‘Selling sickness: influence on influence’, what constitutes good prescribing in 2010?
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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 . Negative effects include the possible side-effects in the short and long term . 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 .
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 . For example, ‘normal’ test scores are increasingly tightened and the definitions for several psychiatric diagnoses are expanded to include ever more people.
Society needs new drugs, but developing them is expensive. We know little about the long term effects of new drugs . How can we organise healthcare and research in a way that will benefit us most? We don’t want to test new drugs in a vulnerable population and waste resources. How do we move from selling sickness to improving health? Answers and solutions are complex and need to be created in a dialogue with all stakeholders together.
Healthy Skepticism International aims to improve health by reducing harm from misleading health information from the pharmaceutical industry. Healthy Skepticism Netherlands (Gezonde scepsis) will be hosting a conference on selling sickness in 2010. The sponsors are the Dutch Ministry of Health and the Dutch Health Care Inspectorate. Collaboration with the World Health Organization (WHO) is in process.
The conference is designed for everyone with an interest in pharmaceutical information and promotion including: health professionals, policy makers, staff of government health and regulatory departments, inspectors, staff of pharmaceutical, advertising and public relations companies, staff of NGOs and journalists. The two days will include many presentations as well as time for networking, panel discussions and poster sessions.
We look forward to meeting you in Amsterdam, on the 7th and 8th of October 2010. See www.gezondescepsis.nl for more information.
- 1.Avorn J. Powerful medicines: the benefits, risks, and costs of prescription drugs. New York: Knopf; 2004. ISBN 978-0-375-41483-1.Google Scholar