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Description
Powerful MedicinesBy: Jerry Avorn, M. D. If you believe that the latest blockbuster medication is worth a premium price over your generic brand, or that doctors have access to all the information they need about a drugs safety and effectiveness each time they write a prescription, Dr. Jerry Avorn has some sobering news. Drawing on more than twenty five years of patient care, teaching, and research at Harvard Medical School, he shares his firsthand experience of the
By: Jerry Avorn, M.D.If you believe that the latest blockbuster medication is worth a premium price over your generic brand, or that doctors have access to all the information they need about a drug’s safety and effectiveness each time they write a prescription, Dr. Jerry Avorn has some sobering news. Drawing on more than twenty-five years of patient care, teaching, and research at Harvard Medical School, he shares his firsthand experience of the wide gap in our knowledge of the effectiveness of one medication as compared to another. In Powerful Medicines, he reminds us that every pill we take represents a delicate compromise between the promise of healing, the risk of side effects, and an increasingly daunting price. The stakes on each front grow higher every year as new drugs with impressive power, worrisome side effects, and troubling costs are introduced.
This is a comprehensive behind-the-scenes look at issues that affect everyone: our shortage of data comparing the worth of similar drugs for the same condition; alarming lapses in the detection of lethal side effects; the underuse of life-saving medications; lavish marketing campaigns that influence what doctors prescribe; and the resulting upward spiral of costs that places vital drugs beyond the reach of many Americans.
In this engagingly written book, Dr. Avorn asks questions that will interest every consumer: How can a product judged safe by the Food and Drug Administration turn out to have unexpectedly lethal side effects? Why has the nation’s drug bill been growing at nearly 20 percent per year? How can physicians and patients pick the best medication in its class? How do doctors actually make their prescribing decisions, and why do those decisions sometimes go wrong? Why do so many Americans suffer preventable illnesses and deaths that proper drug use could have averted? How can the nation gain control over its escalating drug budget without resorting to rationing or draconian governmental controls?
Using clinical case histories taken from his own work as a practitioner, researcher, and advocate, Dr. Avorn demonstrates the impressive power of the well-conceived prescription as well as the debacles that can result when medications are misused. He describes an innovative program that employs the pharmaceutical industry’s own marketing techniques to reduce use of some of the most overprescribed and overpriced products. Powerful Medicines offers timely and practical advice on how the nation can improve its drug-approval process, and how patients can work with doctors to make sure their prescriptions are safe, effective, and as affordable as possible.
This is a passionate and provocative call for action as well as a compelling work of clear-headed science.
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4.5 ★★★★★
Based on 17 reviews
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Product Reviews
★★★★★ 5
Amazing!
Format: Kindle, Format: Kindle
This book was phenomenal, I devoured it within a few days! For this being a debut novel, it is fantastic and I would’ve thought the author was a seasoned author. I have zero complaints about this book.
Let me start by saying that the world building was phenomenal. I could picture everything in my head because of how detailed it was — that’s how good it was written. And I absolutely love the “captive/captor” trope so much, it’s become one of my favorite tropes, so I was pleasantly surprised to see that this book had that.
I loved the banter between Rogue and Ara — they’re both snarky and witty, plus with the romantic tension, it made the dialogue that much better. Speaking of romantic tension, yes there is spice but not so much of it that it overrides the plot, which I loved. For me, this would probably be on the 3/5 level of spice.
This book had a ton of plot twists and I thoroughly enjoyed it.
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Reviewed in the United States on November 13, 2024
★★★★★ 4
High on Tropes and Satisfaction
Format: Kindle
This is a great Romantasy book full of action, adventure, and everything you look for in this genre.
I won’t lie: it does kinda feel like the author found every common trope from every successful book of this kind and threw them all into this novel. But if it ain’t broke, don’t fix it. Especially in romance, there’s a large audience who has specific expectations, and they want them every time. Nothing wrong with that and many times I’m one of them.
I have no idea what defines a spoiler honestly, so
spoiler alert!!!!!!!
Tropes include:
Only one bed at the inn/bar
Dissatisfaction with life before hunk appears
Lost royalty
The chosen one
Montage of dress up time followed by shocked hunk
Forbidden romance between two from rival peoples
Power that cannot be controlled, simply guided/asked
Gathering intel at the inn/bar
FMC who knows how to fight/use weapons well
There’s probably more but no need to list them all.
Good story and I would recommend!
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Reviewed in the United States on June 14, 2024
★★★★★ 5
Just read it. You won’t regret it.
Format: Hardcover
This book completely blew me away. I loved every single character—not just the FMC and MMC, but the side characters too, which is rare. In a first book, side characters can feel flat while the focus is on world-building, but that definitely wasn’t the case here.
The romantic tension between the FMC and MMC was so good—seriously addictive. The plot itself felt pretty straightforward at first, and the world-building was easy to follow. It even gave me Heartless Hunter / Wolf King vibes… until the last 20 pages.
And wow—those final pages. I usually spot plot twists coming, and I thought this one was going to be predictable, but I was completely wrong. That ending genuinely shocked me—I haven’t had that reaction to a book in a long time.
I’m already counting down to book two (and that teaser chapter? Absolutely brutal).
Just read it. You won’t regret it.
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Reviewed in the United States on May 4, 2026
★★★★★ 4
4 Stars for Now!
Format: Kindle
I DEVOURED this book. I was in a huge slump after reading a horrible series right before this but after 3 pages of this book, I was hooked. I read the whole book in 2 days. I think the author did an amazing job at writing an engaging story with an amazing twist at the end. I know many readers feel betrayed by the twist and find the narrator to be unreliable but I feel that the twist was done in a great unsuspecting way. Though I do feel betrayed, I think there is so much room for redemption in the second book!
The author also did an amazing job at world/character building. She was able to do so without interrupting the story which is one of my huge pet peeves. A lot of authors build by taking breaks in the plot or dialogue which I find choppy and disengaging but this author was able to build in an engaging way. There was some lack of world/character building but I think that was due to keeping reader in the dark. The world, politics, and characters were all very easy to understand.
I found the romance a little lackluster and a bit off-kilter. Some of it was really pushy and rushed which left a bad taste in my mouth. I do hope the author delves deeper into the romance in coming books.
The FMC was a breath of fresh air. She was not whiny or stuck-up like most books. She was never afraid to accept help from others but she was still able to shine with her intelligence. Not once did I think she made a poor decision just for the sake of a plot point. She was really easy to like. The MMC could use some work but I think that will happen more in coming books.
This is a MUST read, my only advice would be to wait until it is a finished series!
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Reviewed in the United States on July 30, 2025
★★★★★ 5
Need book 2 please :-)
Format: Kindle
From the very first chapter, Metal Slinger hooked me and refused to let go.
Set in a brutal, metal-bound world where power is carved from steel and survival depends on strength, strategy, and sheer will, this story follows a young woman forced into a dangerous system where control over metal isn’t just magic — it’s dominance, protection, and rebellion. When she’s pulled into escalating conflict and shifting alliances, she quickly learns that power always comes with a cost.
The magic system is sharp and immersive without being overwhelming. The way metal manipulation is woven into combat and politics makes every confrontation feel cinematic and high-stakes. It’s gritty, tense, and beautifully layered.
The Brynn, our FMC absolutely shines. She’s fierce but not untouchable, resilient without feeling unrealistic. Watching her navigate betrayal, survival, and the slow awakening of her own strength felt earned every step of the way. There’s grit in her fight scenes and vulnerability in her quieter moments that make her deeply human.
And the tension? Immaculate. The chemistry simmers under the surface before sparking into something electric. Every reluctant alliance, every charged interaction, every moment of “are they about to destroy each other or kiss?” had me flying through pages.
The pacing is relentless — no filler, no wasted scenes. Twists land hard. Stakes keep climbing. And that ending? Absolutely feral. The kind that leaves you staring at the wall for a minute before immediately checking when book two releases.
✨ Gritty metal-based magic
⚔️ High-stakes survival
🔥 Slow-burn tension
🖤 Fierce, layered heroine
💥 A finale that HITS (but cliffhanger!)
This is one of those fantasies that reminds you why you fell in love with the genre in the first place. If this is just Book One, I am more than ready to be emotionally wrecked again in the sequel.
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Reviewed in the United States on February 14, 2026