cover image POWERFUL MEDICINES: The Benefits, Risks, and Costs of Prescription Drugs

POWERFUL MEDICINES: The Benefits, Risks, and Costs of Prescription Drugs

Jerry Avorn, . . Knopf, $27.50 (464pp) ISBN 978-0-375-41483-1

In this pragmatic volume, Avorn sets out an impressive plan for the American health care system to get helpful drugs to those who need them, protect patients from dangerous side effects and keep costs within reasonable limits. Avorn, chief of the division of pharmacoepidemiology and pharmacoeconomics at Brigham and Women's Hospital in Boston, argues, "[F]or a sum no greater than our current drug budget, medications could provide all Americans with the most productive and cost-effective interventions in all of health care." Avorn claims, "[W]e waste billions of dollars a year on prescription drugs that are excessively priced, poorly prescribed, or improperly taken." To remedy this situation, reform is needed in how new drugs are approved and marketed. In addition, practicing physicians need access to state-of-the-art information about new medications, including how well they compare to established (and often cheaper) products. Computer technology, Avorn shows, can bring together the latest information on treatment options and drug contraindications. But changes in the pharmaceutical industry itself—of which Avorn does not hold a flattering view—may be necessary to eliminate pressure to prescribe the most heavily advertised and costly new product when old standbys are equally effective. Though this informative and witty book is overly long, it makes a compelling case for prescription sanity and shows how constructive change can realistically be achieved. (Aug. 20)