Marked by solid scholarship, measured criticism, and pithy comments: an informative and highly readable study that makes a...




Cogent analysis of how pharmaceutical drugs are approved, promoted, and prescribed in this country, with some well-considered recommendations for improving the present system.

According to Avorn (Medicine/Harvard Medical School), Americans waste billions of dollars on prescription drugs that are overpriced, poorly prescribed, and improperly taken. He draws on his extensive experience as researcher and physician to explore the relationships between benefits, risks, and the economic impact of prescription drugs. While the FDA comes under scrutiny for its failure to properly assess the risks of such medications as the diet drug Redux and the diabetes drug Rezulin, this is not another FDA-bashing book. Avorn’s picture is bigger. Through case studies, he examines decisions made by the regulatory agencies, pharmaceutical companies, health policymakers, and physicians that reveal faults in the entire system. After examining how benefits and risks are discovered and measured, he turns to the difficult question of how these are balanced against each other when making decisions about a drug’s use. Avorn finds that in the real world, the major source of information about drugs is the promotion departments of pharmaceutical companies. Surrounded by “an almost suffocating plethora of information of very uneven quality,” physicians have not been prepared by their medical education to deal with it. He proposes an educational outreach program based in medical schools that would send academic “detail men” to doctors’ offices just as drug companies do. They would provide neutral, evidence-based assessment of drug choices so that physicians would know which treatments were more better, safer, and more cost-effective. Avorn points to Canada, Australia, and Great Britain as countries whose drug-assessment procedures we can learn from. His final chapters offer concrete, practical ideas for improving the ways in which drugs are evaluated and pertinent information about them is disseminated.

Marked by solid scholarship, measured criticism, and pithy comments: an informative and highly readable study that makes a significant contribution to the ongoing discussion of an important health care issue.

Pub Date: Aug. 20, 2004

ISBN: 0-375-41483-5

Page Count: 480

Publisher: Knopf

Review Posted Online: May 20, 2010

Kirkus Reviews Issue: June 15, 2004

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Skloot's meticulous, riveting account strikes a humanistic balance between sociological history, venerable portraiture and...


A dense, absorbing investigation into the medical community's exploitation of a dying woman and her family's struggle to salvage truth and dignity decades later.

In a well-paced, vibrant narrative, Popular Science contributor and Culture Dish blogger Skloot (Creative Writing/Univ. of Memphis) demonstrates that for every human cell put under a microscope, a complex life story is inexorably attached, to which doctors, researchers and laboratories have often been woefully insensitive and unaccountable. In 1951, Henrietta Lacks, an African-American mother of five, was diagnosed with what proved to be a fatal form of cervical cancer. At Johns Hopkins, the doctors harvested cells from her cervix without her permission and distributed them to labs around the globe, where they were multiplied and used for a diverse array of treatments. Known as HeLa cells, they became one of the world's most ubiquitous sources for medical research of everything from hormones, steroids and vitamins to gene mapping, in vitro fertilization, even the polio vaccine—all without the knowledge, must less consent, of the Lacks family. Skloot spent a decade interviewing every relative of Lacks she could find, excavating difficult memories and long-simmering outrage that had lay dormant since their loved one's sorrowful demise. Equal parts intimate biography and brutal clinical reportage, Skloot's graceful narrative adeptly navigates the wrenching Lack family recollections and the sobering, overarching realities of poverty and pre–civil-rights racism. The author's style is matched by a methodical scientific rigor and manifest expertise in the field.

Skloot's meticulous, riveting account strikes a humanistic balance between sociological history, venerable portraiture and Petri dish politics.

Pub Date: Feb. 9, 2010

ISBN: 978-1-4000-5217-2

Page Count: 320

Publisher: Crown

Review Posted Online: Dec. 22, 2010

Kirkus Reviews Issue: Jan. 1, 2010

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Authoritative and, most helpfully, accessible.



Self-help guide for diabetes sufferers, mostly in question-and-answer format, with an emphasis on helping racial and ethnic minority diabetics.

Coleman is a pharmacist with a doctorate in her specialty, Gavin a Ph.D. and M.D. Aside from acknowledgments and a foreword signed by Gavin alone, their voices and expertise are indistinguishable, offering lucid, simple solutions for diabetes patients. Gavin relates watching his great-grandmother endure debilitating pain as a result of diabetes while he visited her as a youngster. He remembers hearing adults mention that sugar killed her, and he wondered how something that tasted sweet could cause so much harm. As an adult, he realized that his great-grandmother's affliction could be controlled through treatment. The authors focus on Type 2 diabetes, the most common form in minority populations. An estimated 18.2 million Americans are diabetic, with perhaps 5 million unaware of their situation. About 11 percent of U.S. diabetics are African-American, and about 8 percent are Latino. The question-and-answer format begins with an overview section about diabetes, with an emphasis on risk factors. Section Two covers management of the disease, including nutrition, exercise, blood-testing, oral medications and insulin use. In addition, the authors continually recommend smoking cessation, as well as instructing patients on the readiness of self-treatment. Section Three explains the complications—high blood pressure, high cholesterol and heart disease—that could arise if the condition remains untreated or treated ineffectively. The questions in all of the sections are worded simply, and the answers are usually free of medical jargon. Though the sudden shifts in tone and voice are occasionally jarring, the writing remains clear enough to distill the facts. The real downside here, though: patronizing, laughable illustrations that degrade the overall product.

Authoritative and, most helpfully, accessible.

Pub Date: Jan. 31, 2004

ISBN: 0-9746948-0-0

Page Count: -

Publisher: N/A

Review Posted Online: May 27, 2010

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