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36
had 21 percent more “serious adverse events”:
Qian, op. cit., p. 11.

36
Vioxx costs $127.99 a month:
Viewed at http://www.cvs.com. Accessed February 25, 2004.

36
Warning Letter to Merck:
Viewed at http://www.fda.gov/cder/warn/2001/9456.pdf. Accessed February 20, 2004.

38
57 percent of all the money spent on prescription arthritis medication:
“Prescription Drug Expenditures in 2001,” op. cit.

CHAPTER 4 THE MYTH OF EXCELLENCE

42
one out of every 100 Americans:
M. Beddow Bayly, “The Story of the Salk Anti-Poliomyelitis Vaccine,” 1956. Published in WHALE, November 2000. Viewed at http://www.whale.to/vaccine/bayly.html. Accessed October 01, 2003.

43
cardiopulmonary bypass was done in Sweden in 1953:
“‘Internal’ Workings of the Cardiopulmonary Bypass Machine, The Chemical Engineers Resource Page.” Viewed at http://www.cheresources.com/cardiopul.shtml. Accessed February 24, 2004.

43
Dialysis, to filter the blood:
William B. Schwartz,
Life Without Disease,
Berkeley, Calif.: University of California Press, 1998, pp. 9–13.

43
Gleevac is a true miracle:
Arnold S. Relman and Marcia Angell, “America’s Other Drug Problem: How the Drug industry Distorts Medicine and Politics,”
The New Republic,
December 16, 2002, pp. 27–41.

44
rated . . . as the most important development:
V. R. Fuchs and H. C. Sox, “Physicians’ Views of the Relative Importance of Thirty Medical Innovations,”
Health Affairs
20:30–34, 2001.

45
“the U.S. population does not have anywhere near the best health in the world.”:
B. Starfield, “Is U.S. Health Care Really the Best in the World?”
Journal of the American Medical Association
284(4):483–485, 2000.

45
comparison of 13 industrialized nations:
The rankings on health outcomes in the world’s industrialized nations, were, from best to worst: Japan, Sweden, Canada, France, Australia, Spain, Finland, the Netherlands, the United Kingdom, Denmark, Belgium, the United States, and Germany.

45
United States again ranked poorly:
“Health at a Glance.” Organization for Economic Co-Operation and Development, 2001, p. 13.

45
United States ranks a lowly 24 among all the OECD countries on infant mortality:
Ibid., p. 17.

45
United States’ position improves only from 24 to 20:
“International Health Statistics,
Chapter 4
: Infant Mortality.” Woodrow Wilson School of Public and International Affairs, p. 46. Viewed at http://www.wws.princeton.edu/cgi-in/byteserv.prl/~ota/disk1/1994/9418/941806.PDF. Accessed February 24, 2004.

45
“healthy life expectancy”:
“World Health Report 2003—Shaping the Future” World Health Organization, 2003, pp. 156–159. Viewed at http://www.who.int/whr/2003/annex_4_en.xls. Accessed May 11, 2004.

46
measures of health system performance:
“World Health Report 2000: Statistics.” Viewed at http://www.who.int/whr2001/2001/archives/2000/en/statistics.htm. Accessed February 24, 2004. By 1998, Americans were losing more years of life; see G. Anderson and P. S. Hussey, “Comparing Health System Performance in OECD Countries,”
Health Affairs
20:219–232, 2001.

46
health expenditures in the United States are projected to exceed $6100:
S. Heffler, S. Smith, S. Keehan, et al., “Health Spending Projections Through 2013,”
Health Affairs.
Viewed at http://content.healthaffairs.org/cgi/reprint/hlthaff.w4.79v1.pdf. Accessed February 26, 2004.

46
United States spends 42 percent more on health care:
U. E. Reinhardt, P. S. Hussey, and G. F. Anderson, “U.S. Health Care Spending in an International Context: Why Is U.S. Spending So High, and Can We Afford It?
Health Affairs
23:10–25, 2004.

47
Sources of data for
Figure 4-1
:
“The World Health Report 2003—Shaping the Future,” the World Health Organization, www.who.int/whr/2003/annex_4_en.xls (Access 3/21/04). “Health at a Glance, OECD Indicators 2003,” Organisation for Economic Co-Operation and Development. 2003, Paris, France.

47
U.S. relative performance declined:
“World Health Report 2000: Statistics,” op. cit.

47
health of the citizens in the other OECD countries is improving more quickly:
“Health at a Glance,” op. cit., pp. 94–95.

48
prescription drugs cost about 70 percent more in the United States:
Patented Medicine Price Review Board of Canada,
Annual Report,
2001, p. 21. Viewed at http://www.pmprb-cepmb.gc.ca/english/pdf/ar2001/ar2001-e.pdf. Accessed February 26, 2003.

48
pharmaceutical companies in the United States:
“Why the Pharmaceutical Industry’s ‘R&D Scare Card’ Does Not Justify High and Rapidly Increasing U.S. Drug Prices,”
Public Citizen,
January 26, 2000. p. 19.

48
of the 569 new drugs approved:
National Institute for Health Care Management Research and Educational Foundation, “Changing Patterns of Pharmaceutical Innovation, May 2002. p. 9. www.nichm.org/innovations.pdf. Accessed February 27, 2003.

48
patients in the United States:
“World Health Report 2000: Statistics,” op. cit.

48
“Since 1900, the average lifespan:
“Ten Great Public Health Achievements—United States, 1900–1999,”
CDC MMWR Weekly
48:241–243, 1999.

49
preventive care as recommended:
J. P. Bunker, H. S. Frazier, and F. Mosteller, “Improving Health: Measuring Effects of Medical Care,”
Milbank Quarterly
72:225–258, 1994.

49
tuberculosis was the leading cause of death:
National Center for Health Statistics, “Age-Adjusted Death Rates for Selected Causes, Death Registration States, 1900–1932, and United States, 1933–98.” Viewed at http://www.cdc.gov/nchs/datawh/statab/unpubd/mortabs/hist293.htm. Accessed February 8, 2003.

49
first effective
medical
therapies for tuberculosis:
J. B. McKinlay and S. M. McKinley, “The Questionable Contribution of Medical Measures to the Decline of Mortality in the United States in the Twentieth Century,”
Millbank Memorial Fund,
Summer 405–428, 1977.

50
inexpensive cotton undergarments:
Rene Dubos,
Mirage of Health: Utopias, Progress, and Biological Change,
New York: Harper & Row, 1959, p. 268.

50
death rate for cancer in the United States:
National Center for Health Statistics, “Age-Adjusted Death Rates,” op. cit.

50
it had become the number one killer:
National Center for Health Statistics, U.S. Centers for Disease Control and Prevention. Viewed at http://www.cdc.gov/nchs/data/hus/tables/2003, 2003hus030.pdf. Accessed January 14, 2004.

50
President Nixon boasted:
Jerome Groopman, “The Thirty Years’ War,”
The New Yorker,
June 4, 2001, p. 32.

50
Cancer death rates were going up:
Quoted ibid.

50
few tremendous successes in this war:
J. C. Bailar and H. L. Gornik, “Cancer Undefeated,”
New England Journal of Medicine
336:1569–1574, 1997.

50
overall death rate from cancer was exactly the same:
National Center for Health Statistics, U.S. Centers for Disease Control and Prevention. Viewed at http://www.cdc.gov/nchs/datawh/statab/unpubd/mortabs/hist293.htm. Accessed January 30, 2003. And H. K. Weir, M. J. Thun, B. F. Hankey, et al., “Annual Report to the Nation on the Status of Cancer, 1975–2000, Featuring the Uses of Surveillance Data for Cancer Prevention and Control,”
Journal of the National Cancer Institute
95:1276–1299, 2003.

50
proper goal of a nation’s health care system:
D. M. Berwick, “A User’s Manual for the IOM’s ‘Quality Chasm’ Report,”
Health Affairs
21(3):80–90, 2002.

51
$80,000 to $200,000 per procedure:
Gina Kolata and Kurt Eichenwald, “Hope for Sale: A Special Report: Business Thrives on Unproven Care, Leaving Science Behind.
New York Times,
October 3, 1999.

52
found that his data were fraudulent:
Denise Grady, “More Deception Is Suspected in Cancer Study,”
New York Times,
March 10, 2000.

52
The researcher’s article was retracted:
Eric Nagourney, “National briefing: Cancer Study Retracted,”
New York Times,
April 27, 2001.

52
failed to show any benefit:
Stadtmauer E. A., O’Neill A., Goldstein L. J., et al., “Conventional-Dose Chemotherapy Compared with High-Dose Chemotherapy Plus Autologous Hematopoietic Stem-Cell Transplantation for Metastatic Breast Cancer,”
New England Journal of
Medicine, 342(15): 1069–1076, 2000.

52
“this form of treatment for women:
Lippman M. E., “High-Dose Chemotherapy Plus Autologous Bone Marrow Transplantation for Metastatic Breast Cancer,”
New England Journal of Medicine,
342:1119–1120, 2000.

53
“One thing is for certain:
George W. Bush, “President Bush’s Vision for More Health Care Choices,” speech before the Illinois State Medical Society, June 11, 2003. Viewed at http://www.georgewbush.com/HealthCare/Read.aspx?ID=1874. Accessed February 26, 2004.

CHAPTER 5 A CASE IN POINT: THE SAGA OF HORMONE REPLACEMENT THERAPY

57
risk of breast cancer increases by 8 percent:
C. Schairer, J. Lubin, R. Troisi, et al., “Menopausal Estrogen and Estrogen-Progestin Replacement Therapy and Breast Cancer Risk,”
Journal of the American Medical Association
283(4):485–491, 2000.

58
“The hormonal dance doesn’t end:
Susan M. Love, M.D., with Karen Lindsey,
Dr. Susan Love’s Hormone Book: Making Informed Choices About Menopause,
New York: Three Rivers Press, 1997, p. 7.

59
Dr. Christiane Northrup:
Christiane Northrup, M.D.
The Wisdom of Menopause: Creating Physical and Emotional Health and Healing During the Change,
New York: Bantam Books, 2001.

59
Premarin (brand name for estrogen) was approved by the FDA in 1942:
See Amanda Spake with Susan Headden, Katy Kelly, the U.S. News library staff, and Nancy Cohen, “Making Sense of Menopause,”
U.S. News and World Report,
2003.

59
each mare produces enough estrogen:
National Women’s Health Network,
The Truth About Hormone Replacement Therapy: How to Break Free from the Medical Myths of Menopause,
Roseville, Calif.: Prima Publishing, 2002, p. 24.

60
In a 1962 article published in
JAMA
:
Cited by Amanda Spake, in “Making Sense of Menopause,” op. cit.

60
hormone pills “are prophylactic:
Ibid.

60
best-selling book,
Feminine Forever:
Robert Wilson, M.D.,
Feminine Forever,
New York: M. Evans & Co., 1968, p. 97. Love,
Dr. Susan Love’s Hormone Book,
op. cit., p. 26.

60
contributions from drug companies:
Ibid.

60
Wilson’s foundation:
Ibid.

61
The Wilsons likened female aging to a disease:
R. A. Wilson and T. A. Wilson, “The Basic Philosophy of Estrogen Maintenance,”
Journal of the American Geriatrics Society
20(11):521–523, 1972.

61
transform his own personal trauma:
Interview with Ron Wilson by Judy Carmen. Copyright Judy Carmen and Ron Wilson, 2002. Sent via e-mail from Ron Wilson to the author, 2003.

62
most frequently prescribed brand-name drug:
The Hormone Foundation, “The Evolution of Estrogen Timeline.” Viewed at http://www.hormone.org/publications/estrogen_timeline/et3.html. Time line covering the period from the 1920s through 2002 is supported by an unrestricted educational grant from Wyeth Pharmaceuticals.

62
one of the five most frequently prescribed drugs:
National Women’s Health Network, op. cit., p. 24.

62
estrogen therapy increased the risk of cancer:
D. C. Smith, R. Prentice, D. J. Thompson, and W. L. Herrmann, “Association of Exogenous Estrogen and Endometrial Carcinoma. Abstract,”
New England Journal of Medicine
293(23):1164–1167, 1975.

62
(endometrial cancer), up to 14-fold:
H. K. Ziel and W. D. Finkle, “Increased Risk of Endometrial Carcinoma Among Users of Conjugated Estrogens. Abstract,”
New England Journal of Medicine
293(23):1167–1170, 1975.

62
adding another hormone, progestin:
M. H. Thom, P. J. White, R. M. Williams, et al., “Prevention and Treatment of Endometrial Disease in Climacteric Women Receiving Estrogen Therapy,”
The Lancet
2(8140):455–457, 1979.

62
studies soon confirmed that progestin protected women:
See Spake, op. cit.

62
HRT had been linked with cancer:
In 1977 the American College of Obstetricians and Gynecologists participated in an unsuccessful lawsuit against the FDA, attempting to block package inserts for estrogen products from including a warning about the increased risk of cancer of the uterus. See National Women’s Health Network, op. cit., p. 25.

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