Editorial Review
The untold crisis in American medicine, with side effects that may be hazardous to your health.
We all know that health care and prescription drug costs are skyrocketing, but few doubt the excellence of American medicine. John Abramson, M.D., an award-winning family doctor on the clinical faculty at Harvard Medical School, reveals, in the same clear language that he used with his patients, how the corporate takeover of clinical research and medical practice is compromising Americans' health. You -- and your doctor -- will be stunned by his findings.
For twenty years, Dr. Abramson cared for patients of all ages in a small town north of Boston. But increasingly his role as family doctor was undermined as pressure mounted to use the latest drugs and high-tech solutions for nearly every problem. Drawing on his background in statistics and health policy research, he began to investigate the radical changes that were quietly taking place in American medicine.
At the heart of the crisis, he found, lies the changed purpose of medical knowledge -- from seeking to optimize health to searching for the greatest profits. The lack of transparency that has become normal in commercially sponsored medical research now taints the scientific evidence published in even our most prestigious medical journals. And unlike the recent scandals in other industries that robbed Americans of money and jobs, this one is undermining our health.
The hormone replacement debacle, it turns out, is not an isolated case. The same kind of commercial distortion now pervades the information that doctors rely upon to guide the prevention and treatment of common health problems, from heart disease to stroke, osteoporosis, diabetes, and osteoarthritis.
The good news, as Dr. Abramson explains, is that the real scientific evidence shows that many of the things that you can do to protect and preserve your own health are far more effective than what the drug companies' top-selling products can do for you -- which is why the drug companies work so hard to keep this information under wraps.
In what is sure to be one of the most important and eye-opening books you or your doctor will ever read, John Abramson offers conclusive evidence that American medicine has broken its promise to best improve our health and is squandering more than $500 billion each year in the process.
Isn't it time to learn the facts, discuss these issues with your doctor, and reclaim the good health and medical care that all Americans deserve?
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Customer Reviews
Overdo$ed Is Right 
2008-08-12
The author, John Abramson, M.D., is a promary care doctor, as well as a Harvard profesor. He stepped down from practicing medicine to devote two years to researching and writing this informative book. Dr. Abramson's book is a well sritten, easy to understand look at what ails American medicine.
The man has a heart for people and seems to genuinely want to practice prevention and not just prescribe ineffective drugs with many very harmful side effects for disease conditions. Dr. Abramson is not against the appropriate use of medication, but advocates using the safest and most economical drugs and not the extremely expensive blockbuster medications the drug companies are pushing that are usually no better than the cheaper ones and often have even nastier side effects than the older, no longer patented alternative medications. Dr. Abramson is also very much into teaching people about lifestyle habits, such as exercise and diet, that are often way more effective than any drug.
The drug companies have definately put cooperate profits above patient safety. The pharmacuetical companies do most of the testing for new drugs in order to get a patent for them. It's extemely danagerous to let the fox guard the hen house. Big pharma has not only deceived the Amercian public with their lies, but they have mislead doctors with their misrepresentation of the actual results of the drug effectiveness and safety studies they have conducted and report on in the major medical journals. The medical device manufacturers have also put profits above what is best for the patient. As well as being nauseating, television drug advertising is criminal. All these happy people enjoying life,while a few of the drugs side affects are hurriedly given, is horrible.
Americans spend more on health care than any other country in the world, and have some of the highest disease rates of all the industrialised nations. The greedy drug companies and medical equipment manufacturers have wrecked our health care system. It needs a radical overhaul as this book will definately show you. My big question is this: "Is a system fueled by such insatiable cooperate greed even fixable?"
Simply a must read 2008-04-06
If you care about your own health or of those you love, read this book and then start questioning your friends and family about what medicines they are taking. I think you will be surprised and start trying to minimize what you put in your body.
It is a sad time when corporate profit has gone above patient safety.
We need to get drug ads off of television.
We need to question what has happened at the FDA.
We need to change the face of health care.
We need to talk to our doctors and help them work with us for our best care. Unfortunately a lot of them are too busy to realize the influence that big pharma has over them. This book is the wake up call that America needed.
Sorting out medical knowledge from advertising 2008-03-09
In "Overdosed America" Dr. John Abramson is mainly concerned with accuracy of information about prescription drugs and about medical devices and procedures in the United States. He shows how drug and device makers manipulate information to present their products favorably. Dr. Abramson leverages experience in public health policy, closely analyzing FDA fast-track approval of painkillers including Celebrex in 1998 and the now withdrawn Vioxx in 1999 (pages 23-38) and NIH revisions to cholesterol guidelines in 2001 (pages 129-148). For those cases, Dr. Abramson provides detailed readings of published studies, showing how drug benefits were promoted and hazards minimized.
Dr. Abramson's most egregious example concerns hazards of Vioxx. A key report about Vioxx appeared November 23, 2000, in the New England Journal of Medicine, then as now edited by Dr. Jeffrey Drazen. It included information about potential hazards. An apparently authoritative review article about Vioxx and Celebrex appeared August 9, 2001, in the same journal, with updated hazard information. The latter article said increased incidence of cardiovascular events associated with Vioxx "may reflect the play of chance." From data published in the latter article Dr. Abramson found that the cardiovascular hazard from Vioxx was statistically significant, unlikely to represent chance occurrences. However, FDA action on the information was delayed until September, 2004, when Merck withdrew Vioxx from the market because of its cardiovascular hazard. On December 8, 2005, the New England Journal of Medicine published a belated "Expression of Concern" saying authors of the November 23, 2000, article had omitted data which they then possessed, showing a greater incidence of cardiovascular events.
Writing before the 2005 disclosure, Dr. Abramson was incensed. Poring over information made available to the public by the FDA, he had already found that the FDA knew of a substantial cardiovascular hazard when Vioxx was approved. Members of the medical community had little access to this knowledge, unless willing to spend hours in background research as Dr. Abramson did, and the general public knew even less. Articles appearing in a major medical journal had promoted benefits of Vioxx and minimized hazards. Dr. Abramson reports pressure from his patients to prescribe Vioxx, inspired by advertising. He accuses "commercial medical research" of "rigging medical studies, misrepresenting...results" and "withholding...findings" (page xvii).
Dr. Abramson's proposed remedy is a new federal agency "to protect the public's interest in medical science" (page 250). It would set standards for "medical research," oversee development of "clinical guidelines," and initiate research "when important scientific evidence was lacking." While describing this new agency, Dr. Abramson does not say but appears to mean by "medical research" mainly "clinical trials" for prescription drugs and medical devices, not the basic research programs sponsored by the NIH and other agencies. The key power of the new agency over prescription drugs and medical devices would be certifications that clinical trials met its standards.
Dr. Abramson makes three more general recommendations to improve health care: a "rebalanced" "mix of physicians," financial rewards to health care providers for "improving the health" of their patients, and "adequate, stable funding" of the FDA and NIH, replacing [prescription drug and medical device] "industry money" (pages 255-256). Dr. Abramson does not provide guidance for making such changes. Instead he calls for "courageous leadership" from someone else, inviting "public hearings" investigating the Celebrex and Vioxx approval processes and investigating "commercial bias in the 2001 update to the cholesterol guidelines."
Despite the intensity of his investigations, Dr. Abramson does not seem to have spent comparable energy on his proposed remedies. Unlike many economists, he seems much impressed with the effectiveness of the Federal Reserve Board and wants to model his proposed agency after it. His proposed new agency appears similar in spirit to "science court," long advocated under different names by Dr. Arthur Kantrowitz, the physicist who founded Avco-Everett Research Laboratory in 1955 and later became a professor at Dartmouth.
A key problem with "science court" was that it would duplicate functions of existing courts, with no clear way to resolve issues of jurisdiction. A key problem with Dr. Abramson's proposed agency is that it would duplicate functions already assigned to the FDA and the NIH, with no clear way to divide responsibilities. Since his core complaint is that those agencies failed, Dr. Abramson ought to have provided a history of how they came to fail and ought to have explored whether and how such failures could be remedied. Avoiding knowledge of failures invites their repetition, should Dr. Abramson's plan somehow be implemented.
Dr. Abramson left his medical practice in 2002 to teach primary care at Harvard Medical School, where he wrote his book. In a January, 2005, interview published by Managed Care, he disclosed frustration trying to teach students to examine evidence critically: "it creates dissonance for them." He explains that "medical students want to learn indications, doses and side effects, because that's what they'll be graded on." Dr. Abramson is himself a primary care physician who did learn how to extract knowledge from muddled evidence and unwarranted conclusions. While his book does not try to deal with a wide range of problems in United States medicine, it is clear and convincing in describing the issues it takes on.
"Overdosed America" can be most closely compared with "Powerful Medicines" by Dr. Jerry Avorn -- both books first published in late summer, 2004. Like Dr. Abramson, Dr. Avorn is an internist who teaches at Harvard Medical School. Unlike Dr. Abramson, Dr. Avorn has spent most of his career in academic medicine, currently heading a group of sixteen scientists and physicians called the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women's Hospital in Boston. Dr. Avorn describes many of the same examples of problem drugs as Dr. Abramson -- including Vioxx, statins and hormone replacement therapy -- but his attitude is different. Where Dr. Abramson is sometimes incensed, Dr. Avorn is philosophical. Faced with probabilities of drug hazards, Dr. Abramson estimates the number of his patients who may suffer. Dr. Avorn says about such issues, "I don't intuit them well" (page 167). Instead, he says he has "developed a passable prosthetic sense of such things."
A policy professional will probably find Dr. Avorn's explorations of prescription drug issues interesting and helpful. Most potential readers will find more insight and motivation in Dr. Abramson's book. It is a long read, travelling through territories likely to be unfamiliar. At the end of the journey, a persistent reader will understand a major problem affecting medical care in the United States and will have some sense of what needs to be done to deal with and correct it.
From a pharmacist 2008-02-13
Another great expose of the greed-based "healthcare " system. I recall back in the 80's when insurance first began to cover prescriptions for $1 copay (back then). The customer would always ask "how much would this cost without insurance?". I would reply about fifty dollars. His eyes would light up like silver dollars. He would be back in a week with a fistful of prescriptions. When previously he would come in maybe once or twice a year he was now coming in every week, getting sicker and sicker. It was only a matter of time before the copays went up to cover the rapidly growing number of prescriptions. The pharmacist became an insurance clerk trying to explain the copay system to disgruntled customers who could no longer get something for nothing.
Wake-up Call 2008-01-13
Since the discovery of penicillin when I was a child, the pharmaceutical industry has increasingly promised to fulfill all our wishes: health, beauty, longevity, a good night's sleep, a great sex life. They serve up a stream of double-blind studies as their scientific proof.
Pharmaceuticals are big business, focused on profits, not our well-being. Overdo$ed America give us, as Paul Harvey used to say, "the rest of the story:" how the drug companies can squelch unfavorable studies or reinterpret negative results; how they use continuing education courses--required for doctors--as a forum to promote their products; how they pay generous consulting fees to influence panel members who establish criteria for drug use. And much more.
Dr. Abramson re-examines the pharmaceutical industry's own double-blind studies with a critical eye, often reaching startling conclusions. Most disturbing is a chart in Chapter 4. Of 23 industrialized countries, the United States had by far the highest medical expenditures and yet ranked next to last in healthy life expectancy. Overdo$ed America meticulously shows us why.
This book is a wake-up call, not a doomsday scenario. Dr. Abramson urges us not to be taken in by flashy advertising. Before you pop another pill, read this book.
Required reading 2007-11-09
The untold crisis in American medicine, with side effects that may be hazardous to your health.
We all know that health care and prescription drug costs are skyrocketing, but few doubt the excellence of American medicine. John Abramson, M.D., an award-winning family doctor on the clinical faculty at Harvard Medical School, reveals, in the same clear language that he used with his patients, how the corporate takeover of clinical research and medical practice is compromising Americans' health. You -- and your doctor -- will be stunned by his findings.
For twenty years, Dr. Abramson cared for patients of all ages in a small town north of Boston. But increasingly his role as family doctor was undermined as pressure mounted to use the latest drugs and high-tech solutions for nearly every problem. Drawing on his background in statistics and health policy research, he began to investigate the radical changes that were quietly taking place in American medicine.
At the heart of the crisis, he found, lies the changed purpose of medical knowledge -- from seeking to optimize health to searching for the greatest profits. The lack of transparency that has become normal in commercially sponsored medical research now taints the scientific evidence published in even our most prestigious medical journals. And unlike the recent scandals in other industries that robbed Americans of money and jobs, this one is undermining our health.
The hormone replacement debacle, it turns out, is not an isolated case. The same kind of commercial distortion now pervades the information that doctors rely upon to guide the prevention and treatment of common health problems, from heart disease to stroke, osteoporosis, diabetes, and osteoarthritis.
The good news, as Dr. Abramson explains, is that the real scientific evidence shows that many of the things that you can do to protect and preserve your own health are far more effective than what the drug companies' top-selling products can do for you -- which is why the drug companies work so hard to keep this information under wraps.
In what is sure to be one of the most important and eye-opening books you or your doctor will ever read, John Abramson offers conclusive evidence that American medicine has broken its promise to best improve our health and is squandering more than $500 billion each year in the process.
Isn't it time to learn the facts, discuss these issues with your doctor, and reclaim the good health and medical care that all Americans deserve?
Overdosed America 2007-09-03
Abramson does a well researched job of explaining why Americans take so many pills, why many of them are not necessary, and how generics are generally as effective as brand names. It is an eyeopener concerning drug research and sales practices. Very useful in most peoples' everyday life.
Exposes the REAL Drug Pushers 2007-08-12
The author demonstrates how the drug companies have learned how to manipulate the system that approves and recommends their product. As a result, your doctor has no clue that there is very weak scientific support behind many of the expensive drugs that they are telling you to take.The power of this book can be demonstrated by its ability to predict future events. For example, shortly after I finished reading it, a study was published in the New England Journal of Medicine regarding the popular and expensive blood sugar controlling drug Avandia. Yes, Avandia does control blood sugar, but it also increases the risk of heart attacks by 43%. Whoops!After reading this book I now understand why the Democrats and Republicans were climbing on top of each other to be the first to pass a drug bill that no one really wanted (except the drug companies). And I know that our health care system is overly expensive and not the best.This is one of several excellent books that explores this fascinating topic. Cholesterol Myths and Cholesterol Conspiracy are some others that come to mind. But this book is broader in scope, and gives tremendous perspective on the health care system as a whole. It is also quite empowering, because you will learn that it's good to be skeptical of doctors, whether they are pushing expensive treatments and drugs, or simply dishing out hackneyed "lifestyle" advice about changing your diet. The bottom line is to keep fit and flexible, and you will be doing more for yourself healthwise than all the prescription pads in the world.
Patients BEWARE your doctor might be harming you with bad drugs 2007-08-04
Thanks Dr. Abramson for being honest enough to write your book and alert the rest of us about how the drug companies have turned our physicians into legalized drug pushers. I had a feeling that this was going on for the past 10 to 15 years when drug ads began appearing on TV, drug reps began swarming around my doctor's office and my own doctor seemed to be recommending too many drugs for my ailments. This book not only made me aware but it angered me to know that there are many patients out there who are literally suffering from the serious side effects of drugs that were recommended by doctors who allowed themselves to be brainwashed by the drug companies. SHAME ON ALL OF THEM for harming us. From now on, I will never trust my doctor completely and I encourage others to do the same. Demand that your doctor recommend natural alternatives and make sure you know ALL of the side effects of a drug before taking it.
classics 2007-08-02
Overdosed America is a classic amongst books that expose problem of America's pharmaceutical industry. This book helps expose the terrible Vioxx and Celebrex scandal whereby side effects of these drugs were known by the pharmceutical industries and to certain extent by the FDA for years before action was taken to either take the drug off the market or blacklabeled was applied. It detailed how the structure of the pharmacuetical industry (lobbist, relation to medical schools, relation to FDA, relation to doctors) lead to disincentive to reduce cost and improve healthcare industry. This book has sprawn a whole literature related to this topic. If you want to read a book related to this field, start with this one. Other books might be written by industry specialists or reporters (this author was retired family doctor), but reading this book first helps you understand what the newer books are responding to.
