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Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs
If you believe that the latest blockbuster medication is worth a premium price over your generic brand, or that doctors have access to all the information they need about a drug’s safety and effectiveness each time they write a prescription, Dr. Jerry Avorn has some sobering news. Drawing on more than twenty-five years of patient care, teaching, and research at Harvard Medical School, he shares his firsthand experience of the wide gap in our knowledge of the effectiveness of one medication as compared to another. In Powerful Medicines, he reminds us that every pill we take represents a delicate compromise between the promise of healing, the risk of side effects, and an increasingly daunting price. The stakes on each front grow higher every year as new drugs with impressive power, worrisome side effects, and troubling costs are introduced.
This is a comprehensive behind-the-scenes look at issues that affect our shortage of data comparing the worth of similar drugs for the same condition; alarming lapses in the detection of lethal side effects; the underuse of life-saving medications; lavish marketing campaigns that influence what doctors prescribe; and the resulting upward spiral of costs that places vital drugs beyond the reach of many Americans.
In this engagingly written book, Dr. Avorn asks questions that will interest every How can a product judged safe by the Food and Drug Administration turn out to have unexpectedly lethal side effects? Why has the nation’s drug bill been growing at nearly 20 percent per year? How can physicians and patients pick the best medication in its class? How do doctors actually make their prescribing decisions, and why do those decisions sometimes go wrong? Why do so many Americans suffer preventable illnesses and deaths that proper drug use could have averted? How can the nation gain control over its escalating drug budget without resorting to rationing or draconian governmental controls?
Using clinical case histories taken from his own work as a practitioner, researcher, and advocate, Dr. Avorn demonstrates the impressive power of the well-conceived prescription as well as the debacles that can result when medications are misused. He describes an innovative program that employs the pharmaceutical industry’s own marketing techniques to reduce use of some of the most overprescribed and overpriced products. Powerful Medicines offers timely and practical advice on how the nation can improve its drug-approval process, and how patients can work with doctors to make sure their prescriptions are safe, effective, and as affordable as possible.
This is a passionate and provocative call for action as well as a compelling work of clear-headed science.
This is a comprehensive behind-the-scenes look at issues that affect our shortage of data comparing the worth of similar drugs for the same condition; alarming lapses in the detection of lethal side effects; the underuse of life-saving medications; lavish marketing campaigns that influence what doctors prescribe; and the resulting upward spiral of costs that places vital drugs beyond the reach of many Americans.
In this engagingly written book, Dr. Avorn asks questions that will interest every How can a product judged safe by the Food and Drug Administration turn out to have unexpectedly lethal side effects? Why has the nation’s drug bill been growing at nearly 20 percent per year? How can physicians and patients pick the best medication in its class? How do doctors actually make their prescribing decisions, and why do those decisions sometimes go wrong? Why do so many Americans suffer preventable illnesses and deaths that proper drug use could have averted? How can the nation gain control over its escalating drug budget without resorting to rationing or draconian governmental controls?
Using clinical case histories taken from his own work as a practitioner, researcher, and advocate, Dr. Avorn demonstrates the impressive power of the well-conceived prescription as well as the debacles that can result when medications are misused. He describes an innovative program that employs the pharmaceutical industry’s own marketing techniques to reduce use of some of the most overprescribed and overpriced products. Powerful Medicines offers timely and practical advice on how the nation can improve its drug-approval process, and how patients can work with doctors to make sure their prescriptions are safe, effective, and as affordable as possible.
This is a passionate and provocative call for action as well as a compelling work of clear-headed science.
480 pages, Paperback
First published August 9, 2004
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Displaying 1 - 14 of 14 reviews
January 17, 2017
This was an excellent book and I got more out of it than The Truth About the Drug Companies: How They Deceive Us and What to Do About It. Although that one had a lot of good info, it was presented in an incendiary style which gets a bit tiresome after awhile.
Jerry Lewis Avorn has a really easy to read style. He tells anecdotes about a particular drug, using real cases, then he goes into the technical details surrounding the development, marketing or research on that particular drug.
I never found his writing boring. There is probably more detail than I needed, but on the other hand, there are no diatribes against the pharmaceutical industry or researchers. It is a well thought out, well rounded presentation of facts about many different facets of the the issue, from R&D, to Government, to hospitals, doctors, and patients.
Jerry Lewis Avorn has a really easy to read style. He tells anecdotes about a particular drug, using real cases, then he goes into the technical details surrounding the development, marketing or research on that particular drug.
I never found his writing boring. There is probably more detail than I needed, but on the other hand, there are no diatribes against the pharmaceutical industry or researchers. It is a well thought out, well rounded presentation of facts about many different facets of the the issue, from R&D, to Government, to hospitals, doctors, and patients.
December 27, 2012
The first hundred pages were fascinating. Then it just turned into a long-winded repetitive rant without substance. I finally put the book down when his opening paragraph compared his "Harvard students" to NASA astronauts. I was hoping to continue to learn something, but got tired of listening to an author name drop. If you know absolutely nothing about pharmacy and want to learn about it, this book can be for you. It explains many simple things in simple terms. But if you're looking for the "why" and deep analysis, or just new information, this book is not for you. You will be bored out of your mind.
I tried putting it down for a few days and returning to it, but still can't do it. This book is just not for me.
I tried putting it down for a few days and returning to it, but still can't do it. This book is just not for me.
August 22, 2021
I learned a lot from this book about weighing the risk vs benefits of taking prescription medications and throwing in the cost only complicates this American conundrum. I think what is missing among all the solutions is the most important one and that is prevention which may just stop the the rolling snowball from even reaching that slippery slope.
June 29, 2021
Absolutely loved it. I got so many takeaways from it about healthcare and the crisis that America is under. The authors clever writing and accurate illustrations of these different problems he discusses make the points he makes even more powerful. This is one that I will keep returning too
September 20, 2007
Those with little to no interest in the sham that is the pharmaceutical industry might not find this book the page-turner that I did. Relevant to my personal experiences in my career, yes. Making me a more aware and informed health care professional, yes. Convincing me to boycott the whole damned industry for their wicked ways, no. Drugs are good. Drugs save lives. Drugs ought to not be some suit's cash cow. Truth be told, I still haven't finished the blasted thing as it is my "cruise book". I'm well through 3/4 of it though. But it's one you can read for hours, put down for months and not have to flip back a chapter to catch yourself up again when you're on your next sun drenched deck chair. Some people take trashy novels on vacation, I take this.
September 22, 2008
Technically I thought this was a really interesting and good book on the issues of medication. However, it was a very, very slow read, and I actually skipped a lot of stuff. Mainly, I skipped everything that was just discussing how research and analysis was done, which I found rather boring and irrelevant. I don't care so much about how it's done rather than the results. But of course, those were still important parts of the discussion of the book. I'd recommend this book to those entering the medical field.
May 16, 2007
This book looks dull I know, but it was incredible. I read this well before I started my graduate classes, but I remember feeling like this book was my own personal amazing professor teaching me everything about the pharmaceutical industry and the FDA. Very important information for all of us in this country. Although much is broken with the system, the author has done a lot of work correcting it and has lots of useful suggestions.
June 23, 2014
This book is essential reading for evidence-based medicine. The only problem is that the flat prose leaves something to be desire. But there are few other books in the area of EBM of such importance. Despite Avorn's stylistic shortcomings--and he might himself think of it as rhetorical neutrality--this book should receive the highest recommendation.
August 14, 2010
This book was given to my husband upon graduation from medical school. Although he hasn't yet had the time to read it, I really enjoyed learning how pharmaceutical companies have come to have the power they do and how medicine can improve to change that.
July 6, 2007
A decently balanced discussion of what is an infinitely more complex issue than is ever likely to be grasped by Marcia Angell's single-channel brain.
October 13, 2008
A Book that change my direction and point of view. Avorn can present such complicated medicines's life into a humour.
July 22, 2012
Slightly repetitive, but a compelling account of some of the things that are wrong with the US health care system.
July 2, 2016
A small tome but not too detailed. Take prescription drugs for the shortest time at the lowest dose to get the desired effect as possible. Regular reviews are just not done...
Displaying 1 - 14 of 14 reviews