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This searing indictment, David Healy’s most comprehensive and forceful argument against the pharmaceuticalization of medicine, tackles problems in health care that are leading to a growing number of deaths and disabilities. Healy, who was the first to draw attention to the now well-publicized suicide-inducing side effects of many anti-depressants, attributes our current state of affairs to three key factors: product rather than process patents on drugs, the classification of certain drugs as prescription-only, and industry-controlled drug trials. These developments have tied the survival of pharmaceutical companies to the development of blockbuster drugs, so that they must overhype benefits and deny real hazards. Healy further explains why these trends have basically ended the possibility of universal health care in the United States and elsewhere around the world. He concludes with suggestions for reform of our currently corrupted evidence-based medical system.
Hardcover: 320 pages
Publisher: University of California Press; 1 edition (March 12, 2012)
Language: English
ISBN-10: 0520270983
ISBN-13: 978-0520270985
Product Dimensions: 6 x 0.9 x 9 inches
Shipping Weight: 1.3 pounds (View shipping rates and policies)
Average Customer Review: 4.8 out of 5 stars See all reviews (36 customer reviews)
Best Sellers Rank: #551,858 in Books (See Top 100 in Books) #50 in Books > Business & Money > Industries > Pharmaceutical & Biotechnology #184 in Books > Textbooks > Medicine & Health Sciences > Administration & Policy > Health Policy #289 in Books > Textbooks > Medicine & Health Sciences > Medicine > Special Topics > History
Dr. Healy moves beyond the boundaries of his specialty, psychiatry, to describe how the changes in Medicine and Medical Care we all perceive are, in fact, symptomatic of the increasing dominance of our Healthcare systems by a vast medical-industrial complex that increasingly drives every aspect of Medicine. He shows how previous "reforms" - prescription drugs, the formation of the FDA, Clinical Trials, Patent Laws, etc. have been co-opted by industry over the years - turning previous "reforms" into strangle-holds that have shaped and contorted traditional medicine, creating physicians who are often functioning as salesmen for the Pharmaceutical and Medical Device Industry, physicians who are treating lifestyles rather than people with disease. This is not a book with complaints about just some aspects of medical care nor is it laced with conspiracy theories. It's a historical travelogue through largely familiar territory, but adding keen insights on the back stories and unintended consequences that have been fundamentally undermining our healthcare system in plain view. His predictions are dire, but impossible to ignore. Pharmageddon is a must-read for anyone in the healthcare world and anyone who plans to need healthcare in the future - in short, everyone.
This book is chock full of evidence that the corruption of the medical system in this country is deep and pervasive. The most important bottom line message is that this corruption has a serious effect on the quality of healthcare delivered by even the most conscientious doctors, nurses, and hospitals.Those who should be looking out for the best interests of patients are mostly failing to do their jobs, even if they are not actively participating in the corruption. For instance, the allegedly prestigious New England Journal of Medicine makes no attempt to check on the veracity of drug company studies and its editor expresses that she has "no regrets" about publishing a fraudulent study of Paxil. (Paxil was found by the study to be no more effective than a placebo and much more likely than a placebo to induce suicidal behavior in young people --- but this data was deliberately left out of the published study by the company who ran the study.)Next time you see one of those attractive young drug salespeople in your doctor's waiting room tell them to look for some honest work.
David Healy has written extensively about the pharmaceutical industry, and this book is one of his best. He gives a short history of how drugs became such big business, and why the incentives are wrong for new drug development. Healy is by no means anti-drug, but he objects to the use of too many drugs and of drugs that have questionable value to the patient. Everyone should be aware of the information in this book before filling their next prescription.
Working as a psychiatrist in different countries, systems and settings as I did during the last 25 years has taught me that nothing is ever written in stone. What is considered safe and effective in one place may be looked at as harmful or useless in another. Psychiatry is definitively not an exact science and working with human beings' sufferings often needs more creativity than rigid guidelines. When working as a community psychiatrist we learn very rapidly the limits of what we were taught in academic forums and research literature. Reading David Healy's book comforted me in something that patients (our co-partners in the difficult business of healing bruised souls) had convinced me of a long time ago: how much they know and how carefully we need to listen to them ...David Healy is a serious man. As a caring clinician and internationally recognized expert in pharmacology, epidemiology and the history of psychiatry, this Irish professor may be reminiscent of both Sherlock Holmes and Atticus Finch.His latest book, Pharmageddon, is a riveting detective story, a meticulous account of the troubling evolution of the practice of medicine and a compelling plea for a better protection of those that medicine is supposed to serve. It is a must-read for all of us. Beware though, that, as a physician or as someone who will sooner or later be a client of the healthcare system, you may be in for a painful ride. It takes only a few pages to realize that, if you are a health care provider, you may already have become, willingly of not, an accomplice of a system that has slowly but surely drifted from the shores of a "First do no harm" philosophy to shores covered by a growing number of victims of poorly or overly prescribed medications. Adverse drug events are currently the fourth leading cause of death in the US and Europe , and possibly the leading cause of death within the mental health domain.David Healy is a courageous man. Twenty years ago, when psychiatrists, like everybody else, wanted so much to believe in the quasi miraculous and purely benevolent powers of new and heavily marketed drugs, he was among the first to take the risky and unpopular position of pointing out the emperor new clothes. He cautioned us that the same pills that may relieve severe depression and save lives may also, occasionally, be the cause of suicidal thoughts and sometimes of suicide itself. By doing this, he saved lives, while compromising his own academic career in a world where academia and research have become increasingly and, in some places, totally dependent upon the financial support of the for-profit pharmaceutical industry.In Pharmaggedon, the author expands his observations from psychiatry to the entire field of medicine. With carefully documented evidence, he brings us on a journey to observe the worrisome directions taken by medicine, which went from a cautious use of potentially poisonous substances and a denunciation of charlatanism to a profession hijacked by the greed of the Pharmaco-Industrial Complex and the doctors who benefit from it. One of the most stunning observations is how "evidence-based medicine," which was developed initially to protect society from quackery, has become the very tool used to turn data inside out in order to "advertise" medications as efficacious or totally safe while, too often, they are neither. Again and again, Healy demonstrates how the globalization and mercantilisation of clinical trials, together with the limited access to raw data from published and unpublished studies, and the ever expanding use of ghostwriting, have often turned evidence-based research into no more than a gimmick to increase sales.Medical ghostwriting is a practice where pharmaceutical or device companies hire medical education, marketing, or communications companies to draft articles that are presented to prominent physicians and scientists to sign on as "authors." The idea, then, is that this will increase the likelihood that the article will be published in important medical journals. The articles may be review articles, editorials, or primary research papers, and they are typically presented to physicians and scientists affiliated with academic institutions. The physicians and scientists agree to sign on even if they may not be intimately familiar with the underlying data or relevant research or provided limited input on the article. Healy estimate than over half of the current medical literature has been "ghostwritten."This drift from science to evidence-biased medicine, and the latter's role in the development of rigid and sometimes inappropriate guidelines, is very disturbing and makes for a very bleak future. Trust, the cornerstone of the relationship between a patient/consumer and his or her physician, seems doomed. Similarly, the trust that a physician needs to have in academia and Pharma in order to subject those in their care to potentially dangerous substances is also highly compromised. Some may regret that, by insisting mostly on the dangers of medications, David Healy does not put enough emphasis on their positive and life saving properties and the true improvement that have been made in reducing side effects. Maybe Healy considered that enough literature has been (ghost) written already on these aspects of pharmacology and that his erudition would be of better use in exposing truths that the majority of us were not aware of.But Healy is not just a spoil-sport. As a good old fashioned physician, he proposes remedies to change a self-destructive medical dynamic. One of the most feasible and important changes that he recommends is the provision of full and free access to raw research data. It is shocking that these data are not already in the public domain since the interpretation of them affects not only our health but a good part of our economy. Another point made by Healy is to challenge a "prescription-only" system because a "prescription-only arrangement means that doctors have to give us disease if they want to give us pills" (or I would add, if they want to be paid).I may need a little more convincing from the author as to what would safely replace this system. I would hope that this problem could be addressed with the regular updating of physicians' pharmacological knowledge - one where we would be considered smart and mature enough by academia and Pharma - to be informed of the risks of a molecule as well as their vaunted benefits. Other useful changes could be made at the level of billing practices, for instance in the design of a system that does not penalize the doctor financially for not prescribing anything.David Healy has put theory into practice by creating RxISK.org, a free website (not sponsored by Pharma or advertising) for patients and their doctors to research and report drug side effects.There is certainly a long road between appealing ideas and their execution in a world dominated by people who may all have some short-term interest in the status quo.Let's hope, however, that, just as Atticus Finch's words helped to transform society for the better, David's Healy's Pharmageddon will give us the tools, courage and strength to rethink and transform the way medicine is designed and delivered.Finally, if there is only one thought you want remember from this book, it should be this almost prophetic counsel by Philippe Pinel, from two hundred years ago: "It is an art of no little importance to administer (medication) properly, but it is an art of much greater and more difficult acquisition to know when to suspend or altogether to omit them."Amen.Bernadette Grosjean.M.D.Associate Professor of PsychiatryDavid Geffen School of Medicine at UCLA
As an experienced physcian I wished Dr Healey had written this book years ago. From drugs that worked like penicllin we have been guided to accept drugs that by statistical maniuplation have often only a slight beneficial effect. It should be included in a course in medical schools,it would save lives,reduce health costs and break the concept that if it is new it must be better. Dr A.R
Anyone who is using pharmaceuticals, might need them in the future or has a loved one who needs to take them needs to read this book. People who pay taxes that cover the costs of these drugs might also like to read it to find out whose pocket your money is going into. Its absolutely shocking to learn how pharmaceutical companies manipulate drug trials, science and statistics to make it look like these drugs are safe and how the government turns a blind eye to what's going on in return for some kick backs. There's much more.Protect yourself by reading this book. I had to get it through because it seems to be permanently "unavailable"in Canadian bookstores....Hmmmm. How could that happen?
Pharmageddon
