Overdosed America by Jay Abramson Term Paper

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Chapter 10: Direct to Consumer Advertising

Television

Television advertising has caused a rift in traditional doctor-patient relationship.

Patients arriving for doctor visits with a firm, fixed idea of outcome -- prescribe me the drug because I saw it on television! Encourage consumers to think buying drug like buying soap.

End of expectation that individual doctor knows best and best medical care emerges from open discussion of patient symptoms, concerns, and exam and consideration of the options, some of which may involve lifestyle changes not drugs

Radio

1. Even in car, hear about medical miracles that can change your life. Unending assault on consumer ears through various media.

Public Relations

There are financial ties between many of the supposedly most trusted medical experts and the medical industry

Medical 'news' or advertising masquerading as news

Studies on real news shows, funded by drug companies are presented as objective

Inadequate medical coverage and research on news -- medical news not hard news so less fact-checking

Lazy reporters -- accept biased reports as facts

XI. Chapter 11: Follow the Money -- Supply-side medical care

More care and more intervention means more money, but is not necessarily better medicine and better for the patient

Supply-side medicine means medicine has primary interest of improving financial health of hospital

XII. Chapter 12: Biomedicine limits

A. Scandal of using technology simply because 'you can' -- near-automatic use of medical technologies, such as cardiac catheterization, less because they are needed than because they are available

XIII. Chapter 13: What research shows about staying healthy.

Case study of the selling of Fosomax

1.Studies in respected peer-reviewed medical Journal of American Medicine promise the moon -- say Fosamax works

2. Randomized clinical trials of Fosamax published in medical journals show dramatic reductions in the relative risk of hip fracture for women with osteoporosis. JAMA in 1998 says women with an average age of 68 and a T score of - 2.5 or less (bone density score that means osteoporosis) who took Fosamax for four years were 56% less likely to suffer a hip fracture than women in the control group.

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How many hip fractures were really prevented? With no drug therapy at all, women with osteoporosis had a 99.5% chance of making it through each year without a hip fracture

Creation' of illness in media, medical journals, and advertising

Also, osteoporosis drugs work on outer part of the bone, the cortical bone. This increases the score on bone density test but does not necessarily contribute proportionately to fracture resistance. Statistics look good, but drugs don't change much.

Prevention better

Walking statistically better way of reducing hip fractures

XIV. Chapter 14: Solutions

Value of preventative medicine -- medicine should not be a commodity

System not working -- currently costs America 500 billion a year

Remember that America spends more on medicine than any other industrialized nation and still not healthiest and not every American is covered by insurance

America spends more on high-tech neonatology than other Western countries but has a higher infant-mortality rate because of inattention to low-tech prenatal care.

Gap is widening between the scientific evidence that impartial experts

Paxil example -- based on nine clinical studies on adolescents

No more effective than placebos

Increases the frequency suicidal thoughts and attempts)

Solution of drug company

Created task force of the American College of Neuropsychopharmacolgy which approved drug under review although 9 of the 10 task force members had financial ties to pharmaceutical industry

FDA epidemiologist in charge of analyzing all the antidepressant studies involving children concluded Paxil dangerous but barred from testifying at government hearing

Use of preventative, non-drug methods to treat depression like physical exercise, therapy better, especially in young people

Endovascular Technologies example (subsidiary of Guidant, the company that manufactures defibrillators)

Manufactured a $10,000 device to repair aortic aneurysms -- malfunctioned in a third of the 7600 patients in study

Company underreported number to FDA, and this never checked. Guidant later disclosed 2628 new malfunctions, resulting in 12 deaths.

Company still in business although $92 million poorer after criminal and civil payments….....

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