GENERATION RX

An incisive analysis of the power of Big Pharma, packed with revealing interviews, statistics and irreverent sketches of political and industrial leaders.

Critser (Fat Land, 2002), a journalist whose pieces on the pharmaceutical industry and the politics of medicine have appeared in Harper’s and the Wall Street Journal, examines the story behind the soaring use of prescription drugs by Americans—from three prescriptions per person per year in 1993 to 12 in 2004. He charges that the pharmaceutical industry has used political clout to weaken the FDA and speed its approval process, has used direct-to-consumer advertising to promote chronic-disease awareness and thus increase demand for its products and has made physicians a party to their marketing efforts. These, he says, are directed at three principal groups: “The Tribe of High-Performance Youth,” with Ritalin especially in demand for boys considered hyperactive; “The Middle-Years Tribe,” the major consumers of performance enhancers, sleeping pills and heartburn remedies; and “The Tribe of High-Performance Aging,” for whom polypharmacy, or the use of multiple drugs, is now commonplace. Our “spiraling prescription drug culture,” with its $180 billion price tag, is impacting not just our wallets but our bodies, Critser asserts, citing potential hazards to the liver, heart, lungs, the gut and even the brain. While the author devotes most of his text to explaining just how we became so deeply pharmaceutical-ized and why we should be concerned about it, he does offer some suggestions for change. These include a more independent and tough-minded FDA and a greater sense of responsibility on the part of the pharmaceutical industry. An appendix provides a useful guide to finding information about prescription drugs.

If a knowledgeable public is the key, this straightforward, highly readable book is a step in the right direction.