Ill informed: how drug companies convince Americans they're sicker than they are.

• Author: Brownlee, Shannon
• Position: On Political Books - Generation Rx: How Prescription Drugs Are Altering American Lives, Minds, and Bodies - Book Review

Generation Rx: How Prescription Drugs Are Altering American Lives, Minds, and Bodies By Greg Critser Houghton Mifflin, $24.95

Sometime in the late '80s, the CEO of the drug company Glaxo-SmithKline realized he had a problem. Glaxo's lead drug at the time was Zantac, which accounted for one-third of the company's bottom line and was also the world's bestselling ulcer medicine. Zantac had to stay the world's bestselling ulcer medicine for another few years while Glaxo scientists searched for replacements because the drug was slated to lose its patent protection in 1997. The problem was, evidence had been accumulating for several years suggesting that ulcers are not caused by an excess of stomach acid, which Zantac was really good at suppressing, but rather by a bacterium known as Helicobacter pylori. "The implication, hopeful for patients," as author Greg Critser puts it, "was also dismal for Glaxo." Scientists from Glaxo and other companies pooh-poohed the bacterial theory, but by the early 1990s, clinical trials had shown that antibiotics could, in fact, effectively clear up ulcers, leaving Glaxo and Zantac in search of a new market.

The company's salvation lay just north of the stomach, with the condition Gastroesophageal Reflux Disease, or GERD. GERD occurs when the esophageal sphincter, the ring of muscle at the top of the stomach, allows acid to creep up the esophagus. Basically, GERD is chronic heartburn--heart-burn so bad it can eventually damage the cells lining the esophagus. Zantac was great at treating GERD, too, but there was just one problem: GERD isn't common. Heartburn, on the other hand, is; but, unfortunately for Glaxo, most people considered heartburn nothing more than one of the wages of overindulgence, treatable with an over-the-counter remedy or a little more self-control at the dinner table--not with a prescription drug. What Glaxo needed to do was persuade people that ordinary heartburn was an early-warning sign of GERD.

So, Glaxo and its marketing team set about popularizing GERD and its potentially dire consequences through a marketing technique that is now used routinely by drug makers, and which came to be known as "condition branding," or selling a disease along with a drug. To brand GERD, Glaxo launched a public relations campaign called "Heartburn Across America." The campaign used the graphic of an erupting volcano to illustrate to consumers the severity of GERD. The company also set up the Glaxo Institute for...