PILLS, PROFITS, AND POLITICS by Milton & Philip R. Lee Silverman


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A fair, lucid, and detailed summary of the excesses that have plagued drug production, promotion and prescription since ""the great drug therapy era"" began (with the discovery of sulfanilamide) in 1935, and of the gradual increase in federal efforts to regulate the whole business, concluding with the authors' own eminently reasonable suggestions. They are careful to give due credit to the drug industry for many outstanding advances in medical treatment, and to distribute a fair share of the blame for irrational prescribing and self-medication to medical schools -- which don't sufficiently educate physicians in either pharmacology or healthy skepticism; doctors who, out of gullibility, laziness or haste, rely on commercial drug promotion as their main source of information; and laymen who either venerate doctors or self-administer over-the-counter nostrums in an often willful ignorance. But it is the profit motivated drug industry that the authors mainly implicate with rewards unrivaled by any other American industry jacked up still further by such fradulent-to-unethical practices as the pushing of masses of duplicative ""me-too"" products and largely useless ""fixed-ratio combination"" products; the promotion of marked-up brand name products over equally effective and cheaper ""generics""; all sorts of high-pressure sales tactics; and worst, the promotion of products not adequately proven safe. Against a colorful background of pre-20th century pharmacology (blundering and intuitive), the authors provide an excellent documentary of the struggle of interests over drug regulation (including the ambivalent role of the AMA); they feel federal safety-and-effectiveness testing and informational services are necessary and still inadequate, and show that industry cries of ""communism"" and ""sagging profits"" have so far been groundless. Since considerable evidence is marshalled with vigor and wit, this is definitely for the intelligent layman, the concerned physician, and the policymaker.

Pub Date: Aug. 12th, 1974
Publisher: Univ. of California Press