Are drug companies "disease – mongering" to boost sales?

In the April 20 issue of The New England Journal of Medicine, a research team reported on "prehypertension", the condition of being in danger of developing hypertension (high blood pressure). First identified in 2003, prehypertension, is defined as blood pressure readings from 120/80 to 139/89 . While this risk of being at risk of HPB can be modified with diet and daily exercise, the NEJM reports that it can also be treated with Atacand.

To a growing number of doctors and healthcare providers, the very idea of treating the risk of a risk is wrong. Some are calling the event "disease-mongering", defined as the corporate-sponsored creation or exaggeration of illnesses for the sole purpose of selling more drugs. Prehypertension "is a classic case of a risk factor being turned into the disease," says Dr. Steven Woloshin of the Veterans Affair Outcomes Group in White River Junction, Vt. "If you make a cut-off for blood pressure that's close to the normal range, then just about everyone can be diagnosed."

Disease–mongering, according to critics, is on the rise. It all starts when a drug is developed for some once–rare condition. This leads to heavily promoted disease–awareness campaigns, which in turn trigger increasing numbers of diagnoses and prescriptions. The list of suspects may include restless legs syndrome, social anxiety disorder, erectile dysfunction, and more. "Of course, some people have these diseases very seriously," says Dr. Robert L. Klitzman, a psychiatrist and bioethicist at Columbia University. "The problem is that mild cases are being made to seem more serious than they are." The other problem is that occurrences of everyday life, such as sadness, shyness, forgetfulness, and the occasional upset stomach, are being made into medical conditions. Social anxiety disorder (severe shyness) was a rarely seen condition until GlaxoSmithKline PLCs Paxil was approved to treat it. Glaxo's disease-awareness campaign in the late 1990s was quickly followed by rising numbers of social anxiety disorder.

"Drug companies are playing off the desire we all have to get rid of things that bother us," says Klitzman. Patients seeking a quick fix for conditions that might be treated better through lifestyle changes, need to know this could mean taking a pill every day for years. A proposition that is both risky and expensive. "We realize that not every medicine is for every person," says a spokeswoman for Glaxo, which develops drugs for restless legs syndrome, social anxiety disorder, and other diagnoses that are under criticism. "The labels contain important information about whether it's appropriate, and we're confident that doctors consulting with patients will assess their health–care issues and the risks and rewards and make an appropriate decision."

Critics aren't convinced, seeing that many doctors get their information about disease treatment from the pharmaceutical industry. Drug companies often fund research for diseases that then get published in medical journals. They also frequently subsidize continuing medical education classes for doctors. Dr. Woloshin from Veterans Affairs recognizes that some people are helped by Paxil (severe shyness), Requip (restless legs syndrome), and Viagra (erectile dysfunction). However, he worries that overtreatment drains the money for crucial research into more serious illnesses. "None of these companies is coming up with a cure for TB," he notes.