March 2005

Jack D. Crispin, Jr.

nonfiction

Overdosed America: The Broken Promise of American Medicine by John Abramson

Informed consent. This is the principle by which all health care is delivered. Your doctor discusses with you your condition and the options for treating it. You may get a second opinion from another doctor. You may search the web or read up at the library, but somewhere along the line, you make the decision on the treatment. But what if the information on the treatment that the doctors have, that the internet sites and medical journals give, is aimed not at what is best for you but what will bring the most revenue to the companies making the drugs and equipment for the treatment?

Anyone with a half dozen neurons still firing in the old noggin should realize that is what “direct to the consumer” advertising is all about. Those TV ads, magazine ads, newspaper ads, billboards, spam, junk mail and on and on ad nauseum don’t care if you have received the correct diagnosis (you can decide that for yourself, can’t you?), or know anything about other treatments. They want your money, stupid!

Dr. John Abramson opens the subject in Overdosed America: The Broken Promise of American Medicine by maintaining that these same companies are now able to twist the results of studies presented in what in the past has been regarded as reliable sources of information: medical journals! The esteemed New England Journal of Medicine, the Journal of the American Medical Association, the Lancet and others have reported studies in which the sponsoring medical/pharmaceutical companies have been able to adjust the results given or the manner in which they are given, solely to increase sales! "Rigging medical studies, misrepresenting research results published in even the most influential medical journals, and withholding the findings of whole studies that don't come out in a sponsor's favor have all become the accepted norm in commercially sponsored medical research."

Those television ads are more than just annoying. They hurt the consumer two-fold. First, they can convince the consumer they have disorders or diseases they do not. The obvious example is the ad campaign for depression/social anxiety/premenstrual irritability, but it goes further back than that. In 1942, premarin was approved by the FDA for the treatment of menopause symptoms. The drug was originally created to treat a minority of women for only a few years, but Wyeth-Ayerst began to market the drug as Hormone Replacement Therapy (HRT) and convinced millions of women that menopause was a disease. Years later, studies were finally released showing an increased risk of heart disease, breast cancer, dementia, stroke, blood clots, etc. Even after this, HRT is still advertised on the television.

The marketing campaigns also hurt the consumer by wasting billions of dollars of the pharmaceutical companies' money, and allowing them to focus on renaming drugs and disorders instead of finding new treatments and cures. There is currently a shortage of tetanus vaccines because vaccines do not make pharmaceutical companies money. Drugs that consumers will be convinced they need to take the rest of the lives, like antidepressants and cholesterol medication, is where the real profits are. Out of the 78 new drugs approved by the FDA in 2002, only 17 of them contained new active ingredients.

As a practicing pharmacist, I agree with the doctor’s conclusions and his belief that it is only going to get worse, until there are some major changes in the regulatory agencies involved. He further charges that this bias not only decreases the quality of the treatment, but is responsible for the horrendous cost of medical treatment today, and explains why we, as Americans, pay more than anyone else in the world but are receiving far from the best treatment.

This book is well written and covers several areas of medical treatment to illustrate the author’s points. There may be too much statistical analysis for some, but you can skip the numbers and rest assured the author has done the math to back up his assertions. One thing I would have liked to have seen is more of the author’s recommendations on trustworthy information sources. He does include a few, and maybe that is all there is currently. This isn’t so much a happy ending story of "Here is the problem and we have fixed it." It is more a rallying the masses with "Here is the problem and this is what you can do to help (yourself and medicine in general)."

I recommend this book to anyone who has ever been sick, is being treated for something now, or realizes they make get sick sometime before they die. Did I leave anyone out? Obviously everyone has a stake in this, and here is some good information you need before you consent to anything.

Overdosed America: The Broken Promise of American Medicine by John Abramson
HarperCollins
ISBN: 0060568526
352 Pages