Drugs for Life: How Pharmaceutical Companies Define Our Health

Experimental Futures

by Joseph Dumit

Every year the average number of prescriptions purchased by Americans increases, as do healthcare expenditures, which are projected to reach one-fifth of the U.S. gross domestic product by 2020. In Drugs for Life, Joseph Dumit considers how our burgeoning consumption of medicine and cost of healthcare not only came to be, but also came to be taken for granted. For several years, Dumit attended pharmaceutical industry conferences; spoke with marketers, researchers, doctors, and patients; and surveyed the industry's literature regarding strategies to expand markets for prescription drugs. He concluded that underlying the continual growth in medications, disease categories, costs, and insecurity is a relatively new perception of ourselves as inherently ill and in need of chronic treatment. This perception is based on clinical trials that we have largely outsourced to pharmaceutical companies. Those companies in turn see clinical trials as investments and measure the value of those investments by the size of the market and profits that they will create. They only ask questions for which the answer is more medicine. Drugs for Life challenges our understanding of health, risks, facts, and clinical trials, the very concepts used by pharmaceutical companies to grow markets to the point where almost no one can imagine a life without prescription drugs.

Genres: Nonfiction, Anthropology, Medicine, Science, Sociology, Drugs, Medical

280 pages, Paperback

First published August 15, 2012

About the author

Joseph Dumit is Director of Science and Technology Studies and Professor of Anthropology at the University of California, Davis. He is the author of Drugs for Life: How Pharmaceutical Companies Define Our Health, Picturing Personhood: Brain Scans and Biomedical Identity and editor, with Regula Valérie Burri, of Biomedicine as Culture: Instrumental Practices, Technoscientific Knowledge, and New Modes of Life.

Reviews

[Jessaka · Rating 5 out of 5]

This is a very serious, researched book. How do I know this? It cost me $18 on kindle. It is written by a college professor, the head of the Science department at UC Davis. The research that he put into this book made my head spin, so much so that I don't remember everything that he said. Not that I would if it was a simple book.

I may come back to this review from time to time to add more information as I remember it.

The author says that big pharmacy is no longer Run by scientist but by economist. There Idea is to make more money and to get people on drugs, Preventative drugs, any drugs. He has not blame the doctors for pushing drugs, but I have not finished the book. If he does, I will come back and add that. .Not only that but the commercials on TV are Design to make the patient ask his doctor for drugs. All I know for sure is this, some doctors that I have gone to are big on pushing drugs and it is continual no matter what I say.

1. Clinical trials are done through the drug company and not outside Sources.
2. Half of all people who have heart disease have a low cholesterol level.

I have now finished the book, And I saw No indication that he was blaming the doctors . .

[Angel · Rating 5 out of 5]

I just spent over an hour writing a review on this book and the Goodreads website went down due for maintenance just before I saved it.

I do not have time to even attempt to duplicate my review.

This was a great book packed with information that is hard to stomach because it deals with our health and well-being.

Joseph Dumit had the methodology and patience to tackle the subject matter in a fair and practical manner.

Great read.

I received this book from Goodreads First Reads.

[Elari · Rating 4 out of 5]

It drags. But it drives the message home nicely.

[Anna · Rating 3 out of 5]

This was a decent book, with a strong premise. There is a lot wrong with the fact that pharmaceutical companies are in charge of clinical trials, but Dumit makes a good argument that even if clinical trials were perfectly regulated, it wouldn't change the fact that pharmaceutical companies have a growth imperative and trials have to fit into this growth imperative. Our risk of dying is 100% no matter what we do, hence health is an infinite growth market. There are always risks that can be reduced, and because pharmaceutical companies define the questions, they look only toward questions that would indicate ever more drugs.

Having said that, the book seemed overly long and like it could have fit within a tight essay instead. Dumit also confuses the issues with psychotropic medication, which to my mind do not actually fit into this book very well, with the issues with statins and other medications that we take for asymptomatic conditions of "being at risk". It's easy to hate on psychotropic meds, but it is ridiculous to imply that psychotropic medication is taken for asymptomatic conditions.

[Carrie Everett · Rating 4 out of 5]

I was introduced to Dumit’s work in my “Anthropology of Ecstasy” class, about embodiment, medicine and healing, and notions of the self. Human subjectification and Dumit’s “objective self-fashioning” were heavily emphasized; how are cultural and economic messages integrated into one’s understanding of their personhood? What is the role of language in this process? Must these shifts involve the dissociation of mind and body? Of mind and experience?

His analysis felt narrow at times — I would have loved to hear more about how sociocultural norms and structures (not just socioeconomic) facilitate the continual increase in drug prescriptions, and there were many missed opportunities for how this impacts the disabled community — we are made to be more fearful of disabled bodies (& the idea that each individual can take full control of their health encourages ableist sentiments by blaming people for their illnesses), but changing pharmaceutical parameters broadens the definition of disability

This was an enjoyable read overall, and an important reminder to think critically about your self. Life is not in competition with health, despite what biomedical capitalism conveys.

[Alex McLane · Rating 3 out of 5]

2 jokes introduces the book - 1) Doctor tells patient "your blood pressure is off the chart, you're overweight, out-of-shape, and your cholesterol is god-awful. I find you perfectly normal." 2) Doctor tells patient "the good news is your cholesterol hasn't gone up. The bad news is the guidelines have changed making you at risk and in need of remediation." - 50 years ago the very concept of a risk factor was created along with large-scale prospective clinical studies.

[Sarah Cavar]

I’d love to give this five stars — in many ways, it deserves that rating. But this book includes absolutely no critical disability analysis whatsoever. In a book detailing the relationship between capitalism, the medicalization of everyday life, and medical power, looking at both disability and Madness, both as examples and analytical frames, is non-negotiable. Unfortunately, this book failed to do so.

[Matthew · Rating 5 out of 5]

I think he could have been more critical, especially of pharmaceutical companies and marketers; however, considering that he presented several of the chapters are conferences for those groups, I'm not surprised by the lack of criticality and his sympathy. There are definitely parts that drag, but it's generally an interesting and informative read.

[Wesley · Rating 4 out of 5]

I read this for a medical anthropology class, and it was the basis for a lot of interesting discussions that made me like the book more as we talked about it. Even though Dumit doesn’t always have a great prose, this book is very accessible and makes clear and important arguments that address the power pharmaceutical companies have over consumers, and medical professionals & institutions alike.

[Travis · Rating 5 out of 5]

Incredible, accessible, and incisive critique of Big Pharma -- demonstrates the logics and processes of how medicine has become an industry. The marketable culture of risk and health is made clear in a way that I think needs to be taught and shared more widely.

[Emily · Rating 4 out of 5]

Depressing but enlightening, and easily understandable by anyone who has worked in marketing, been marketed to, or been to a doctor in the United States. It's presented as a resigned indictment of medical capitalism, almost with a shrug emoji and a "welp, it's what's happening and I don't see a way out" attitude. I think the idea that pharmaceutical companies realize that their approach is problematic but blame consumers for the way the market works is very telling.

[Amber · Rating 3 out of 5]

redundant

[Emmy · Rating 4 out of 5]

Undergrad. Emily Wanderer. 2019

[Shubham · Rating 4 out of 5]

really liked it

[Michael Burnam-Fink · Rating 4 out of 5]

Joseph Dumit’s new book, Drugs for Life, is subtitled “How pharmaceutical companies define our health.” He has a clear perspective, and one that makes his ‘apoplectic’ (his own words, page 177); that pharmaceutical companies in the latter half of the 20th century have misused science to manufacture a population perennially at risk, so as to satisfy the capitalist demand for ever expanding markets and increasing profits, at the expense of both truth and health. But in some cases, if you’re not mad, you’re not paying attention, and Dumit has performed a valuable service in tracing and revealing the constructed nature of the facts that underpin the modern healthcare system.

Dumit frames his book around a double insecurity: that we as modern biocitizens can never be sure that our bodies are not concealing some future illness, and that knowing this, we can never be sure how best to react to this risk. He argues that the randomized clinical trial model developed in the 1950s established illness as invisible and unknowable, except in statistical terms. This would not be a problem, except that by and large the only organizations with the resources necessary to conduct clinical trials are pharmaceutical companies, and they’re motivated to expand the size of their market above all else.

This conflict of interest means that the number of sick people, and the attendant personal and social cost of illness, has consistently risen over the past 70 years. More aggressive screenings for cancer, heart disease, and mental illness, and broader diagnostic standards, mean that larger number of people become patients and potential customers. The logic of NNT (number-needed-to-treat), becomes perversely twisted. A NNT of 1 (everybody treated improves) is the worst from a financial standpoint, while higher NNT means a less effective drug, and great financial returns. Similarly, direct comparative study between similar drugs, research on tropical diseases, and acute cures over chronic disease maintenance, are all discouraged.

Dumit’s sources for these “revelations” are the textbooks and journals produced by pharmaceutical executives themselves, analyzed using Actor Network Theory(ish) approaches to epistemology, and how facts circulate through society, and a theory of power and political economy strongly influenced by Marx. The theoretical framework is workable, but not brilliant. Marks-The Progress of Experiment, is a better book on randomized clinical trials in a historical context.

Where this book shines is in the ethnography of patient types, about how people respond to living in a culture of “surplus health”. The Expert Patient, critically engaged with the latest scientific literature, is the neoliberal ideal of the engaged and critical consumer. In practice, most of us are the Fearful Subject, perennial under threat from all directions, only able to achieve a paranoid vigil against illness that will inevitably fail. And at some point, a person reaches a balance with Better Living Through Chemistry, believing that they can trade off risks and pleasures through a studied management of ignorance.

Having read a few of these books (Epstein-Black Coat, White Hat and Conrad-The Medicalization of Society), Dumit is equally outraged but a little bit more balanced. He sees the corruption as systemic rather than personal, as something that patients and doctors are forced to buy into as part of becoming informed users of the latest medical data. The (unstated) problem for is not so much that health has become commoditized, but that we are unwilling to face up to our own mortality.

[Jewelia · Rating 5 out of 5]

This book was a required reading for one of my classes in college and it was so interesting that I came back to it and read it again after graduating. This book is slightly dense for the average reader but it is an eye-opening book about the health and pharmaceutical industry as a growth industry and their control over the production of health facts. It is applicable to every human being today as the health and pharma industry is a huge part of our every day lives. This book will make you think deeper every time you see news of a new research study finding or get prescribed a new medication to add into your rotation. Even though it was written about a decade ago, it is still extremely relevant and will stay relevant as long as the pharma industry continues to exist as a growth industry.

[J.T. · Rating 5 out of 5]

I cannot recommend this book highly enough. The last line of the book sums it up best: "We all say we want to cut healthcare costs and make medication more effective, but do we really mean it?"

[Adnan · Rating 4 out of 5]

Eye opener. Capitalism vs health and medicine!

[Elizabeth]

As heard on Thinking Allowed.