Download Source Analysis and Comparison Part One: Source Two

Source Analysis and Comparison Part One: Source Two
Michelle Mills
Focused Inquiry 112
An analysis of:
“Pharmaceuticalization of Society in Context: Theoretical, Empirical and Health
Dimensions” by John Abraham
Publication Information:
Abraham, J. "Pharmaceuticalization of Society in Context: Theoretical, Empirical and
Health Dimensions." Sociology 44.4 (2010): 603-22. Web.
Main Claim and Summary
“Pharmaceuticalization should be understood by reference to five main explanatory
factors, which are mutually interactive but competing. These dimensions are:
biomedicalism (including industry drug research, development and innovation);
medicalization; industry drug promotion and marketing; consumerism; and the ideology
or policy of the regulatory state.” (603)
In this article, John Abraham explores the many elements affecting
pharmaceuticalization, “the process by which social, behavioural or bodily conditions are
treated or deemed to be in need of treatment, with medical drugs by doctors or patients”.
In his evaluation of this phenomenon, Abraham first disputes the biomedicalist view that
pharmaceuticalization is a product of increased medical need. He then elaborates on the
effects of consumerism working for and against pharmaceuticalization. After this,
Abraham returns to biomedicalism to discredit the idea that the drug industry has been
growing due to a growth in drug innovation.
Key Points
“Deep-seated … is the biomedicalist view that growing pharmaceuticalization reflects
progress in medical science, enabling people with conditions … were previously
undiagnosed or untreated, to receive medication that they need … Yet, during this
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Source Analysis and Comparison Part One: Source Two
Michelle Mills
increased pharmaceuticalization, the technical advances declared by biomedicalism
exhibited many uncertainties within scientific literature and clinical settings” (607)
o “ADHD illustrates why, in many psycho-social areas of medical intervention, the
biomedicalist thesis is unpersuasive because of technical implausibilities and the
fact that broadening diagnostic criteria could readily reflect medicalization as
much as discovery of previously undetected sick people.” (608)
o
“The biomedicalist claim that the growth of pharmaceuticalization in these areas
is merely a reflection of health needs is not credible because industry-sponsored
disease-awareness campaigns have exaggerated the benefits of drugs, such as
SSRIs, tranquillizers and Viagra, resulting in them being prescribed in ways that
have no techno-scientific basis.” (608)
o “Pharmaceuticalization is also driven by industry promotion and advertising of
individual drug products to the medical profession for established medical
conditions, whether on- or off-label. Zyprexa, a drug approved for treatment of
schizophrenia and bipolar disorder, was also promoted to doctors by the
manufacturer’s marketing staff for off-label treatment of established dementia and
Alzheimer’s condition, reaching global sales of US$4.8 billion, even though there
was no scientific evidence to support such off-label use.” (609)
“Overall, pro-pharmaceuticalization consequences of access-oriented collaborative
consumerism tend to outweigh the de-pharmaceuticalization effects of injury- oriented
adversarial consumerism, though both play a role in shaping the nature of
pharmaceuticalization in society.” (612)
o “The growth of injury-oriented adversarial consumerism has not increased
pharmaceuticalization. Rather, it has raised doubts about the safety of drug
products and hence reduced pharmaceutical prescription and use (Scrip, 2008e).
As occurred with arthritis drugs, injury-oriented adversarial consumerism can be
powerful enough to produce de-pharmaceuticalization.” (611)
o “… American access-oriented collaborative consumerism has been largely
successful in making pharmaceuticals available to patients sooner, so increasing
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Source Analysis and Comparison Part One: Source Two
Michelle Mills
pharmaceuticalization, though it is doubtful that such haste and ‘fast-tracking’,
which involve less regulatory checks on drug safety and efficacy, are beneficial to
public health.” (611)
o “In the UK, access-oriented collaborative consumerism has focused on patient
access to new drugs on the NHS. … For example, in March 2005, NICE
recommended that four drugs to treat Alzheimer’s disease were not cost-effective
for the NHS. However, following a high profile media campaign and formal
appeal to NICE involving patient groups such as the Alzheimer’s Society, NICE
revised its guidance to allow NHS funding of the drugs for people with moderate,
but not early, stages of the disease. The Alzheimer’s Society then took NICE to
court, which insisted that NICE should make the drugs available to all those with
the disease.” (611)
“Deregulatory ideology (and associated policies) have been drivers of growing
pharmaceuticalization, not primarily by releasing many more innovations needed by
patients and medical professionals, as the biomedicalism thesis would have it, but rather
mainly by allowing the industry to expand its markets for drugs that offer little or no
therapeutic advance in a sea of declining innovation.” (615)
o
“By the late 1980s and early 1990s, it was known to biomedical scientists that
bacterial resistance to existing antibiotics was becoming a significant health
problem … Yet, between 1983 and 2004, the development of antibiotics
declined steadily: FDA approved 16 between 1983 and 1987; 14 between
1988 and 1992; 10 between 1993 and 1997; seven between 1998 and 2002;
and just three in 2003 and 2004.” (615)
o “Pharmaceutical product innovation declined during the same period that
pharmaceuticalization in many psycho-social and lifestyle areas has increased
(Figures 1 and 2). More importantly, the number of NMEs offering significant
therapeutic advance (those given ‘priority’ review by FDA) has also
declined.” (605)
o “Thus, aggregating the sector as a whole, pharmaceuticalization in the form of
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Michelle Mills
new drugs offering significant therapeutic advance has been shrinking in the
last 15 years.” (615)
Biography and Credibility
John Abraham is a professor of sociology at University of Sussex. He has three
postgraduate degrees: MSc in Science Policy Studies, MA in Sociology and DPhil in
Politics. Dr. Abraham has published over seventy articles in major international journals
and over fifty empirical research articles. The British Sociological Association nominated
this article, for the Sage Prize of best sociology article of the year for excellence and
innovation.
("Prof John Abraham." John Abraham : University of Sussex. N.p., n.d. Web. 26 Oct. 2014.
<http://www.sussex.ac.uk/profiles/6>.)
To find this article, I used the VCU library search engine, with the search
“pharmaceutical industry consumerism.”
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