Selling Sickness: How the World's Biggest Pharmaceutical Companies Are Turning Us All into Patients

David Bennett is the national director of the Department of Workplace Health, Safety and Environment at the Canadian Labour Congress in Ottawa.

Ray Moynihan is a broadcast journalist with academic credentials. Alan
Cassels is a drug-policy researcher at the University of Victoria. Their
strategy, in Selling Sickness, is to take 10 diseases or conditions
arising out of lifestyle and to examine the drug regimes attendant on
them. Of these 10, five are essentially mental conditions, where
etiology and the consequences (success) of drug treatment are far harder
to determine than for physical conditions.

The social history of these diseases and their remedies differ from
case to case, but they broadly conform to a pattern. Drug companies
first identify, construct, or invent a disease or condition, and
then—usually concurrently—produce a drug to alleviate the condition.
The disease is widely and strongly advertised, along with the remedy:
“an ill for every pill.” The benefits are touted, sometimes backed
by shoddy or inadequate research, and the drawbacks minimized. The
result is to make patients of us all, victims of multiple diseases
unheard of a generation ago, beholden to transnational drug companies
and suffering from the social malaise incurred by the presumption of
illness. A concomitant result is the progressive inability of the public
medical system to meet the demands of an increasing volume of costly
drugs.

When drug companies do not pursue this strategy, the failure is
proportional. When we see, for instance, the ads for nonprescription
remedies for insufficient tearing of the eyes, we can be pretty sure
that the drug remedy will fail to take off. What the companies need is a
campaign to show that insufficient tearing is a widespread condition,
something not easy to do.

Selling Sickness is powerfully and cogently argued. The book would have
been more convincing if there were a literary tradition documenting the
changing conceptions of health and disease and the legitimacy of drug
treatment as the central type of remedy. The authors cite Ivan Illich,
who was not a physician and who started such a tradition in 1976 with
Limits to Medicine (aka Medical Nemesis). The fact that the critical
tradition was largely stillborn is not the fault of Moynihan and
Cassels.