Rethinking Medications
Truth, Power, and the Drugs You Take
By Jerry Avorn
As the nation faces new controversies over the risks, effectiveness, and prices of drugs and vaccines, RETHINKING MEDICATIONS offers a clear and engaging account of how we got here, and we can do now.
We are living through a time of unprecedented controversy and confusion about some of the most fundamental aspects of our medicines:
- Does it work? Who says? How do we know?
- Is it safe to take? What’s the evidence? How can we be sure?
- Is it worth its price? Who sets that price, anyway? Why do Americans pay twice as much as people in other countries for the same medicines?
- With new leadership at FDA, CDC, NIH, and the entire Department of Health and Human Services, who decides these life-and-death questions for the nation, and how well are they doing?
- …and finally: How do these issues affect the choices that patients and doctors need to make every day?
Questions like these have been out there for a long time, but now they have moved to the forefront of public attention. Beyond the noise and the hype, there’s a great deal we can understand about the drugs we use. That knowledge can point us to a coherent way forward.
Readers will find the Endnotes provided on this site for easier reference as you’re reading the book. The Connect tab will enable you to offer feedback, which I’d greatly appreciate.
I hope you’ll find RETHINKING MEDICATIONS interesting, engaging, and useful in these increasingly complicated times
Jerry Avorn, M.D.
Professor of Medicine
Harvard Medical School
About the Book
A leading medical expert explains why some 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.
"A masterful assessment of a highly flawed health care system."
— Kirkus
"A damning survey of the drug development system’s many failures, this enlightens even as it infuriates."
— Publishers Weekly
"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
"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."