Overdosed America (56 page)

246
four times more likely to
cause
a cardiovascular complication:
Post-heart attack patients in the LIPID study treated with a statin had 0.6 per
fewer
heart attacks and deaths due to heart disease per 100 patients each year (the rate of overall cardiovascular complications was not presented), compared with 2.5
more
cardiovascular complications for every 100 patients over the age of 65 treated with Vioxx instead of naproxen each year.

246
stomach acid–blocking drugs:
“Out of Bounds,” op. cit.

246
used to prevent osteoporosis:
M. R. McClung, P. Geusens, P. D. Miller, et al., “Effect of Residronate on the Risk of Hip Fracture in Elderly Women,”
New England Journal of Medicine
344(5):333–340, 2001.

247
“when you get to add hotels”:
Sheryl Gay Stolberg and Gardner Harris, “Industry Fights to Imprint on Drug Bill,”
New York Times,
September 5, 2003.

247
Congress was not even allowed to see:
Robert Pear, “Democrats Demand Inquiry into Charge by Medicare Officer,”
New York Times,
March 14, 2004.

247
Thomas Scully had received an ethics waiver:
Robert Pear, “Medicare Chief Joins Firm with Health Clients,”
New York Times,
December 19, 2003.

248
“We can’t let that [estimate] get out”:
David Rogers, “White House Suppressed Costs for Medicare Bill, Official Says,
Wall Street Journal,
March 15, 2004.

248
likely to increase even more than predicted:
J. A. Doshi, N. Brandt, and B. Stuart, “The Impact of Drug Coverage on COX-2 Inhibitor Use in Medicare,”
Health Affairs
Web Exclusive; February 18, 2004. W 4-94 to 105. Viewed at http://content.healthaffairs.org/cgi/reprint/hlthaff.w4.94v1.pdf.

248
Dr. Donald Berwick:
Quoted in B. Sibbald, “U.S. Health System Needs Major Overhaul: Academy,”
Canadian Medical Association Journal
164:1197, 2001.

248
more than half the budget:
U.S. General Accounting Office, “Food and Drug Administration: Effect of User Fees on Drug Approval Times, Withdrawals, and Other Agency Activities,” September 2002.

250
independent national public body:
Sheldon Krimsky,
Science in the Private Interest,
Lanham, Md: Rowman & Littlefield, 2003, p. 229. See also S. C. Schoenbaum, A.-M. J. Audet, and K. Davis, “Obtaining Greater Value from Health Care: The Role of the U.S. Government,”
Health Affairs
22(6):183–190, 2003.

250
National Institute for Clinical Excellence (NICE):
Viewed at http://www.nice.org.uk/cat.asp?c?137. Accessed February 19, 2004.

251
Sponsors [of clinical research]:
K. Dickersin and D. Rennie, “Registering Clinical Trials,”
Journal of the American Medical Association
290:516–523, 2003.

253
18,000 Americans die unnecessarily each year:
“Insuring America’s Health: Principles and Recommendations,” Institute of Medicine, January 2004.

253
ABCNews/
Washington Post
poll:
This poll was conducted October 9–13, 2003.

253
cost of covering all Americans:
J. Hadley and J. Holahan, “Covering the Uninsured: How Much Would It Cost?”
Health Affairs
Web Exclusive. June 4, 2003.

253
$500 billion:
See
Chapter 11
.

254
barely half of the standards:
E. A. McGlynn, S. M. Asch, J. Adams, et al., “The Quality of Health Care Delivered to Adults in the United States,”
New England Journal of Medicine
348:2635–45, 2003.

255
increased more than fivefold:
K. Levit, C. Smith, C. Cowan, et al., “Health Spending Continues in 2002,”
Health Affairs
23:147–159, 2004.

255
approximately 12,000 deaths:
B. Starfield, “Is U.S. Health Really the Best in the World?”
Journal of the American Medical Association
284:483–485, 2000.

255
Health care providers that deliver high quality:
Reed Abelson, “Hospitals Say They’re Penalized by Medicare for Improving Care,”
New York Times,
December 5, 2003.

258
President Teddy Roosevelt:
Edmund Morris,
Theodore Rex,
New York: Random House, 2001.

258
but not in the rest of the world:
Worldwide sales of COX-2 inhibitors totaled $6.7 billion in 2003. David L. Shedlarz, Executive Vice President and Chief Financial Officer, Pfizer, “Pfizer Themes: Performance, Opportunities, Differentiation,” November 12, 2003.

258
two most heavily advertised:
Kathy Blankenhorn and David Lipson, “Business Watch: 2001 in Review,”
IMS Health,
May 2002. Viewed at http://www.imshealth.com/vgn/images/portal/cit_759/2006112572bus2.pdf on October 24, 2003.

259
$5.3 billion of COX-2 inhibitor sales:
“IMS Reports 11.5 Percent Dollar Growth in 2003 U.S. Prescription Sales,”
IMS Health,
February 17, 2004. Viewed at http://biz.yahoo.com/bw/040217/175915_1.html on March 11, 2004.

P
RAISE FOR
Overdo$ed America

“The strength of
Overdo$ed America
is in these close readings of the research. Abramson walks the reader through the contradictions he’s discovered between the exorbitant claims made for the products and the actual study data.. . . Enlightening.”

—
Washington Post Book World

“A powerful and coherent case that American medicine has gone badly astray and needs a new paradigm—one untainted by profits.”

—
Publishers Weekly

“[R]eaders who might be inclined to view
Overdo$ed America
as simply another in the growing number of diatribes against drug companies should be aware that this book makes its arguments in a detailed, well-referenced manner. Moreover, responsibility for the overdosing of America goes far beyond the drug industry, resting equally with the nation’s physicians. I beg all of my physician colleagues to read this book and to think deeply about how we are practicing our chosen profession.”

—Thomas Bodenheimer, M.D.,
Health Affairs

“Required reading for all medical students and doctors.”

—
Journal of the American Medical Association

“Some of the nation’s worst drug dealers aren’t peddling on street corners, they’re occupying corporate suites.
Overdo$ed America
reveals the greed and corruption that drive health care costs skyward and now threaten the public health. Before you see a doctor, you should read this book.”

—Eric Schlosser, author of
Fast Food Nation

“I have taught with Dr. Abramson for several years; he is a superb family doctor, researcher, and communicator. In
Overdo$ed America
he uses all of these skills to present a clear and concise explanation of how American medicine has gone astray and what you can do to optimize your health. This book is a must-read for both patients and doctors concerned about health and the quality of medical care.”

—Herbert Benson, M.D., author of
The Relaxation Response
and
The Breakout Principle

“
Overdo$ed America
fulfills all of the criteria for high quality in health services: the right diagnosis and the right prescription at the right time. It is required reading for everyone: Americans will learn about the perverse incentives in their health care system, and those abroad will learn of the perils of importing what the United States is now trying to sell them.”

—Barbara Starfield, M.D., M.P.H., University Distinguished Professor, Johns Hopkins University and Medical Institutions

“Most Americans assume that the scientific information provided to patients and physicians is accurate, that clinical practice is guided by science, and that as a result—more medical care means better medical care.
Overdo$ed America
provides a compelling and well-documented analysis of why each of these assumptions is wrong. It is a book every American should read.”

—Elliott Fisher, M.D., M.P.H., Professor of Medicine, Dartmouth Medical School

“Reading
Overdo$ed America
is an important act of self-care. Not only is this book essential for all those who want to intelligently reclaim responsibility for their own health but it should also be required reading for all health care professionals who are truly committed to their clients’ welfare.”

—Cheryl Richardson, author of
Take Time for Your Life, Life Makeovers
, and
Stand Up for Your Life

“Dr. John Abramson has done a wonderful job of taking us beyond the infomercials, commercials, and sound bites to the real story about the drugs we take. This book should be read by everyone before they pop another pill.”

—Susan Love, M.D., M.B.A.

HARPER
PERENNIAL

This book is intended to provide information about medical issues in general, but not provide specific professional advice to any particular reader about his or her medical condition. Accordingly, any such information is not intended to replace or substitute for professional medical advice or the labeling recommendations of any given product. Readers are advised to consult their own physicians, with whom they can consider individual health needs and concerns, for specific medical advice and treatment. Every effort has been made to make sure that the information in this book is complete and accurate. Neither the author nor the publisher shall be liable or responsible for any loss or damage incurred allegedly as a consequence of the use and application of any information or suggestions contained in this book.

A hardcover edition of this book was published in 2004 by HarperCollins Publishers.

P.S.™ is a trademark of HarperCollins Publishers.

OVERDO$ED AMERICA
. Copyright © 2004, 2005, 2008 by John Abramson, M.D. All rights reserved under International and Pan-American Copyright Conventions. By payment of the required fees, you have been granted the nonexclusive, nontransferable right to access and read the text of this e-book on-screen. No part of this text may be reproduced, transmitted, downloaded, decompiled, reverse-engineered, or stored in or introduced into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical, now known or hereinafter invented, without the express written permission of HarperCollins ebooks

F
IRST
H
ARPER
P
ERENNIAL EDITION PUBLISHED
2005.

The Library of Congress has catalogued the hardcover edition as follows:

Abramson, John.

Overdo$ed America : the broken promise of American medicine / John Abramson.

p. cm.

Includes bibliographical references and index.

ISBN 0-06-056852-6

1. Medicine—United States. 2. Medical care—United States. 3. Pharmaceutical industry—United States. I. Title.

R151.A23 2004

ISBN: 978-0-06-134476-3 (P.S. edition)

EPUB Edition February 2013 ISBN 9780062281432

08 09 10 11 12
ID/RRD
10 9 8 7 6 5 4 3 2 1

*
The standard way to determine whether a treatment has a significant effect is to calculate the probability that the observed difference in outcome (improvement or side effect) between the patients in the group that received the new treatment and the group that received the old treatment (or placebo) would have happened by chance if, in fact, the treatment really had no effect whatsoever. The conventional cutoff for determining statistical significance is a probability (
p
) of the observed difference between the groups occurring purely by chance less than 5 times out of 100 trials, or
p
< .05. This translates to: “the probability that this difference will occur at random is less than 5 chances in 100 trials.” The smaller the
p
value, the less likely it is that the difference between the groups happened by chance, and therefore the stronger—i.e., the more statistically significant—the finding.