketing machinery of the most profitable industry on earth. Drug companies are systematically working to widen the very boundaries that define illness, and the markets for medication grow ever larger. Mild problems are redefined as serious illness and common complaints are labeled as medical conditions requiring drug treatments. Runny noses are now allergic rhinitis, PMS has become a psychiatric disorder, and hyperactive children have ADD. When it comes to conditions like high cholesterol or low bone density, being "at risk" is sold as a disease. Selling Sickness reveals how widening the boundaries of illness and lowering the threshold for treatments is creating millions of new patients and billions in new profits, in turn threatening to bankrupt health-care systems all over the world. As more and more of ordinary life becomes medicalized, the industry moves ever closer to Gadsden's dream: "selling to everyone."

Editorial Reviews

From Publishers Weekly

This accessible study about the collusion between medical science and the drug industry emphasizes how drug companies market their products by either redefining problems as diseases (like female sexual dysfunction) or redefining a condition to encompass a greater percentage of the population. Moynihan, a health journalist for the New England Journal of Medicine and the Lancet, and Cassels, a Canadian science writer, note, for instance, that eight of the nine specialists who wrote the 2004 federal guideline on high cholesterol, which substantially increased the number of people in that category, have multiple financial ties to drug manufacturers. Physicians now routinely prescribe cholesterol-lowering pills (statins) that may have perilous side effects, when many people could lower their risk of heart attack with less costly and dangerous steps, such as exercise and improved diet. Through aggressive merchandising, funding of medical conferences and expensive perks, drug companies win doctors over to diagnosing these "diseases" and prescribing drugs for them. Unfortunately for these authors, much of this territory has been covered by several books in the past year, most notably Marcia Angell's The Truth About the Drug Companies
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to the Hardcover edition.

From Booklist

Science and medicine writers Moynihan and Cassels conjecture that most Americans believe, based on information gleaned from a deluge of pharmaceutical-company advertisements, that conditions such as hypertension, high cholesterol, menopause, and chronic constipation are bona fide diseases. They quote reputable medical experts, however, who refute such understandings. What's more, they suggest that billions of precious and diminishing health-care dollars are squandered treating those nondiseases of healthy, wealthy Americans and would be better spent treating the legitimately sick poor and fighting the international AIDS epidemic. Quoting former Merck CEO Henry Gadsen--who, in a 1976 Fortune article, confessed that "it had long been his dream to make drugs for healthy people. Because then, Merck would be able to 'sell to everyone'"--they lay the blame for the misdirected billions at the feet of just such pharmaceutical giants as Merck. Finally, they counterpoint glossy pharmaceutical ad campaigns with alternatives that consumers may consider before asking their doctors for prescription drugs they saw touted on TV. Donna Chavez
Copyright © American Library Association. All rights reserved --This text refers to the Hardcover edition.

See all Editorial Reviews

Product Details

• Paperback: 272 pages
• Publisher: Nation Books; 1 edition (June 23, 2006)
• Language: English
• ISBN-10: 156025856X
• ISBN-13: 978-1560258568
• Product Dimensions: 8.3 x 5.4 x 0.7 inches
• Shipping Weight: 8.8 ounces (View shipping rates and policies)
• Average Customer Review: 4.4 out of 5 stars  See all reviews (40 customer reviews)
• Amazon Best Sellers Rank: #71,873 in Books (See Top 100 in Books)
  • #20 in Books > Business & Investing > Industries & Professions > Industrial Relations

More About the Author

Discover books, learn about writers, read author blogs, and more.

Customer Reviews

Most Helpful Customer Reviews

80 of 85 people found the following review helpful:

5.0 out of 5 stars Peak oil and Health -- you might not even be ill, September 17, 2006

By 

Alice Friedemann (Oakland, California) - See all my reviews
(REAL NAME)   

This review is from: Selling Sickness: How the World's Biggest Pharmaceutical Companies Are Turning Us All Into Patients (Paperback)

After oil production peaks, higher energy prices are likely to sink the world economy into a never-ending depression, so it will be important to stay healthy, because everything, and especially medical costs, are likely to be more expensive in the future. Before you incur high medical costs you can little afford, make sure you're even ill first. A great deal of fat could be cut out of the health care system right now and used instead to help people who are truly ill.

Getting healthy people to buy drugs they don't need, which won't cure what they don't have, and potentially have unpleasant to dire side effects, sounds like such a crazy premise, even Hollywood wouldn't buy it.

Yet that's just what's happened, as Moynihan and Cassels document in their book "Selling Sickness". The 500 billion dollar pharmaceutical industry has plenty of money to spend convincing us that our ordinary travails mask mental illnesses, and common aches and pains need treatment.

Americans represent five percent of the world's population, but we consume fifty percent of prescription drugs.

Millions of healthy people have asked their doctor about that purple pill they saw on television, or been given drugs pushed by the army of 80,000 drug salesmen who've influenced your doctor with free lunches and far more.

Many people now take drugs that may have harmful side effects and won't make much of a difference in improving their health. Hormone replacement therapy turned out to increase the chance of heart attacks for women, one of the blockbuster cholesterol lowering drugs was withdrawn from the market because it was implicated in causing deaths.

The FDA isn't looking out for you either, as shown in the chapter on irritable bowel syndrome. The FDA let the drug Lotronex remain far too long on the market, despite evidence coming in from doctors that it was killing, hospitalizing, and causing complications never seen before by doctors treating this syndrome.

How has the pharmaceutical industry pulled this off?

1) The point where you "need" to take a particular drug is continually lowered (i.e. for cholesterol, high blood pressure, etc), often far lower than necessary. Many of the doctors setting these lower standards have financial ties to the drug companies, so when more drugs are sold to more people, they stand to profit. Every time the good cholesterol level is lowered, millions of new customers are created overnight.

2) New diseases are invented that don't really exist. Menopause, for example, is a natural part of the life cycle. It's doubtful that attention deficit disorder and other "diseases" in the book exist.

3) Pharmaceutical companies exaggerate the good the drug will do for you. Brittle bones are only 13% of the problem in osteoporosis, which tends to affect people the last chapter of their life. Far more important is: don't fall! Be sure you've got good eyeglasses; your rugs won't slip, exercise, and so on.

4) You'll never see ads telling you the one thing you need to know: if you want to lead a healthy life, eat a good diet and exercise. But you will see all sorts of deceptive ads, which this book does a good job of describing. You'll be angry and sometimes shocked when you see the dirty tricks used to promote drugs.

There are people who stand to benefit from these drugs, the book is definitely not saying they're totally useless, and in fact, many of the people who do need these drugs aren't getting them.

But before you decide to take a drug, be sure to do research first to make sure you really need it. If you have one of the following, or know someone who does, you might want to read this book, which discusses depression, high cholesterol, menopause, attention deficit disorder, high blood pressure, premenstrual dysphoric disorder, social anxiety disorder, osteoporosis, irritable bowel syndrome, and female sexual dysfunction. The final chapter is entitled "What can we do?"

[...]

39 of 41 people found the following review helpful:

3.0 out of 5 stars OK, But There Are Better Books on the Topic!, December 25, 2005

By 

Loyd E. Eskildson "Pragmatist" (Phoenix, AZ.) - See all my reviews
(HALL OF FAME REVIEWER)    (REAL NAME)   

This review is from: Selling Sickness: How the World's Biggest Pharmaceutical Companies Are Turning Us All Into Patients (Paperback)

The marketing strategies of the world's biggest drug companies now aggressively target the healthy and the well. Common complaints have been transferred into frightening conditions and more and more ordinary people turned into patients. The drug companies have found that there's a lot of money to be made telling healthy people they're sick. With less than 5% of the world's population, the U.S. makes up over 50% of the world market for prescription drugs. Ironically, these much-hyped medicines sometimes cause more harm than good; another problem is that drug companies encourage over-reliance on drugs - instead of smoking cessation and exercise.

After this introduction, "Selling Sickness" goes on to cover examples in cholesterol, depression, high blood pressure, etc. Cholesterol, for example, has become a $25 billion, rapidly-expanding industry, even though cholesterol is only one of several factors affecting health, and for many, not a factor at all. As with many other conditions, the definition of what constitutes "high cholesterol" is regularly revised. In the latest instance (2004), eight of the nine experts on the panel also served as paid speakers, consultants, or researchers to the world's major drug companies. In most cases the experts had ties to at least four of the companies.

It is estimated that almost 90% of those writing guidelines have conflicts of interest because of financial ties to the industry. Close to half the billion/year funding for medical education comes from drug companies. About 300,000 meetings, events, and conferences are sponsored by the industry each year, often hosted by societies like the American Heart Association, partly funded by the drug companies as well. These entangled relationships are often not revealed.

After it was revealed that one NIH researcher had received $430,000 from industry sources and another held stock worth almost $2 million in drug companies, the NIH announced a moratorium on financial ties to private companies for all scientific staff.

The "bad news" about "Selling Medicine" is that the situation is not as simple as it appears. Medical experts' time is valuable - drug companies are not likely to obtain the benefit of their knowledge without payment. Thus, some "conflict of interest" is inevitable. The problem is determining whether the situation has gotten out of hand. How this might occur is suggested in the chapter on high-blood-pressure where it is noted that one could state that lowering high blood pressure reduces the threat of heart-attack by 33% (pretty impressive) - until one realizes the risk was only 3% to start with. Books that address this issue much more effectively include "Overdosed America: The Broken Promise of American Medicine" by John Abramson, and "The Truth About the Drug Companies: How They Deceive Us and What to Do About It" by Marcia Angell.

84 of 94 people found the following review helpful:

5.0 out of 5 stars Big Pharma Mashed Again, October 2, 2005

By 

Joel M. Kauffman (Berwyn, PA United States) - See all my reviews
(REAL NAME)   

This review is from: Selling Sickness: How the World's Biggest Pharmaceutical Companies are Turning Us All into Patients (Hardcover)

An excellent exposé of 10 or more examples of manufactured or exaggerated illness, from adult attention deficit disorder to osteoporosis. Overblown promotions of drugs and concealment of drug side-effects well explained. Big Pharma's use of public relations firms to create fear of some more or less normal condition is shown. Big Pharma's capture of the FDA and other agencies is shown.

Big Pharma's secret ownership of some patient support groups is shown, as is its control of much Continuing Medical Education. Its lobbying is legendary.

Even if you know about this disgrace in the USA, there are many aspects that may be new to you, so read this book.
Easy to read, good referencing, decent index.

Weak technically, but this might have been a desire not to stress the reader. Still, authors seem unaware that older people with the highest cholesterol and LDL levels live the longest (Schupf N, Costa R, Luchsinger J, et al. (2005). Relationship Between Plasma Lipids and All-Cause Mortality in Nondemented Elderly. Journal of the American Geriatrics Society 53:219-226.), or that blood pressure rises naturally with age, and only the top 10% of BP levels can be treated with any benefit.