Healthy Skepticism Library item: 18241

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Foppe van Mil JW, van Eijk MEC
‘Selling sickness: influence on influence’, what constitutes good prescribing in 2010?
International Journal of Clinical Pharmacy and Pharmaceutical Care 2010 May 7;
http://springerlink.com/content/k1368t3844w4g97q/fulltext.html

Abstract:

When a decision is made to prescribe a drug, we carefully balance its intended and unintended effects. Positive effects include minimizing the patient’s complaints and disease risks like premature death [1]. Negative effects include the possible side-effects in the short and long term [2]. Guidelines on disease management are based on research evaluating these aspects. The more severe the disease burden or the risks of a condition, the more risks of drug treatment we accept [1].

When we look at prescribing decisions as a delicate balance of risk management and effectiveness, we realize that the nature of the disease definition or the risk perceived to be associated with a condition can strongly influence prescribing volume [3, 4]. “Selling sickness” has been described as the process of widening of the definitions of disease-in part by transforming risks into diseases-a process often fuelled by the pharmaceutical industry [4]. For example, ‘normal’ test scores are increasingly tightened and the definitions for several psychiatric diagnoses are expanded to include ever more people.