10_Medications and the Pharmaceutical Industry - Cohen et al

10_Medications and the Pharmaceutical Industry - Cohen et...

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Unformatted text preview: 284 The Social Organization of Medical Care type of third—party payer (Sclar et al., 1998); cul« tural preferences for certain diagnoses and medica— tions (Payer, 1990); new technologies and changed political and economic environments which affect medication availability and determine its regulation (Davis, 1996); and promotional practices by phar— maceutical manufacturers which—as we discuss in this article——respond to and create professional and consumer demand. . . . 2. The question of the placebo is a most complex one, given the demonstrated efficacy of placebos in nu, merous ailments, but also given the fact that place— bos usually have to be believed in to work. In other words, the drug’s impact is not only determined by the interaction of a chemical substance with the body, but also by the expectations of the user and the deceptions of the provider. In this connection, inert placebos (e.g. sugar, yeast) may simply be con- trols for the “normal state.” To study better the ef— fects of medications beyond placebo effects, med— ications must be compared to “active” placebos (e.g. atropine), substances which produce bodily changes (such as increased heartbeat or sweating) and thus which patients may “actively” believe to be genuine remedies. In the few studies that use ac— tive placebos as controls, the relative efficacy of the tested medication is typically much lower than in studies using inert placebos (see, generally, Fisher and Greenberg, 1993). 3. IMS Health (2000a), a commercial company which tracks retail sales of prescription drugs world—wide, lists 16 “therapeutic categories” of medications, in decreasing order of sales in retail pharmacies for 12 months leading up to February 2000: cardiovascular, alimentary/metabolism, cen- tral nervous system, anti~infectives, respiratory, genito—urinary, musculo«skeletal, cytostatics, der— matologicals, blood agents, sensory organs, diag» nostic agents, hormones, miscellaneous, hospital solutions, parasitology. REFERENCES Abraham, J. (1995). Science, politics and the pharma- ceutical industry: Controversy and bias in drug reg- ulation. London: UCL. Adams, K.M. and Bieliauskas, LA. (1994). On per» haps becoming What you had previously despised: Psychologists as prescribers of medication. journal of Clinical Psychology in Medical Settings, 1, 189—97. Agency for Health Care Policy and Research (AHCPR). (1999). Treatment of depression: Newer pharma— cotherapies. Summary, evidence report/technology assessment 7. Rockville, MD: AHCPR. Available at: http://www.ahcpr.gov/clinic/deprsumm.htm [ac cessed 13 July 2001]. Antonuccio, D., Danton, WG., DeNelsky, G.Y.,‘ Greenberg, R.G. and Gordon, J.S. (1999). Raising questions about antidepressants. Psychotherapy and Psychosomatics, 68, 3—14. Baberg, H.T., Nelesen, R.A. and Dimsdale, J.E. (1996). Amphetamine use: Return of an old scourge in a consultation psychiatry setting. American jour- nal ofPsychiatry, 153, 789—93. Baum, C., Kennedy, D.L., Knapp, D.E., Juergens, JP. and Faich, G.A. (1988). Prescription drug use in 1984 and changes over time. Medical Care, 26, 105-14. Breggin, RR. and Cohen, D. (1999). Your drug may be your problem: How and why to stop taking psy- chiatric medications. Cambridge, MA: Perseus. Bush, P.J. (1977). Psychosocial aspects of medicine use. In A.I. Wertheimer and P.J. Bush (Eds), Per— spectives on medicines in society. Hamilton, IL: Drug Intelligence. Bush, P.J. and Osterweis, M. (1978). Pathways to medicine use. journal of Health and Social Behav- ior, 19, 179—89. Buske, L. (2000). Drug costs surpass spending on physicians. Canadian Medical Association journal, 162, 405-6. Cobert, B. and Silvey, J. (1999). The Internet and drug safety? What are the implications for pharma— covigilance? Drug Safety, 20, 95—107. Cohen, D. (1996). Les ‘nouveaux’ médicaments de l’esprit: Marche avant vers le passe? (The “new” mind drugs: Forward step into the past?) Sociologie et sociétés, 28, 17—34. Cohen, D. (1997b). Psychiatrogenics: Introducing chlorpromazine in psychiatry. Review of Existen— tial Psychology and Psychiatry, 23, 206—33. Cohen, D. and McCubbin, M. (1990). The political economy of tardive dyskinesia: Asymmetries in power and responsibility. journal of Mind and Be- havior, 11, 465—88. Davidson, W, Molloy, W. and Bédard, M. (1995)- Physician characteristics and prescribing for elderly people in New Brunswick: Relation to patient out' comes. Canadian Medical Association journal, 152, 1227—34. Davis, P. (1996). Contested ground: Public purpose and private interest in the regulation of prescription drugs. New York: Oxford University Press. DeGiacomo, P., Silvestri, A., Pierri, G., Lefons, E. and Corfiati, L. (1986). Research on effects of P53" chodrugs on human interaction. A theoretical/CX' perimental approach. Acta Psychiatrica ScandinflV‘ ica, 74, 417-24. Diller, L.H. (2000). Kid trician questions the ' dren. Salon Health ar http://www.salon.co kid,drugs/ [accessed Eichenwald, K. and K0] conflicts for doctors. Estroff, SE. (1985). M1 of psychiatric client; Berkeley, CA: Univer Fisher, S. and Greenbe the double-blind desi drugs? journal of I 181, 345—50. Fisher, 5. and Greenb placebo to panacea.- the test. New York: ‘ Fried, S. (1998). Bitte world of legal drugs. Goldsmith, J. (2000). our health system? 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