Advocates of rapid access to medicines and critics fearful of
inadequate testing both argue that globalization will supersede
national medical practices and result in the easy transfer of
pharmaceuticals around the world. In
Pharmacopolitics,
Arthur Daemmrich challenges their assumptions by comparing drug
laws, clinical trials, and systems for monitoring adverse reactions
in the United States and Germany, two countries with similarly
advanced systems for medical research, testing, and patient care.
Daemmrich proposes that divergent "therapeutic cultures--the
interrelationships among governments, patients, the medical
profession, and the pharmaceutical industry--underlie national
differences and explain variations in pharmaceutical markets and
medical care.
Daemmrich carries the United States-Germany comparison from 1950 to
the present through case studies of Terramycin (an antibiotic),
thalidomide (a sedative), propranolol (a heart medication),
interleukin-2 (a cancer therapy), and indinavir (an AIDS drug). He
points to different political constructions of "the patient" in the
United States and Germany to clarify important differences in
government policies and in the distribution of power among key
social actors. Daemmrich advises that international regulatory
harmonization and globalization in medicine must retain flexibility
for social and political variation between countries, even as they
achieve technical standardization.