Rethinking Medications - by Jerry Avorn

About the Book

"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."--Provided by publisher.

Book Synopsis

Suddenly, everything seems up for grabs about the medicines we take: Do they really work as advertised? Do some of them have dangerous, undisclosed side effects? Why are they so expensive, even unaffordable?

A leading medical expert provides a clear-headed, dispassionate understanding of life-and-death questions that have suddenly become so contentious. Groundbreaking research has given us many remarkable new drugs to treat conditions that have plagued patients for generations. But at the same time America's drug evaluation process, once the envy of the world, is being seriously undermined.

Under pressure from the pharmaceutical industry and politicians, the Food and Drug Administration has lowered its approval standards to allow new medicines onto the market without the rigorous assessment that once made it the global gold standard for medication regulation. Instead of carefully reviewed scientific evidence, government officials now make alarming public statements about effectiveness and risks, unmoored from scientific evidence. All this while out-of-control drug prices--far higher in the US than anywhere else in the world--put badly needed treatments beyond the reach of many patients.

Dr. Jerry Avorn, a physician and professor of medicine at Harvard, has been studying these issues for decades. In Rethinking Medications, he engagingly explains how we got here and provides concrete solutions to ensure that all our medicines are effective, safe, and affordable. The book takes on the most fundamental aspects of the medicines we take:

• Does it work? Who says? How do we know?
• Is it safe? What's the evidence? How can we be sure?
• Why is my prescription so expensive? Is it worth what it costs? Who determines that price? Why does the US pay twice as much as other countries for the same medicines?
• With new leadership at FDA, CDC, NIH, and the whole Department of Health and Human Services, who decides these life-and-death questions for the nation, and how well are they doing their jobs?
• ...and finally: how do all these issues affect the choices that patients and doctors make every day?

Rethinking Medications draws on Dr. Avorn's long experience as a clinician, outspoken patient advocate, and the founder of an internationally respected research group at Harvard. He illustrates this accessible and entertaining account with examples from cancer drugs to opioids, from treatments for rare diseases to psychedelics. Throughout, Dr. Avorn proposes practical advice for consumers, policymakers, and practitioners to address these problems. At a time when all our assumptions about scientific evidence, regulation, pricing, and the role of government are under assault as never before, this book points to actionable solutions within reach and a way out of the current confusion, beyond all the noise.

Review Quotes

"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

"Dr. Avorn is uniquely qualified to write this book. He writes with the authority of seasoned scholar and the clarity of a skilled communicator. High profile examples are documented to illustrate his insights.The content is extraordinarily up to date...This is an important book for our time. Dr. Avorn builds his case skillfully and litigates his recommendations for reform persuasively. It is appropriate reading for medical professionals, policy makers, pharmaceutical professionals, and healthcare consumers. Highly recommended!"--David Weinberg, MD, Science-Based Medicine

"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.

"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.