The trend, which is dubbed "disease mongering" by the experts, "turns healthy people into patients, wastes precious resources, and causes iatrogenic harm," David Henry, a professor of clinical pharmacology at the University of Newcastle in New South Wales, Australia, and Ray Moynihan, a journalist and conjoint lecturer at the university wrote in a commentary in PLoS Medicine.

"Like the marketing strategies that drive it," Henry and Moynihan added, "disease mongering poses a global challenge to those interested in public health, demanding in turn, a global response."

The article is one of 11 discussing disease mongering and how the health community can help counter it, that appear in a special theme issue of the journal. The articles were published to coincide with an international conference on the issue starting April 11 at the University of Newcastle.

Henry and Moynihan said disease mongering is exemplified "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."

The different forms of disease mongering include "aspects of ordinary life, such as menopause, being medicalized; mild problems portrayed as serious illnesses, as has occurred in the drug company-sponsored promotion of irritable bowel syndrome, and risk factors such as high cholesterol and osteoporosis being framed as diseases," the researchers wrote.

The Pharmaceutical Research and Manufacturers of America denied the disease mongering allegations.

"To say we are in the business of scaring healthy people to seek treatment is simply unfair and untrue," PhRMA Senior Vice President Ken Johnson told United Press International.

Johnson said industry-funded awareness campaigns can help patients recognize disorders they may be suffering from and get appropriate treatment.

"The old saying 'knowledge is power' is very real and very true, particularly as it relates to patients learning about a new disease or health condition," he said. "Without this knowledge, many patients run the risk of not recognizing early symptoms of debilitating diseases. Worse, they risk not getting the treatment they need to live longer, healthier lives."

Henry and Moynihan agreed that in some cases, disease mongering can have a positive impact, such as the industry-funded public education campaigns about the prevention and treatment of HIV/AIDS.

But in other instances, they wrote, it can be viewed as a crude attempt to build market share for a drug, such as Lilly's promotion of premenstrual dysphoric disorder, a condition that some consider nonexistent, "to help sell a rebranded version of fluoxetine (rebranded from Prozac to Sarafem)."

Another example is Pfizer's efforts to create awareness of erectile dysfunction to increase the potential market for Viagra, Joel Lexchin, of York University's school of health policy and management in Toronto, Canada, wrote in one of the articles.

Efforts are already being undertaken around the world to identify and counter disease mongering, Henry and Moynihan stated. These include the advocacy group Health Action International, the Australian watchdog group Media Doctor (which Henry co-founded) and the Royal College of General Practitioners in the United Kingdom.

Challenges could also come from industry itself, they say. "It may be that as key shareholders and company executives alike understand more of the implications of what their marketing departments do, a challenge to the excesses of disease mongering may come from within industry," they wrote.

Peter Lurie, deputy director of Public Citizen's Health Research Group, agreed for the need to curtail disease mongering.

"The last thing we need are essentially healthy people being subjected to drug that are usually expensive and sometime dangerous when they don't really have an illness at all," Lurie told UPI.

But disease mongering has been a successful strategy and is "being increasingly refined by the pharmaceutical industry and its colleagues in the advertising industry," he said.

Combating it will require a multi-pronged approach that includes existing patient groups refusing pharmaceutical company funding and more awareness and vigilance from journal editors and the media to ensure that bogus or exaggerated studies are more carefully vetted.

Barbara Mintzes, of the University of British Columbia's department of anaesthesiology, pharmacology and therapeutics, wrote in the journal that regulatory authorities should play a greater role in controlling disease mongering.

"A key question is whether there is sufficient political will among government regulatory agencies to better enforce existing regulations governing drug promotion or to introduce new solutions," Mintzes wrote. "Most regulatory agencies fail to treat regulation of drug promotion as a public health concern. Unless this changes, the public can expect more unfettered disease mongering warning them that without the latest treatment, life will be grim indeed."

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