The Truth about the Drug Companies: How They Deceive Us and What to Do about It

Marcia Angell's background (physician; former editor of the New England Journal of Medicine) make her uniquely qualified to write this book. Among her key points are that 1)most of the expenditures for developing new drugs are funded by the government, 2)most of the drugs are "me-too" variations with little or no benefit vs. those currently on the market (a fact concealed by comparing them vs. a placebo instead of existing drugs, or by testing a new drug vs. an inappropriate dosage of something else), 3)companies spend more on marketing than research, 4)considerable extra profits derive from minor tweaking of existing drugs to all extending their patent protection, 5)that in 2002 the top ten drug companies made greater profits than the other 490 businesses on Fortune's Top 500 list, 6)how pharmaceutical companies' consulting agreements" with government officials at the FDA and NIH distort regulation, 6)that drug companies only publish and report positive results from tests, and 7)the strong hold drug companies have on Congress through their political donations. This book cries out for change!

I will try to keep my review as non-partisan as possible, but I have to say - after reading the one star reviews that have blind faith in the drug companies, they are either naive, rich enough to afford the latest greatest meds (which may or may not be that great), or have a financial stake in big pharma. Read them and laugh or grimace. Certainly, there are people who are so pro-corporate that they will keep insisting that corporations have their best interest at heart. This book is not for you. Compared to a lot of other books in this genre (basically, pro pharma reform), this one shines. Mostly this is due to the authors front row seat experience, and her style translates well to a lay audience - a rare skill. That is why I recommend this book instead of others. We desperately need more quality nonbiased research that does not choose to put a product in a unfairly favorable or unfavorable light due to the deep products of a sponsoring company. The public deserves better. I encourage all of you who hear about this study or that on whatever news outlet you listen to - take a look at 1 - what the study actually compared and 2 -who sponsored it. There's a lot of bias out there.

One of the great exposés of all time, "The Truth About the Drug Companies" punctures much of the self-generated publicity of what has come to be called "Big Pharma. Beautifully written, edited and referenced in academic style, Dr. Angell begins softly and with understatement, building logically to a shattering set of conclusions and recommendations. Pharma's claim that high drug prices in the USA are required to support innovative research is shown with plausible data to be false. Most of the innovative drugs are actually discovered in universities, at the NIH and in small companies. Pharma's expenditures for research are shown to less than half of those for sales and marketing and lobbying. About 4/5 of research dollars spent are on "me-too" drugs that are minor variations on the original drug of each type, and thus of no value to ordinary citizens. Dr. Angell explains how Big Pharma had patent law changed to obtain up to 23 years of protection. And how minor changes in the drug molecule have somehow become patentable in direct contravention of patent law that obvious minor changes are not patentable. Mere changes in formulation somehow became protected. Dr. Angell confirms other reports that Big Pharma has the most powerful lobby in Washington, resulting in "...an iron grip on Congress and the White House". Big Pharma has had laws passed forbidding importation of its own drugs from outside the USA. There is no technical justification for this. Big Pharma has arranged that the Medicare Drug Benefit to become effective in a couple of years does not permit Medicare to negotiate prices. This is contrary to the ability of all other national health services in the world to negotiate prices. Dr. Angell confirms that both the NIH and FDA are subservient to the wishes of Big Pharma. This is largely done by offering "consulting" agreements to federal employees, and to members of FDA advisory committees. The FTC and FDA crumbled to Big Pharma's wishes to advertise drugs direct to consumer, a total disaster so far, because the true benefits of many drugs, often quite minor and sometimes even negative, cannot be communicated in a TV ad. The pervasive bribing of doctors to prescribe the latest drugs is confirmed. Big Pharma's influence on medical schools is shown, as is the control of Continuing Medical Education, required for certain certifications and hospital privileges. "The Truth..." is truly great because a number of concrete suggestions are made to undo the damage: "Despite all its excesses, this is an important industry that should be saved - mainly from itself" (p237). Of the suggestions Dr. Angell made, the one most possible to be implemented are removing the control of clinical trials of drugs from Big Pharma and having the NIH do it. (Of course, there is the caveat that NIH employees must stop receiving compensation or gifts from Big Pharma.) Some of the scientific transgressions of Big Pharma in running and reporting on drug trials

As a pharmacist for 27 years, six of those working in sales for one of the "big pharma" companies, I was pleased to see that Dr. Angell has got it EXACTLY right. Pharmaceutical companies are now multinational corporations whose motives are the same as all mega corporations... money and profits. I know Dr. Angells chapters on "The Hard Sell", "Marketing Masquerading as Education", and "Marketing Masquerading as Research" are factual. I received training in all these methods of bullying physicians into writing prescriptions for my products using many of the methods described in this book! Dr. Angells descriptions of the pharmaceutical industries hold on politicians and the FDA is, again, completely correct. Until politicians believe they may not be re-elected if they continue to pander to "big pharma", it will never change. If you are at all concerned about the outrageous price of prescriptions (and you should be), this is a must read. Better yet, send a copy to your congressman, senators and state representatives. You can bet "big pharma" is squirming over this one!

I should start with a disclaimer. I'm a Vice President within one of the largest drug companies in the world and I have spent close to twenty years marketing drugs. So I guess I'm not supposed to like this book. But the truth is I thought it was fantastic. First, for those of you who are not familiar with the healthcare industry, you should know that Ms. Angell is better capable of writing this masterpiece than any other author. She used to be Editor-in-Chief of The New England Journal of Medicine, which is considered the most prestigious medical journal in the world. Don't let her credentials scare you off, though. This is easy reading and the book captures your attention like a true business thriller, only this is real life suspense. But this volume is much more than simple entertainment. It is quite possibly one of the best analyses of the state of the U.S. drug industry today, complete with footnotes backing up every statement the author makes. You will learn not only that in 2002 the top ten drug companies made a higher profit than the other 490 businesses together on the Fortune 500 list. You will also understand how the drug industry has been able to achieve such a business success and how this success, as is often the case throughout history, will likely be their downfall. A political tidal wave is building which will forever change both the industry and many of its infamous business practices. It is sad to note that the drug industry today is equally poorly regarded as the tobacco companies, and this is a testament not only to the shortsighted foolishness of their management, but also to the fact that you can fool some of the customer some of the time, but not all of them all the time. So is there no hope? Well, Ms. Angell doesn't only state the problem she also presents solutions and ends her story with several thoughtful suggestions on how to change the way we discover, market and distribute new drugs. Her advice is wise and absent of quick fixes. Only time will tell if there will be a movement so strong that it can defeat ingrained business practices of the richest companies in the world. What may help is that the drug companies are their own worst enemies. They have antagonized grannies all over the US with their work to stop reimportation of cheaper drugs into the US, a practice that has been in place for many years in Europe. And anyone in marketing or public relations can tell you that no money in the world can help you win against millions of mad grandmothers.