Generation Rx: How Prescription Drugs Are Altering American Lives, Minds, and Bodies (Paperback)

by Greg Critser (Author) "In the world of bureaucratic Washington, D.C., few if any possess the gravitas and smarts to get away with quoting Teddy Roosevelt..." (more)
Key Phrases: pharma executives, big pharma, pediatric trials, United States, New York, Gerry Mossinghoff (more...)

Editorial Reviews

From Publishers Weekly
According to Critser, almost half of all Americans use a prescription drug daily; one in six take three or more. What are the possible consequences of the staggering recent growth in the use of such drugs? Journalist Critser (Fat Land: How Americans Became the Fattest People in the World) lays out the cautionary facts in exquisite detail. The saga of big pharma gives new meaning to the term "slippery slope": none of it could have happened, he says, absent Reaganite deregulatory fervor, which led to the taking of several bold risks, most of which were perceived in the 1980s, even by drug makers, to be "downright dangerous"—including direct-to-consumer promotion (DTC) and the advent of off-label marketing—drug manufacturers encouraging doctors to prescribe medications for maladies for which the FDA has not approved their use. Some of this territory about our growing dependence on prescription drugs and the impact of DTC advertising was covered last year by Marcia Angell and others, yet it's a story worth heeding again in the wake of the recent furor over Vioxx. Critser's account is solid, thorough and told with vigor.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to the Hardcover edition.

From Bookmarks Magazine
Critics were enthralled—and disturbed—by Critser’s muckraking portrait of the pharmaceutical industry and the overmedicated public it purports to serve. The book is sure to make people think twice the next time they reach into their medicine cabinet. Critser presents compelling evidence that drugs are not adequately tested before they hit the market and that drug companies seem to be inventing ailments that their pills can cure. But the book is not just a big-business exposé. Critser also explores the societal pressures that lead Americans of all ages to turn to pills to fulfill the burdensome expectations they place on themselves. And he uses gentle humor to avoid coming off as excessively alarmist.

Copyright © 2004 Phillips & Nelson Media, Inc. --This text refers to the Hardcover edition.

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Product Details

• Paperback: 308 pages
• Publisher: Mariner Books (January 5, 2007)
• Language: English
• ISBN-10: 0618773568
• ISBN-13: 978-0618773565
• Product Dimensions: 8 x 5.4 x 0.8 inches
• Shipping Weight: 10.4 ounces (View shipping rates and policies)
• Average Customer Review: 3.6 out of 5 stars See all reviews (10 customer reviews)
• Amazon.com Sales Rank: #67,013 in Books (See Bestsellers in Books)

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Customer Reviews

Most Helpful Customer Reviews

21 of 22 people found the following review helpful:

4.0 out of 5 stars Interesting observations, engaging arguments, October 17, 2005

By	Sreeram Ramakrishnan (Yorktown Heights, NY) - See all my reviews (TOP 1000 REVIEWER)    (REAL NAME)

This review is from: Generation Rx: How Prescription Drugs Are Altering American Lives, Minds, and Bodies (Hardcover)

Clearly, this is a book worthy of the acclaim the author recieved for his previous work. In this critical account(well-researched, but starting with a very biased opinion to begin with) Crister takes a look at how "Big Pharma" has evolved and changed everyone's lives. The early parts of the book focusses on the evolution of the trade group associated with the drug companies, their motivation and objectives, the personalities involved in its growth, and the inter-play with the politicians and regulatory agencies. Much of that discussion is based on the patent laws and their impacts on the drug companies and the patients.

Essentially, the author states a bold premise at the outset of the book - the prescription medication habits of patients is centered around "polymedication" (using multiple medicines to treat the same condition) and overmedication and that it is the fault of the drug companies for creating that scenario. While the observations in the book are perhaps accurate and convincing, it certainly does provide a skewed picture of the operations of the drug companies (no one can dispute the fact that they are for-profit companies trying to increase shareholder value).

Whether you agree with the author's premise or not, the book systematically explains his rationale for his premise, interspersed with some interesting anecdotes regarding advertising, direct-to-consumer marketing, politics, and personalities.

A good (albiet, slightly biased) look at the operations of Big Pharma. At the very least, one can gather excellent information on the politics and marketing mechanisms of Big Pharma and their interactions with the regulatory agencies. A must read for anyone who is a patient (or "consumer" of drug companies!) or an investor in Big Pharma.

18 of 19 people found the following review helpful:

4.0 out of 5 stars All I can say is Wow, November 19, 2005

By	Stephanie Manley (Houston, TX) - See all my reviews (TOP 500 REVIEWER)    (REAL NAME)

This review is from: Generation Rx: How Prescription Drugs Are Altering American Lives, Minds, and Bodies (Hardcover)

Like many other American's I have taken perscription medicines. Often I have wondered why I am getting the script for the latest drug I have seen on TV when I know other, cheaper drugs have worked in the past. This book really delves into the way drug companies market themselves to the physicians, and then how and why they started marketing to consumers.
I don't know how many of you have sat in doctor's offices waiting for your appointments and have been frustrated when drug company representatives come in to visit the doctor while you wait. Perhaps this has happened to you. I have been amazed as to why going in for something simple you can walk out with several perscriptions. Greg Critser suggests that it is through marketing and giving incentives to physicians this happens. As physicians write more and more perscriptions they are gifted by the drug companies. Once they realized how great that marketing technique worked, we started to see ads directed at consumers.
In their marketing, they have often suggested that some drugs work on symptions that the drug did not intend to treat initially; for example, Paxil for shyness, Prozac for PMS. Doctors can legally perscribe a drug for any reason they want to. Meaning marketing in this way, the drug isn't tested properly, and is being given to patients to test out the drug. In recent years we have had problems is Phen-Phen, and Viaox.
This book is heavily slanted against the drug companies. The book does cast them as a villian, no doubt. What I liked was that it made you think. Perhaps with some knowledge of how the drug business works, a consumer can go in and ask if the drug was specifically developed for what the intent of treatment is. You might even want to learn to ask about alternative and less expensive treatment. It was good, but very biased read.

11 of 11 people found the following review helpful:

3.0 out of 5 stars A History and Critique of Pharma "Tribal Marketing", December 23, 2005

By	John Mack - See all my reviews (REAL NAME)

This review is from: Generation Rx: How Prescription Drugs Are Altering American Lives, Minds, and Bodies (Hardcover)

Greg Crister, in his new book, Generation Rx: How Prescription Drugs Are Altering American Lives, Minds, and Bodies, puts forth the notion that "big pharma" has created a nation of pharmaceutical tribes, each with its own unique beliefs, taboos, and brand loyalties. According to Crister, there are 3 such tribes:

1. Tribe of High-Performance Youth: children and adolescents who are medicated for depression, attention deficit disorder, and a range of other psychological and behavioral problems mostly because of "their parents' completely under-standable wish that they perform well in a society of ever increasing demands to perform well, nay, superbly."

2. Tribe of Productivity and Comfort (MiddleYears): those of us at the middle-to-late points in our careers as parents and/or earners who are preprogrammed to consume drugs like Lipitor, Viagra, Prozac, and Prilosec, to "shore up our ability to produce more and better and to relieve discomfit, including the discomfit of having to watch what and how much we eat and drink and of sitting on our duff."

3. Tribe of High-Performance Aging: seniors who take drugs "not only to alleviate the discomfit of aging, but also to extend their lives."

Crister credits Pat Kelly, president of U.S. Pharmaceuticals for Pfizer, for inspiring the idea of consumer tribalism-pharma's need to sell lifestyle, not things. "By conjuring brand tribalism-an intense, interactive, and information-driven promotion of a product and the values it is made to seem to embody-a company can not only gain new customers, but also hold on to the old ones," says Crister.

According to Crister, before big pharmaceutical companies could create these tribes to consume their drugs, they had to become "unbound" from government restrictions. Crister devotes about 100 pages-38% of the book-to a history of how direct-to-consumer (DTC) advertising became legal is the U.S.

I found this to be the most interesting part of the book because of the first-hand accounts of people who played critical roles in making DTC advertising possible. Some of these "DTC pioneers" are still part of the pharmaceutical advertising scene today. Also, I know some of these people personally, which makes reading the story all the more interesting. Crister's account-which I have no reason to believe is inaccurate (the book is chuck full of references)-gave me insight into the backgrounds of these pioneers and how they got to where they are today.

Crister seems to have had unusual access to the principals-including pharmaceutical executives-involved. He peppers his story with many quotes and colorful phrases based on these interviews. Although I am happy that these people's stories have been told in their own words, some of these words have been used to make Crister's case against the industry.

There are a few juicy anti-DTC quotes from pharma execs in the book. Although the execs made these statements prior to DTC becoming legals, twenty-five years later and with eight years of DTC experience, the industry is still confronted by critics regarding DTC's cost, educational effectiveness, and ability to present risk information. For a review of these issues, see my article, "DTC Pros and Cons Presented at FDA Hearing," in Pharma Marketing News (www.pharmamarketingnews.com).

Crister, of course, has an axe to grind with the pharmaceutical industry and offers up the same criticisms of pharma marketing practices as did many other critics before him. His distinction, however, is the colorful and amusing language he uses. Here's a sampling in no particular logical order:

* On blockbuster drugs: "By late 2004, blockbusterism, the jumbo golden Rx goose, seemed to have laid its last egg."
* On CME: "The Demi Moore of this lap dance is CME."
* On Gen-X marketing: "The synergy marketers boogied at full tilt." I am still not sure what he means by that.
* On the liver: "the canary in the mineshaft of Generation Rx."
* On patients as consumers: "a person with medical needs" these days acts "as if he is not going to the doctor but rather to the mall." Crister's main reform idea is that patients should stop thinking of themselves as consumers and that we all should cut down our own use of prescription drugs. Not a bad suggestion, but utter radicalism to some pharmaceutical marketers.
* On the Pharmaceutical Marketing Congress: "the world's fair of pharmaceutical marketing."
* On Pat Kelly, president of U.S. Pharmaceuticals for Pfizer: "unquestionably, the definitive lead guitar player in the rocking world of modern drug marketing."
* On physician detailing: "more of a pharmaceutical lap dance than, like, and old-fashioned sales call." For more on the relation of sex and sales reps, see Pharma Marketing Blog ("Sexy Reps Sell Rx"; www.pharmamarketingblog.com).
* On polypharmacy: "in that regard most drug companies have been as responsible as a thirsty sailor in port after a year at sea." He said "thirsty," but I am sure he meant "horny."

Aside from the seminal events described above, Crister also recounts the history of many other "firsts" in DTC, including the first DTC ad that mentioned a drug by name and, afterward, the first non-branded, help-seeking ad that was designed to "drive patients to their doctors." I'll leave it up to you to read the book if you want to learn more about these events.

I will also leave it up to you to read the book for Crister's solutions, which appear to be the usual ones suggested by other critics. Crister does suggest something unique: get a healthy life in order to "pharmaproof" yourself.