Selling Sickness: Trying New Drugs

Notes on Selling Sickness (2005) by Roy Moynihan and Alan Cassels

Chuk Moran
14 min readJan 24, 2020


Selling Sickness explains how pharmaceutical companies establish diseases in order to sell treatments (drugs). In some cases, the treatment helps. In others, it may hurt. In most cases, it’s not clear at all who benefits from feeding millions of First World consumers all these drugs.

The book positions itself as controversial, but I don’t agree. Almost everything they describe is plainly true. Large corporations are trying to make money and will push as far as they can, including some level of regulatory capture. I don’t think anyone disagrees with this. What might be controversial, however, is the way we regard this situation. The authors resort to dramatic rhetoric about fear-mongering corporations, helpless victims, and the brave few who will stand for truth. Here, I’ll summarize their claims and offer my own, less dramatic take.

Constructing “Conditions”

Although there could be other ways to think of health, the contemporary pharmaceutical industry has learned to sponsor the construction of a condition, encourage doctors to find it in many patients, and link it in everyone’s mind with a treatment (xii). They aim to “create an inextricable bond between the conditions and the drug. And it works. Think ADD and you think medication” (74)

How do they do this?

Winning Buy-In from Doctors

Companies offer plum consulting gigs to doctors who will play ball (tow their line), and have been very successful in encouraging research activity around certain conditions to get them to develop the way they want. For example, by sponsoring a conference on ADHD, a company can develop a condition to get it included in the DSM or classified as a particular type of problem, such as a neurotransmitter problem. This book is full of excellent examples, including that 8 of the 9 experts who wrote the (then current) cholesterol guidelines for the US Federal Government also served as paid speakers, consultants or researchers to the world’s major drug companies.

To me, this sounds like regular life. In many professions, it becomes difficult, after a certain point, to raise…