| About the author Jerry Avorn, M.D, is Associate Professor of Medicine at Harvard Medical School and Chief of the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women�s Hospital, one of its main teaching institutions. He grew up in New York City and attended Columbia University, graduating in 1969. While in college, he was principal author of Up Against the Ivy Wall, a history of the student demonstrations there. He attended Harvard Medical School and completed his training in internal medicine at its teaching hospitals. He has remained at Harvard since 1969, serving as a primary care physician, faculty internist, consulting geriatrician, and health services researcher. Early in his career, Dr. Avorn established an interdisciplinary research team to study how physicians prescribe drugs, how patients take them, and the clinical and economic outcomes that result. His studies helped define how pharmaceutical company promotion and scientific information interact to shape doctors� decisions about which drugs to use, with the former often dominating the latter. Later research documented the high rate at which patients do not take their medications as directed, and the factors (older age, low income, non-white race) associated with this common problem. Other studies measured the risk of side effects caused by specific drugs, such as the appearance of a condition similar to Parkinson�s disease in older patients taking certain potent tranquilizers. He and his colleagues have also published several studies on the cost-effectiveness of drugs, systematically comparing a product�s beneficial effects with its price tag. In the 1980s, Dr. Avorn devised a new approach to improve doctors� ability to make accurate prescribing decisions. He observed that the promotional activities of pharmaceutical companies and their sales representatives (known as �detail men�) used cutting edge strategies to change physician behavior and sell their products. By contrast, medical school faculty may have had a more complete and balanced grasp of the scientific issues, but were much less effective communicators. He devised an approach known as �academic detailing� which took the effective communications strategies of the drug industry and used them to present unbiased, evidence-based education about proper prescribing. In several papers in the New England Journal of Medicine, JAMA, and other medical journals, he and his colleagues showed that such programs could improve prescribing decisions and more than cover their costs through reductions in improper medication expenditures. Today, programs based on this work are in place in the United States, Canada, Europe, Australia, and throughout the developing world. The unit he now heads, the Division of Pharmacoepidemiology and Pharmacoeconomics (known internally as DOPE), continues to study the relationship between the benefits, risks, and costs of medications; it also conducts a teaching program on these topics at the Brigham and Women�s Hospital for the Harvard medical students, interns, and residents studying there. Dr. Avorn is the author of over 200 papers in the medical literature on medication use and outcomes, and is one of the most frequently cited researchers in the field of social science and medicine. A cogent advocate for more rational prescribing, he has testified several times before Congress on medication-related issues, and his work has been featured on National Public Radio (All Things Considered, Morning Edition, The Connection) and in The Washington Post, The Boston Globe, and USA Today. Dr. Avorn lives outside Boston with his wife, Karen Tucker; they have two sons, Nat and Andrew. He will donate his share of all proceeds from Powerful Medicines to establish a fund to support public-interest research and education about prescription drugs. |