Rethinking Medications

Truth, Power, and the Drugs You Take

Author: Jerry Avorn

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Description

A leading medical expert explains why too many of the medications Americans take are poorly evaluated, overpriced, or pose unwarranted risks--and what we can do to fix that.

Groundbreaking research has given us many remarkable new medicines, but America's drug evaluation process, once the envy of the world, is being seriously compromised. Under pressure from drugmakers, the FDA has been lowering its approval standards and has let poorly effective or risky products enter the market--while our prescription prices, the highest in the world, put crucial treatments beyond the reach of many. In Rethinking Medications, Dr. Jerry Avorn explains how we got here and what we can do to ensure that our medicines are dependably effective, safe, and affordable.

Part of the problem is the power of pharma's biggest-in-Washington lobbying clout, which influences members of Congress from both parties. That leverage is extended by the FDA's growing dependence on fees the industry pays to get its drugs approved. The increasingly revenue-driven US healthcare system shapes the way doctors prescribe medications--sometimes to the detriment of their clinical decisions.

Based on his decades of practice and research at Harvard Medical School and his role at the very center of many of these controversies, Dr. Avorn presents compelling clinical illustrations of these issues across the medical spectrum: from cancer drugs to opioids, from treatments for rare diseases to psychedelics. Throughout, he offers practical steps that consumers, policymakers, and practitioners can take to address these problems--at a moment when our assumptions about scientific evidence, regulation, pricing, and the role of government are being contested as never before.

Critic Reviews

"A masterful assessment of a highly flawed health care system."--Kirkus
"This eye-opening look at the pharmaceutical industry should make FDA officials want to scrutinize drug approvals more carefully, doctors want to prescribe more carefully, and patients want to consume more carefully."--Booklist
"A damning survey of the drug development system's many failures, this enlightens even as it infuriates."--Publishers Weekly
"Rethinking Medications gives us the historical and recent lessons we need to move forward with smarter solutions for the U.S. healthcare industry."--Mark Cuban, entrepreneur, drug cost innovator, and former Shark Tank principal.
"Rethinking Medications offers a rare combination of deep knowledge, common sense, and an engaging style; Avorn's account of pharma's achievements and scandals is simultaneously illuminating and infuriating. Americans have been paying too much for drugs and too little attention to the ways we could improve drug policy. This book is a guide to how we could be a healthier nation at a more affordable cost."--Paul Starr, Pulitzer Prize-winning author of The Social Transformation of American Medicine

"Jerry Avorn is a leading academic force in assessing safety and efficacy of prescription drugs, in many ways serving as the conscience for the pharma industry. In Rethinking Medications, he provides a systematic and up-to-date interrogation that will be useful for patients."--Eric Topol, MD, Executive Vice President, Scripps Research Institute, and author of Deep Medicine and The Patient Will See You Now
"With admirable clarity and vivid examples, noted medical researcher Jerry Avorn takes a bracing multidisciplinary approach to raising and deftly answering every question you have--as well as many that may not have occurred to you--about the vital role of prescription drugs in all our lives."--Howard Gardner, author of Frames of Mind: The Theory of Multiple Intelligences and Hobbs Professor of Cognition, Harvard University

About the Author

Jerry Avorn, MD, is a professor of medicine at Harvard Medical School and a senior internist in the Mass General Brigham health-care system. He built a leading research center at Harvard to study medication use, outcomes, costs, and policies and developed the educational outreach approach known as "academic detailing," providing evidence-based information about medications to prescribers. One of the nation's most highly cited researchers, Dr. Avorn is the author of Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs, and he has written or cowritten over six hundred papers in the medical literature as well as opinion pieces in The New York Times, The Washington Post, JAMA, and The New England Journal of Medicine.