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Prescribing by Numbers

Drugs and the Definition of Disease

Jeremy A. Greene

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Winner, 2009 Rachel Carson Prize, Society for the Social Studies of Science

Winner, 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…

Winner, 2009 Rachel Carson Prize, Society for the Social Studies of Science

Winner, 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.

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Prescribing by Numbers

Jeremy A. Greene

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Reviews

Reviews

Greene provides suggestions on how to address some of the problems inherent in medical prevention.

Shows how the process of defining disease 'illustrates the porous relationship between the science and the marketing of health care.'

A gripping story... Greene warns us in his superb book that things are not always as they are claimed.

This is, I believe, one of the best, and most significant, books published recently on the development of medical practice and the pharmaceutical industry in the USA in the second half of the twentieth century.

Greene focuses on the question of how public health priorities became closely aligned with the pharmaceutical industry's marketing practices... Offers a nuanced description of the development of 'therapeutics of risk reduction' with multiple lines of influence, subtle power shifts, and gains and losses for patients and physicians.

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About

Book Details

Publication Date
Status
Available
Trim Size
6
x
9
Pages
336
ISBN
9780801891007
Illustration Description
10 halftones, 3 line drawings
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

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

Author Bio
Jeremy A. Greene
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Jeremy A. Greene

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.