Overdosed America: The Broken Promise of American Medicine

Dr. Abramson became frustrated with patients who already "knew" what they needed via drug company ads, and "retreated" to teaching at Harvard Medical School. His personal experience and ability to carefully review medical research combine to produce an excellent book. Much of what Abramson reports involves the drug industry. He gives specific examples where published drug studies focus on recipients non-representative of typical (target) users - eg. younger, and less prone to adverse reactions. Sometimes the reported data show (if one has the time to read carefully) that the true targets do WORSE with the medication, and this finding is obscured by positive results with the more numerous (atypical) younger selected test patients. Other medical research reporting ploys utilized by drug companies include: 1)reporting initially positive results, while omitting adverse subsequent outcomes, 2)combining serious (when increased) and minor (when decreased) adverse event numbers to cover up problems, 3)comparing a strong dose of a new medicine with an inappropriate weak dose, comparing a new drug with a placebo, instead of existing efficacious drugs, 4)not reporting negative drug trials, 5)failing to point out that lifestyle changes often provide much better results than drugs, and 6)pulling advertising from medical journals running unfavorable articles. The result is typically increased cost of care, and less than ideal results. Sometimes, however, it is much worse. Dr. Abramson reports that anti-arrhythmic drugs (reduce dangerous rapid heartbeat) were found to INCREASE death rates in '80 - however, the results were not published until '93, resulting in an estimated 20-75,000 extra deaths/year. How are the drug companies able to do this? Abramson ticks off the mechanisms: 1)conflicts of interest - eg. NIH, FDA and many other leading physicians being paid "consulting" fees; 2)lobbying - drug companies spend the most, and have one lobbyist for every member of Congress; 3)providing funding (and control) for clinical trials - government funding had fallen to 20% by '02, and drug companies have moved most trials away from academic centers with high standards; and 4)funding over 70% of physician continuing medical education in '03. Drug companies are not the only problem. Similar problems exist with recommendations for expensive procedures - eg. cardiac surgery, spinal fusion for back pain, and even dietary suggestions (leading physicians paid as consultants by the dairy and meat industries). So how much extra costs result from all this? Abramson does not attempt a direct estimate, but does point out that U.S. healthcare is 40 - 60% more expensive than other leading nations, while our life expectancies lag. Another perspective is provided by the fact that regional variations in Medicare expenditures show 60% difference, with the areas spending less receiving easier access and better outcomes. Dr. Abramson has provided an excellent public service

I have been a physician for 10 years. I have seen my profession gradually being taken over by the pharmaceutical industry. I have seen countless patients harmed - alas even killed - by drug reactions and polypharmacy. I have sat and listened to countless drug representative presentations that were outright falsehoods and misrepresentations. It has been months - maybe even years that I have had available to me a medical education conference that was not somehow tainted by drug company money and therefore propaganda. I have repeatedly had patients in my office begging me for medication that they do not need. They want it simply because it was on TV News last night - and came with a promise of metaphysical salvation. I spend much time every day dissuading patients from taking medication they simply do not need - indeed may even cause real medical problems. The issues that are discussed in this book are very very real - and the scary part is I do not see my fellow physicians doing a single thing to address these huge problems. Dr. Abramson - thank you for hopefully what will be the opening salvo in a very important battle.

In the news this morning (November 20, 2004): The Associated Press reports that shares in pharmaceutical giants AstraZeneca PLC and GlaxoSmithKline PLC dropped after safety concerns over the anti-cholesterol drug, Crestor, and asthma drug, Serevent, were raised. For those who have read Dr. Abramson's book, Overdosed in America, safety concerns with Crestor will come as no surprise. Dr. Abramson has done a more than credible job of researching the current state of medical care in the United States (taking three years away from his private practice to do so). Examining the links between emphasis on lowering cholesterol and drug company profits is just one area of current American medical care he tackles. There are those who will argue that his common-sense approach to reducing health care costs while, at the same time, increasing American health, is too simple to be worthwhile. However, Dr. Abramson's recommendations are based on solid research findings. Sometimes, answers can be simple. Overdosed America is an important book backed up by Dr. Abramson's painstaking research. Read it to save your wealth. Read it to save your health. December Update: I am astonished to see such highly negative reviews of Overdosed America. Are these the same folk who would never buy an automobile or vacuum without checking Consumers' ratings? Surely, they have failed to read the book carefully or they could not suggest that much valuable research will be lost if we become actively involved in our own medicine and related pharmaceuticals instead of passive consumers of whatever latest pill that's being pushed. Surely, they have failed to read carefully if they believe that the studies "proving" the safety of pharmaceutical are always fully and accurately reported. My only beef with Dr. Abramson is that he is, in my opinion, far too lenient on doctors. While I realize that they are already overworked, I think that prescribing pharmaceuticals about which they know only what is given them by drug company representatives is reprehensible. We all have our part to play to keep medical costs and medical errors under control. To my mind the responsbility falls on doctors just as much as consumers. Nonetheless, this book is far more than a sensationalism of the problems with current pharmaceuticals. The information it contains could save a life - your life or someone you love! Phyllis Staff, Ph.D. author, "How to Find Great Senior Housing" and "128 Ways to Prevent Alzheimer's and Other Dementias" P.S. Added October 18, 2006: Events of the last two years have only buttressed the premise of Abramson's book. This is a "must-read" for anyone concerned about health and well-being. Don't miss it!

As a community health nurse, I have been observing the increasing commercialization of medicine and medical knowledge over the past decade. Dr. Abramson has hit the nail on the head - while the cost of health care continues to rise, the quality of the care and the outcomes have not increased. It is a travesty that the elderly and patients suffering from chronic conditions are being hoodwinked into choosing between food and pills , and that we are not focusing on lifestyle changes that will enhance and prolong the quality of life.

Dr. Abramson's book concerns the influence that pharmaceutical companies have on physicians' knowledge. Chapter by chapter, he discusses the top selling medications prescribed in America and explains, in detail, all of the clinical trials that support the use of the medications. Then, he explains how the clinical trials were conducted (usually with the pharmaceutical companies preferred methods) and what the statistics behind the clinical trials REALLY support. As a consumer who believed until recently was an "informed consumer," I was shocked to discover that the information I was getting on the National Institute for Health's website "pubmed.org" was less than definitive when it came to clinical trials. With Dr. Abramson's book, I now understand that those clinical trials, which most doctors depend on in helping them treat their patients are wildly distorted. I applaud Dr. Abramson for writing this book. Just as Rachel Carson's book Silent Spring served as a catalyst for supporting changes in how we respect our environment, physicians, consumers and politicians should read this book and take action to protect our nation's health. I think before another advertisement for a medication is splashed before our televisions, computers and magazines, there should be a warning box that reads "This medication may be dangerous to your health, so discuss alternatives with your doctor before trying it!" This book was the most important book that I've read in the last few years and I thank Dr. Abramson for taking the time to write it and making it "user friendly."