Rethinking Medications

Truth, Power, and the Drugs You Take

By: Jerry Avorn

Narrated by: Jerry Avorn MD MD

Suddenly, everything seems up for grabs about the medicines we take: Do they really work as advertised? Do some of them have dangerous, undisclosed side effects? Why are they so expensive, even unaffordable?

A leading medical expert provides a clear-headed, dispassionate understanding of life-and-death questions that have suddenly become so contentious. Groundbreaking research has given us many remarkable new drugs to treat conditions that have plagued patients for generations. But at the same time America’s drug evaluation process, once the envy of the world, is being seriously undermined.

Under pressure from the pharmaceutical industry and politicians, the Food and Drug Administration has lowered its approval standards to allow new medicines onto the market without the rigorous assessment that once made it the global gold standard for medication regulation. Instead of carefully reviewed scientific evidence, government officials now make alarming public statements about effectiveness and risks, unmoored from scientific evidence. All this while out-of-control drug prices—far higher in the US than anywhere else in the world—put badly needed treatments beyond the reach of many patients.

Dr. Jerry Avorn, a physician and professor of medicine at Harvard, has been studying these issues for decades. In Rethinking Medications, he engagingly explains how we got here and provides concrete solutions to ensure that all our medicines are effective, safe, and affordable. The book takes on the most fundamental aspects of the medicines we take:

• Does it work? Who says? How do we know?
• Is it safe? What’s the evidence? How can we be sure?
• Why is my prescription so expensive? Is it worth what it costs? Who determines that price? Why does the US pay twice as much as other countries for the same medicines?
• With new leadership at FDA, CDC, NIH, and the whole Department of Health and Human Services, who decides these life-and-death questions for the nation, and how well are they doing their jobs?
• …and finally: how do all these issues affect the choices that patients and doctors make every day?

Rethinking Medications draws on Dr. Avorn’s long experience as a clinician, outspoken patient advocate, and the founder of an internationally respected research group at Harvard. He illustrates this accessible and entertaining account with examples from cancer drugs to opioids, from treatments for rare diseases to psychedelics. Throughout, Dr. Avorn proposes practical advice for consumers, policymakers, and practitioners to address these problems. At a time when all our assumptions about scientific evidence, regulation, pricing, and the role of government are under assault as never before, this book points to actionable solutions within reach and a way out of the current confusion, beyond all the noise.

Entertaining, beautifully researched, and important

Dr. Avorn achieves the impossible: he puts the “care” back in healthcare. Some topics touch each of us individually; others are just plain fascinating; still others, he brings acumen (both clinical and societal) and a terrific sense of humor to enlighten and dissect.

Read and discuss

Accessible read for the medical community and anyone who takes any kind of medication which means everyone. Was pleasantly surprised by the transparency and truth telling which was so inspiring. An added bonus is the call to action with practical steps provided at the end for decision making and advocacy.

Amazing perspective

Great perspective on the background of so much like the policies, the FDA, laws and more on medications. Especially even better to hear it from Jerry himself.

Great material, inconsistent vocal performance by author

The material is very interesting and provides great insight from a dedicated doctor entrenched in patient care advocacy. I’m very thankful that he shared his experiences and thoughts on the issues surrounding US healthcare challenges, especially with the FDA, the pharmaceutical industry, and the medical educational community. He has a friendly personality and makes honest attempts to mix mild humor throughout the reading. His voice is gravelly and may be difficult for some listeners. There are several obvious edits where the quality of his voice changes, seemingly to a passage of time for a re-record. But you shouldn’t be listening to this for a smooth listen, the content is compelling just the same.

A must read if you are interested in prescription medicines

This is an important overview of his w drugs get approved and the intersection of medicine and politics. The author is unusual in how he combines his moral compass with his work. He doesn't just talk the talk but steadfastly walks the walks. Thank you Jerry! I learned a lot!