Disease mongering and low testosterone in men: the tale of two regulatory failures

Disease-awareness campaigns on low testosterone and ageing highlight the need for changes to regulations

Currently, direct-to-consumer advertising of prescription-only medicines is legal in only two industrialised countries, the United States and New Zealand. However, in countries where direct-to-consumer advertising is not allowed, including Australia, Canada and countries in the European Union, pharmaceutical companies have found ways to sidestep this prohibition through intensive use of the internet, social media and print and broadcast media — for example, by running “help-seeking” or “disease-awareness” campaigns.1 These unbranded promotional campaigns feature a condition treated by the manufacturer’s product, and often encourage viewers or readers to ask their doctor about a newly available treatment. However, there are many examples of drug company-funded disease-awareness campaigns that exaggerate disease risks and prevalence, and misrepresent treatment effectiveness.2 Aspects of ordinary life (such as menopause or unhappiness) are “medicalised”, and conditions that are often mild (such as irritable bowel syndrome and restless legs syndrome) are portrayed as serious illnesses. Disease-awareness campaigns can affect consultation and prescribing rates, with potential negative effects on public health if they encourage inaccurate health beliefs and incite consumers to request inappropriate treatments from health care providers.3,4