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.
List of Illustrations xi
1. Responding to Facts 27
2. Pharmaceutical Witnessing and Direct-to-Consumer Advertising 55
3. Having to Grow Medicine 87
4. Mass Health: Illness Is a Line You Cross 105
5. Moving the Lines: Deciding on Thresholds 135
6. Knowing Your Numbers: Pharmaceutical Lifestyles 181
Conclusion. Living in a World of Surplus Health: Frequently Asked Questions 197
"Drugs for Life is simply superb, a major accomplishment in the study of pharmaceuticals and their expanding relation to life itself. There is no recent scholarly work that attempts or accomplishes what Joseph Dumit does here, tackling the relation between big pharma and clinical epistemology in such a comprehensive and satisfying way. He deftly links critical debates across the life and human sciences, making an important and compelling argument on a matter central to contemporary public debate."—Lawrence Cohen, author of No Aging in India: Alzheimer’s, the Bad Family, and Other Modern Things
"Drugs for Life shocks the reader into seeing health, medicine, pharmaceuticals, and the pharmaceutical industry and drug research for what they are from a cultural standpoint: a new framing of the future world for all of us. And that future is now and troubling and transformative of human conditions. A remarkable contribution that will perturb and disturb professional and general readers."—Arthur Kleinman, coeditor of Global Pharmaceuticals: Ethics, Markets, Practices
"In this provocative and important book, Joseph Dumit brings a new approach to bear on critiques of the pharmaceutical industry and U.S. healthcare. He marshals ethnographic research among drug company executives and marketing strategists, along with the analysis of scientific and popular representations of their products, showing how consumers have been tutored into a proactive stance toward health. Over the past few decades, we have come to live by 'the numbers' and 'risk factors' that make embracing lifelong pharmaceutical regimes seem like common sense. But is it? Dumit explores the pharmaceuticalization of American culture and consciousness with a light, accessible touch that belies the depth of his knowledge."—Rayna Rapp, author of Testing Women, Testing the Fetus: The Social Impact of Amniocentesis in America
“Although its topic is an abstract one, much of Drugs for Life consists of insightful readings of advertisements, of statements by marketers and of patients' accounts. Dumit has pulled together a tremendous number of telling arguments and phrases, and can be at his best when reading them.”
Times Higher Education
“Drugs for Life is a synthetic achievement. It captures a web of phenomena occurring in disparate spaces—clinical research, treatment guidelines, advertising practices, biotechnology investments—and shows how they interact to reconfigure our intuitive, personal sense of what health is and what living requires. For this reason, it is destined to enter the canon of science and technology studies.”
“Thought-provoking and chilling. . . . All registered nurses would . . . benefit from his analysis."
“A rich and valuable contribution to literature on medical ethics, cultural studies, and the sociology of medicine. Highly recommended. Upper-division undergraduates and above.”
A. W. Klink
“Dumit examines the role played by the pharmaceutical industry and the rise of evidence-based medicine, which have redefined the borders between sickness and health along statistical lines. Drugs for Life is recommended for anyone who has ever been told they're at risk for illness.”
“Drugs for Life is a brilliant and provocative analysis of the new cultural and business logics of science, medicalization, and the drug industry.”
“Drugs for Life is one of the best among many recent works on the pharmaceutical industry, and certainly the most sophisticated by the standards of science and technology studies.”
Science as Culture
"Drugs for Life is a welcome addition to the fields of medical sociology, medical anthropology, the history of medicine, and STS more broadly. . . . Drugs for Life is provocative beyond the empirical area of pharmaceuticals. For example, scholars who research nondrug substances and materials will find in Drugs for Life a blueprint for success in the pharmaceutical industry that is provocative for understanding why not all products have this degree of ubiquity in the prevention of illness. Scholars who research medical equipment, devices, or tissues that exhibit druglike characteristics will find this work provocative."
East Asian Science, Technology and Society
"[T]his book or one of its kind is an important read for those involved in the care of patients or the education of medical students or residents."