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The Story of Medication Use and Misuse in the United States

September 2021 Vol 14, No 3 - Perspectives
Jack E. Fincham, PhD, RPh
Professor, Osher Lifelong Learning Institute, University of Arizona, Tucson, AZ, and Dean Emeritus, University of Kansas School of Pharmacy
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Government, Big Pharma, and the People: A Century of Dis-Ease

By Mickey C. Smith (with Kolassa EM and Pray WS)
New York, NY: Routledge Taylor Francis Group; 2021; 502 pp

There have been so many significant and dramatic changes in the healthcare system in the United States during the past century. The task would be monumental for anyone to chronicle and outline the precedents, outcomes, results, and societal impacts of how health and patient outcomes have been revolutionized in any segment of the healthcare system.

Mickey C. Smith, PhD, has accomplished this feat with this impactfully detailed, exceptionally well-referenced (734 references!), and exceedingly well-written book, analyzing the medication use construct and all its complexity in the United States.

In this inclusive book, Dr Smith provides a thorough analysis of the detailed structure of the medication use process from the synthesis of new compounds, the approval of medications for use, the marketing of pharmaceutical drugs, the use and misuse of medications, the pricing and profits derived from medications, and the outcomes of medication use—economic, therapeutic, and societal.

This book focuses on the pharmaceutical industry, its interactions with the government, and the resultant outcomes for patients and society from the early 1900s through the present. The continuing interactions between the pharmaceutical industry, federal and state governments, and society are the major foci of this book.

The author describes how government—through regulations, payment, and oversight—affects the pharmaceutical industry, and the consequences of their activities are described for patients and consumers who rely on the government and the pharmaceutical industry for health outcomes that may positively (ie, improved health and quality of life) or negatively (ie, drug-related adverse events) affect patients and their well-being. Health professionals (such as physicians, pharmacists, and nurses) are continuously affected by the interplay of the pharmaceutical industry and state and federal governments, and, ultimately, by consumers who use prescription and over-the-counter medications daily.

Dr Smith has more than 5 decades of experience as an academic researcher, has published more than 400 research and professional articles, and has written or edited more than 20 books. He has taught undergraduate and graduate courses as a nationally and internationally recognized teacher, researcher, and scholar, and has thoroughly analyzed the impact of the pharmaceutical industry, government regulatory bodies, and the health and economic outcomes of drug formulations and approvals, marketing, and sales on their ultimate use by patients throughout every component of our society.

Dr Smith’s professional experience working as a pharmacist; working for the pharmaceutical industry; serving as a government consultant at the state, federal, and international levels; researching many segments of the medication utilization process; and formulating and teaching marketing concepts and applications provide him with a significant knowledge base to provide important insight, understanding, and evaluation in this new book.

His ability to describe the scope of the pharmaceutical industry and how it affects virtually everyone daily provides the reader with a great opportunity to gain a practical and factual understanding of the pharmaceutical industry and the implications of its activities for every segment of our society.

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Last modified: February 27, 2025