Overdosed America (41 page)

Waitzkin, Howard.
The Second Sickness: Contradictions of Capitalist Health Care.
Lanham, Md: Rowman & Littlefield Publishers, 2000.

Welch, H. Gilbert.
Should I Be Tested for Cancer? Maybe Not and Here’s Why.
Berkeley, University of California Press, 2004.

Wilber, Ken.
The Marriage of Sense and Soul: Integrating Science and Religion.
New York and Toronto, Random House, 1998.

The pagination of this electronic edition does not match the edition from which it was created. To locate a specific entry, please use your e-book reader’s search tools.

absolute risk, 14–16, 165–66, 229

academic experts.
See
conflicts of interest

academic research, 94–95, 109, 196–97.
See also
medical research

Activase, 226–27

Actonel, 214–15, 246

advertising.
See
direct-to-consumer (DTC) advertising

AFCAPS/TexCAPS study, 137–40

age

antidepressants and, 243

coronary heart disease and, 129, 136–42, 145

menopause and, 61

osteoporosis and, 212, 215, 219

strokes and, 16

AIDS, 43, 80

alcohol consumption, 20, 45, 238

alendronate, 213–15, 218, 246

allergy drugs, 152–53

ALLHAT study, 107–9, 143–44, 203

alteplase, 226–27

Alzheimer’s disease, 58, 69, 104

American Heart Association, 100, 224, 226–27, 237

American medicine.
See
health care system, U.S.

angina, 14, 132

angioplasty, 169, 171–72, 221

Annals of Internal Medicine
, 96

antiarrhythmic drugs, 114

antibiotics, 49

antidepressant drugs, 11, 114–17, 163, 232–34, 243

anti-inflammatory drugs.
See
Celebrex and Vioxx

aortic aneurysm device, 243–44

arrhythmia, 44, 98–101, 114

arthritis.
See
osteoarthritis

aspirin, 16, 49, 34–35, 132

AstraZeneca, 101, 148

atrial fibrillation, 7–8

Atromid-S, 133

back pain, 182–83

back surgery, 177–78, 182–83

balloon angioplasty, 169, 171–72, 221

Berlex Laboratories, 89

bias.
See
commercial research bias

biomedical engineering, 42–44, 176–77, 243–44

biomedical model, 189–208

as folk medicine, 201–4

lifestyle factors vs., 11, 204–6

medical education and, 197–200

osteoarthritis and, 190–94

patients vs. persons and, 206–8

roots of, 194–97

blood pressure

coronary heart disease and, 129, 221

drugs, 104–5, 107–9, 245

hormone replacement therapy and, 67

screening, 49

strokes and, 17, 20, 225

body mass index (BMI), 238

bone marrow transplantation, 41, 51–52

bone mineral density (BMD) tests, 62, 211–20

breast cancer, 234.
See also
cancer

bone marrow transplantation and high-dose chemotherapy for, 39–42, 51–53

hormone replacement therapy and, 55–58, 61, 68, 69–71

Bristol-Myers Squibb, 90–91, 146, 227–28, 242

campaign contributions, 90–91

Canada, 159–61, 171, 174, 175, 245

cancer, 234–35

breast (
see
breast cancer)

endometrial (uterine), 62, 70

heart disease vs., 220

mortality rates, 50

screening, 49, 235

statin drugs and, 145–46

study patients for, 104

cardiac catheterization, 169, 171–72, 175

cardiac defibrillators, 44, 98–101

cardiopulmonary bypass surgery, 43, 169–73, 175–76

cardiovascular complications, 26–27, 33–36, 38, 107–9, 246

CARE study, 142–43

Carnegie Foundation, 196–97

cataract surgery, 177

Celebrex and Vioxx, 23–38

biomedical model and, 203–4

CLASS study of Celebrex, 29–33

clinical practice guidelines about, 191, 259

early studies of, 4–7

FDA Warning Letters about, 23–24, 36

marketing of, 4–7, 10–11, 153–55

medical journals and, 4–7, 25–27, 37–38

Medicare and, 245, 246, 248

osteoarthritis and, 191

public hearings about, 258

VIGOR study of, 33–36

censoring, informed, 30

censorship, medical journal self-, 113

Center for Medical Consumers, 167

chemotherapy, 41–42, 51–52, 56–57

chlorpheniramine, 153

cholesterol.
See also
cholesterol guidelines of 2001

C-reactive protein (CRP) test and, 164–66

hormone replacement therapy and, 67

levels of, in U.S., 45

cholesterol guidelines of 2001, 129–48

conflicts of interest and, xvii, 127, 133–35

diet and, 224

formulation of, 129–31

linking cholesterol with coronary heart disease, 131–33 (
see also
coronary heart disease)

primary prevention of heart disease, 136–43

profits from, 146–48

public hearings about, 259

secondary prevention of heart disease and, 142–43

testing and failure of, 143–46

chronic myelogenous leukemia, 43–44

cigarettes.
See
smoking

Claritin, 152–54, 157

CLASS study, 24, 29–33.
See also
Celebrex and Vioxx

clinical practice guidelines, xvii–xviii

cataract and back surgery, 177

cholesterol (
see
cholesterol guidelines of 2001)

conflicts of interest and, xiii, 127–28, 133–35, 146–48, 227, 249–50

clinical trials.
See
medical research

clofibrate, 133

clot-busting drugs, 4, 221

colon cancer, 234

commercial research bias, 13–22, 93–110.
See also
medical research

absolute vs. relative risk and, 14–16, 165, 166, 229

advertising and research companies and, 109–10

Celebrex and Vioxx research (see Celebrex and Vioxx)

cholesterol research (
see
cholesterol guidelines of 2001)

commercial funding, 94–97 (
see also
drug companies; funding)

commercial goals vs. health goals, 21–22, 50–51, 53, 241–44

conflicts of interest and (
see
conflicts of interest)

damage control and, 107–9

data manipulation, 34–36

data omission, 29–31

data transparency and, 27–28, 94, 105–6, 251–52

dosage manipulation, 101–2

failure to compare existing therapies, 17, 102–3

FDA drug approval and Rezulin, 86–88

ghostwriters and, 106–7

hormone replacement therapy (
see
hormone replacement therapy)

implantable defibrillators, 98–101

independent review for, 249–53

medical journals and, 25–27, 37–38, 93–94, 96–97 (
see also
medical journals)

osteoporosis research, 211–20

Paxil research, 243

premature termination of research, 104–5

publication bias as, 113–17

research design changes as, 31

septic shock research, 161–63

stroke research, 13–22

unbiased information vs., 167

unrepresentative patients, 16–17, 33, 103–4, 206–8, 251

commercial speech, 37–38, 157–59

conflicts of interest

academic experts, xxii, 18, 243

cholesterol guidelines, 135, 147–48

clinical guideline experts, xxi, 127–28, 133–35, 146–48, 227, 249–50

continuing medical education, 121–23

damage control, 109

FDA, 85–87, 89–90

ghostwriters, 106–7

hormone replacement therapy, 60–61

medical journal, 26

medical news stories, 166–67

NIH researchers, 86–90

independent review and, 258–59

surgeons, 177–78

confounding factors, 66–67

consciousness, 206–8

consulting contracts, 88–90, 109, 249.
See also
conflicts of interest

consumer health web sites, 219

consumerism, medical.
See
medical consumerism

continuing medical education (CME), 117–24, 250

CONVINCE study, 104–5

coronary artery bypass surgery, 43, 169–73, 175–76

coronary heart disease (CHD), 220–225.
See also
blood pressure; heart attacks; strokes

arrhythmia, 44, 98–101, 114

biomedical model and, 201–2

cardiovascular complications, 26–27, 33–36, 38, 107–9, 246

cholesterol and (
see
cholesterol; cholesterol guidelines of 2001)

defibrillators for, 98–101

hormone replacement therapy and, 58, 63, 67–68

prevention of, 237–239

supply-side medical care for, 169–73, 174–76

surgery for, 43, 169–73, 175–76

costs, medical.
See also
profits

antidepressant drugs, 117

bone marrow transplantation, 51

Celebrex and Vioxx, 5, 10, 36, 38

commercial vs. health goals and, 51

defibrillator, 98–100

doctor awareness of, 126

Gleevac, 44

health care system performance vs., 46–47, 180–81, 184, 210, 248–49, 254–56

health insurance and, 75–82, 253–54

ischemic stroke drug, 226

marketing and, 10, 154, 159, 166

Medicare prescription drug bill and, 247–48

randomized controlled trials (RCTs), 66

reducing, xvii–xviii, 249–56

statin drugs, 15, 135, 136, 138–39

supply-side medical care and, 184–85

surgical procedures, 174–78

unnecessary medical services, xix–xx, 52–53, 84, 178–81

Xigris, 162

counseling, 11, 232–33

counterfeit Canadian drugs, 159–61

Covera, 104–5

COX-2 inhibitors.
See
Celebrex and Vioxx

C-reactive protein (CRP) test, 164–66

Crestor, 133, 148

CT scans, 44, 181–83

damage control by, 26, 107–9

data

FDA, 28, 37

manipulation (
see
commercial research bias)

omission, 29–31

transparency, 27–28, 94, 105–6, 251–52

death rates.
See
mortality rates

defibrillators, 44, 98–101

dementia, 58, 69, 104

depression, 10–11, 114–17, 163, 232–34

design, changed research, 31

detailing drugs, 124–26

diabetes

hormone replacement therapy and, 67

Rezulin drug, 86–88

strokes and, 225, 227

diagnostic tests, xix–xx, 84, 164–66, 169, 171–72, 211–20

dialysis, 43

diclofenac (Voltaren), 25, 29–30

diet.
See also
lifestyle health factors

basic health and, 45, 238

cancer and, 234–35

cholesterol guidelines and, 135

coronary heart disease and, 201–2, 221–25

diabetes and, 229–31

life expectancy and, 49

obesity and, 235–37

osteoporosis and, 218

stroke and, 17

direct-to-consumer (DTC) advertising, 150–59.
See also
marketing

advertising agencies and research companies, 109–10

Claritin, 152–54

Celebrex and Vioxx, 5–6, 28

as commercial speech, 157–59

FDA approval of, 150–52

FDA warnings about (
see
warning letters, FDA)

health insurance and, 80

medical consumerism and, xx,

medical journals and, 112–13

diuretics, 8, 245

doctor-patient relationship, 3–11

drug costs vs., 3–6

heart disease and, 7–10

health insurance and, 75, 78–80

hormone replacement therapy and, 55–58

individual responsibility and, 256–57

medical consumerism vs., xx, 5–7, 9–11, 38, 155–57 (
see also
medical consumerism)

osteoarthritis and, 190–94

patients vs. persons and, 206–8

social anxiety disorder and, 232–33

strokes and, 13

doctors.
See also
doctor-patient relationship

conflicts of interest (
see
conflicts of interest)

deception of (
see
doctors, deception of)

education of (
see
medical education)

primary care, vs. specialist, 82–85 (
see also
primary care doctors)

supply-side medicine and, 179

doctors, deception of, 111–28

clinical guidelines and, 127–28

commercial bias in continuing medical education, 117–20

drug reps and, 124–26

medical journals and, 93–94, 112–17

prescribing habits and, 120–24, 126, 155–57

dosages, tinkering with, 101–2

drinking, 20, 45, 238

drug companies.
See also
drugs; medical-device companies

data ownership by, 27–28, 105–6

deception of doctors by (
see
doctors, deception of)

financial relationships with (
see
conflicts of interest)

health and, 209

lobbyists, 90–91

marketing (
see
marketing)

medical research and (
see
commercial research bias)

profits (
see
profits)

new drugs by, 48

drugs.
See also
drug companies

anti-arrhythmic, 114

antibiotics, 49–50

antidepressants, 11, 114–17, 163, 232–34, 243

arthritis (
see
Celebrex and Vioxx)

aspirin, 16, 49, 34–35, 132

coronary heart disease, 8, 221

costs (
see
costs, medical)

FDA approval process, 85–90

free samples of, 124–26

health insurance coverage, 21–22, 79–80, 244–49

importing, 159–61

medical breakthroughs, 43–44

new, by U.S. drug companies, 48

osteoporosis, 212–20

researching (
see
medical research)

septic shock, 161–63 253–54

statins (
see
statin drugs)

tinkering with dosages, 101–2