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Healthy Skepticism International News

February 2005

Book Review: Overdosed America

Abstract:

Review of John Abramson. Overdosed America ‘The broken promise of American Medicine’ 2004; New York: Harper Collins
In the late 1990’s for-profit hospitals were competing for the lucrative market in bone marrow transplants for patients with breast cancer. Even when four of five randomised controlled trials showed no benefit, the American Society of Clinical Oncologists saw this as ‘mixed early results’. Subsequently the fifth study that did show benefit for BMT and its population was found to be fraudulent.

Since the FTA adopted the practice of accepting contributions from drug companies to speed up the process of drug approvals, the number of drugs approved by them but later withdrawn from the market for safety reasons increased from 1.6 % of all drugs approved between 1993 and 1996 to 5.3% between 1997 and 2000 (p. 86). A 2000 newspaper article (USA Today) claimed that 54% of experts on Advisory Committees of the FDA have ‘a direct financial interest in the drug or topic they are being asked to evaluate’.

The role of public relation companies in drug company activities has spread from marketing to research (p. 109). The emergence of medical education and communication companies (MECC’s). One of the biggest of these companies says in its marketing materials ‘medical education is a powerful tool that can deliver your message to key audiences and get those audiences to take action that benefits your product’.

This is an excellent book and not just in relevance to American readers. Many of the drugs and conditions considered have similar patterns of promotion and treatment in European countries and Australasia.

Dr Jon Jureidini ( .(JavaScript must be enabled to view this email address) )

 

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909