Prescribing by Numbers: Drugs and the Definition of Disease

Prescribing by Numbers: Drugs and the Definition of Disease

by Jeremy A. Greene
ISBN-10:
0801891000
ISBN-13:
9780801891007
Pub. Date:
12/15/2008
Publisher:
Johns Hopkins University Press
ISBN-10:
0801891000
ISBN-13:
9780801891007
Pub. Date:
12/15/2008
Publisher:
Johns Hopkins University Press
Prescribing by Numbers: Drugs and the Definition of Disease

Prescribing by Numbers: Drugs and the Definition of Disease

by Jeremy A. Greene

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Overview

Winner, 2009 Rachel Carson Prize, Society for the Social Studies of ScienceWinner, 2012 Edward Kremers Award, American Institute of the History of Pharmacy

The second half of the twentieth century witnessed the emergence of a new model of chronic disease—diagnosed on the basis of numerical deviations rather than symptoms and treated on a preventive basis before any overt signs of illness develop—that arose in concert with a set of safe, effective, and highly marketable prescription drugs. In Prescribing by Numbers, physician-historian Jeremy A. Greene examines the mechanisms by which drugs and chronic disease categories define one another within medical research, clinical practice, and pharmaceutical marketing, and he explores how this interaction has profoundly altered the experience, politics, ethics, and economy of health in late-twentieth-century America.

Prescribing by Numbers highlights the complex historical role of pharmaceuticals in the transformation of disease categories. Greene narrates the expanding definition of the three principal cardiovascular risk factors—hypertension, diabetes, and high cholesterol—each intersecting with the career of a particular pharmaceutical agent. Drawing on documents from corporate archives and contemporary pharmaceutical marketing literature in concert with the clinical literature and the records of researchers, clinicians, and public health advocates, Greene produces a fascinating account of the expansion of the pharmaceutical treatment of chronic disease over the past fifty years.

While acknowledging the influence of pharmaceutical marketing on physicians, Greene avoids demonizing drug companies. Rather, his provocative and comprehensive analysis sheds light on the increasing presence of the subjectively healthy but highly medicated individual in the American medical landscape, suggesting how historical analysis can help to address the problems inherent in the program of pharmaceutical prevention.


Product Details

ISBN-13: 9780801891007
Publisher: Johns Hopkins University Press
Publication date: 12/15/2008
Edition description: New Edition
Pages: 336
Product dimensions: 5.90(w) x 8.90(h) x 1.00(d)
Age Range: 18 Years

About the Author

Jeremy A. Greene is an associate professor of medicine and the Elizabeth Treide and A. McGehee Harvey Chair in the history of medicine at Johns Hopkins University School of Medicine. He is the author of Generic: The Unbranding of Modern Medicine and coeditor of Prescribed: Writing, Filling, Using, and Abusing the Prescription in Modern America, both published by Johns Hopkins.

Table of Contents

Preface
Acknowledgments
Introduction: The Pharmacopoeia of Risk Reduction
Part One: Diuril and Hypertension, 1957-1977
1. Releasing the Flood Waters: The Development and Promotion of Diuril
2. Shrinking the Symptom, Growing the Disease: Hypertension after Diuril
Part Two: Orinase and Diabetes, 1960-1980
3. Finding the Hidden Diabetic: Orinase Creates a New Market
4. Risk and the Symptom: The Trials of Orinase
Part Three: Mevacor and Cholesterol, 1970-2000
5. The Fall and Rise of a Risk Factor: Cholesterol and Its Remedies
6. Know Your Number: Cholesterol and the Threshold of Pathology
Conclusion: The Therapeutic Transition
Notes
Index

What People are Saying About This

Carl Elliott

What is remarkable about this book is not just the grace and assurance of Greene's writing, but the way Greene combines an insider's view of medical practice and pharmaceutical marketing with much broader social currents. It is an extraordinarily impressive work of scholarship.

Carl Elliott, M.D., Ph.D., University of Minnesota Center for Bioethics, author of Better than Well: American Medicine Meets the American Dream

From the Publisher

An insightful, engrossing exploration of how our notions of 'disease' have evolved—with profound implications for understanding the health care of today and tomorrow.
—Jerry Avorn, M.D, Professor of Medicine, Harvard Medical School, author of Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs

What is remarkable about this book is not just the grace and assurance of Greene's writing, but the way Greene combines an insider's view of medical practice and pharmaceutical marketing with much broader social currents. It is an extraordinarily impressive work of scholarship.
—Carl Elliott, M.D., Ph.D., University of Minnesota Center for Bioethics, author of Better than Well: American Medicine Meets the American Dream

Greene’s historical account of our brave new world of drug-driven risk reduction is troubling and calls for some response. Both the scholarly depth and balanced tone of Prescribing by Numbers suggests that rather than simply rooting out bad actors and unethical practices, we must grapple with the very values and structural forces that are central to medical care and health today.
—Robert Aronowitz, M.D., History and Sociology of Science Department, University of Pennsylvania

Jerry Avorn

An insightful, engrossing exploration of how our notions of 'disease' have evolved—with profound implications for understanding the health care of today and tomorrow.

Jerry Avorn, M.D, Professor of Medicine, Harvard Medical School, author of Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs

Robert Aronowitz

Greene’s historical account of our brave new world of drug-driven risk reduction is troubling and calls for some response. Both the scholarly depth and balanced tone of Prescribing by Numbers suggests that rather than simply rooting out bad actors and unethical practices, we must grapple with the very values and structural forces that are central to medical care and health today.

Robert Aronowitz, M.D., History and Sociology of Science Department, University of Pennsylvania

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