Pharmaceuticalization of society in context: theoretical, empirical and health dimensions

Sociological interest in pharmaceuticals has intensified, heightening awareness of `pharmaceuticalization. It is argued that pharmaceuticalization should be understood by reference to five main biosociological explanatory factors: biomedicalism, medicalization, pharmaceutical industry promotion and marketing, consumerism, and regulatory-state ideology or policy. The biomedicalism thesis, which claims that expansion of drug treatment reflects advances in biomedical science to meet health needs, is found to be a weak explanatory factor because a significant amount of growth in pharmaceuticalization is inconsistent with scientific evidence, and because drug innovations offering significant therapeutic advance have been declining across the sector, including areas of major health need. Some elements of consumerism have undermined pharmaceuticalization, even causing de-pharmaceuticalization in some therapeutic sub-fields. However, other aspects of consumerism, together with industry promotion, medicalization, and deregulatory state policies are found to be drivers of increased pharmaceuticalization in ways that are largely outside, or sub-optimal for, significant therapeutic advances in the interests of public health.