Disease mongering is a pejorative term for the practice of widening the diagnostic boundaries of illnesses and aggressively promoting their public awareness in order to expand the markets for treatment. Among the entities benefiting from selling and delivering treatments are pharmaceutical companies, physicians, and other professional or consumer organizations.
The term “monger” has ancient roots, providing the basis for many common compound forms such as cheesemonger, fishmonger, and fleshmonger for those who peddle such wares respectively. “Disease mongering” as a label for the "invention" or promotion of diseases in order to capitalize on their treatment was first used in 1992 by health writer Lynn Payer, who applied it to the Listerine mouthwash campaign against halitosis (bad breath).
Payer defined disease mongering as a set of practices which include the following:
- Stating that normal human experiences are abnormal and in need of treatment
- Claiming to recognize suffering which is not present
- Defining a disease such that a large number of people have it
- Defining a disease's cause as some ambiguous deficiency or hormonal imbalance
- Associating a disease with a public relations spin campaign
- Directing the framing of public discussion of a disease
- Intentionally misusing statistics to exaggerate treatment benefits
- Setting a dubious clinical endpoint in research
- Advertising a treatment as without side effect
- Advertising a common symptom as a serious disease
The incidence of conditions not previously defined as illness being medicalised as "diseases" is difficult to scientifically assess due to the inherent social and political nature of the definition of what constitutes a disease, and what aspects of the human condition should be managed according to a medical model. For example, halitosis, the condition which prompted Payer to coin the phrase "disease mongering", isn't merely an imagined social stigma but can stem from any of a wide spectrum of conditions spanning from bacterial infection of the gums to kidney failure, and is recognized by the Scientific Council of the American Dental Association as "a recognizable condition which deserves professional attention".
Australian journalist Ray Moynihan has argued that the pharmaceutical industry engages in disease mongering to enlarge its profits, and that it harms patients. His use of osteoporosis as an example of a "made up" disease in this article prompted an angry retort from the president of the British National Osteoporosis Society, stating that the article was insulting to people with osteoporosis and vastly understated the risk of disabling fractures associated with the disorder. Moynihan published a satire of disease mongering in the 2006 April Fool's Day issue of BMJ titled "Scientists find new disease: motivational deficiency disorder".
Other conditions which have been cited as examples of disease mongering include restless leg syndrome, testosterone deficiency, erectile dysfunction, hypoactive sexual desire disorder. Some of these conditions are recognized as medical disorders by professional medical societies and the National Institute of Health and Clinical Excellence. In 2014 an FDA advisory committee voted to limit the use of testosterone replacement therapy products due to potentially increased cardiovascular risk associated with their use.
- Inverse benefit law
- Quaternary prevention
- Schooliosis – an example of disease mongering due to overdiagnosis
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- "nypediatricdds.com" (PDF).
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- Edwards L (July 2002). "The pharmaceutical industry and disease mongering. Article was insulting to people with osteoporosis". BMJ 325 (7357): 216; author reply 216. doi:10.1136/bmj.325.7357.216. PMID 12143857.
- Moynihan R (2006). "Scientists find new disease: motivational deficiency disorder". BMJ 332 (7544): 745. doi:10.1136/bmj.332.7544.745-a.
[Neurologist Leth Argos and a team...] at the University of Newcastle in Australia say that in severe cases motivational deficiency disorder can be fatal, because the condition reduces the motivation to breathe.
- Moynihan R, Henry D (April 2006). "The fight against disease mongering: generating knowledge for action". PLoS Med. 3 (4): e191. doi:10.1371/journal.pmed.0030191. PMC 1434508. PMID 16597180.
- Vitry AI, Mintzes B (June 2012). "Disease mongering and low testosterone in men: the tale of two regulatory failures". Med. J. Aust. 196 (10): 619–21. doi:10.5694/mja11.11299. PMID 22676868.
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- Tiefer L (April 2006). "Female sexual dysfunction: a case study of disease mongering and activist resistance". PLoS Med. 3 (4): e178. doi:10.1371/journal.pmed.0030178. PMC 1434501. PMID 16597176.
- Hatzimouratidis K, Amar E, Eardley I, et al. (May 2010). "Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation". Eur. Urol. 57 (5): 804–14. doi:10.1016/j.eururo.2010.02.020. PMID 20189712.
- "FDA Panel: Limit Testosterone Drug Use – WebMD".
- Moynihan R, Henry D (eds). "A Collection of Articles on Disease Mongering.". PLoS medicine, 2006. Retrieved 2007-06-12.
- Moynihan, R; Henry, D (2006). "The fight against disease mongering: Generating knowledge for action". PLoS Medicine 3 (4): e191. doi:10.1371/journal.pmed.0030191. PMC 1434508. PMID 16597180.
- Conrad, Peter (2007). The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders. Baltimore: Johns Hopkins University Press. ISBN 978-0-8018-8585-3.
- "Doctors' body accuses drug firms of 'disease mongering'". The Daily Telegraph.
- "Potency, Hubris, and Susceptibility: The Disease Mongering Critique of Pharmaceutical Marketing" by Evan Doran & Clare Hogue, The Qualitative Report, 2014 Volume 19, Article 78, 1-18
- "Forced Smiles", by Theodore Dalrymple, The New Criterion, Volume 25 September 2006