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

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Many Americans have wondered why prescription drugs have become so expensive while advertising for those drugs seems to grow exponentially. Former New England Journal of Medicine Editor Marcia Angell has some answers. The pharmaceutical industry, according to Angell, is fraught with corruption and doing a disservice to customers, the federal government, and to the medical establishment itself. In The Truth About the Drug Companies, Angell explains how a huge portion of the revenue generated by "Big Pharma" goes not into research and development but into aggressive marketing campaigns to sell their product. She describes how, even though the drug companies claim that it costs them an average of 802 million dollars per drug to develop new medicines, that figure is obscenely inflated since it factors in marketing as well as expected interest the company would have received had they invested the money in the open market. Meanwhile, Angell says, most of the R & D work is done by colleges and universities funded by the government. There are also problems with the drugs themselves, Angell indicates, since a majority are "me-too drugs", slightly modified versions of existing products which meant to address concerns of consumers most likely to spend money on pharmaceuticals. Thus, the market is filled with remarkably similar drugs to treat depression and high cholesterol while potentially life-saving medicines for diseases afflicting third-world countries are discontinued because they aren't profitable. In the books most damning passage, Angell tells of the high-priced junkets offered to doctors, ostensibly offered as educational opportunities that seem to constitute little more than bribes. The prognosis for reform is a grim one, Angell indicates, due to the massive cash reserves and lobbying efforts of "Big Pharma." Indeed, that lobby was hard at work trying to discredit her claims immediately upon the book's publication. But for anyone who's paid a pharmacy bill, The Truth About the Drug Companies is a fascinating read. --John MoeDuring her two decades at The New England Journal of Medicine, Dr. Marcia Angell had a front-row seat on the appalling spectacle of the pharmaceutical industry. She watched drug companies stray from their original mission of discovering and manufacturing useful drugs and instead become vast marketing machines with unprecedented control over their own fortunes. She saw them gain nearly limitless influence over medical research, education, and how doctors do their jobs. She sympathized as the American public, particularly the elderly, struggled and increasingly failed to meet spiraling prescription drug prices. Now, in this bold, hard-hitting new book, Dr. Angell exposes the shocking truth of what the pharmaceutical industry has become–and argues for essential, long-overdue change.

Currently Americans spend a staggering $200 billion each year on prescription drugs. As Dr. Angell powerfully demonstrates, claims that high drug prices are necessary to fund research and development are unfounded: The truth is that drug companies funnel the bulk of their resources into the marketing of products of dubious benefit. Meanwhile, as profits soar, the companies brazenly use their wealth and power to push their agenda through Congress, the FDA, and academic medical centers.

Zeroing in on hugely successful drugs like AZT (the first drug to treat HIV/AIDS), Taxol (the best-selling cancer drug in history), and the blockbuster allergy drug Claritin, Dr. Angell demonstrates exactly how new products are brought to market. Drug companies, she shows, routinely rely on publicly funded institutions for their basic research; they rig clinical trials to make their products look better than they are; and they use their legions of lawyers to stretch out government-granted exclusive marketing rights for years. They also flood the market with copycat drugs that cost a lot more than the drugs they mimic but are no more effective.

The American pharmaceutical industry needs to be saved, mainly from itself, and Dr. Angell proposes a program of vital reforms, which includes restoring impartiality to clinical research and severing the ties between drug companies and medical education. Written with fierce passion and substantiated with in-depth research, The Truth About the Drug Companies is a searing indictment of an industry that has spun out of control.


From the Hardcover edition.

Reader Reviews:

This is the question to be asked - are the pharmaceutical companies current priorities humanitarian or financial? I am a recent cancer survivor and very thankful for the meds I received via chemo/radiation therapy and those I continue to take for further protection. On the other hand, the cost for such is astronomical and one can't help but wonder about those afflicted who haven't a great insurance plan to cover those costs. Furthermore, no one need go any further than Enron to see how easily money can take precedence for some at the detriment to others. We all seek better health care at an affordable cost. Why shouldn't questions be asked and accountability be expected from this industry who holds a big chunk of our lives in their hands by not only what they distribute [and this has questionable issues also], but also how much they charge for such.To not ask questions and hold this industry accountable would be foolish. Making money is one thing and how you spend it is another. One reviewer commented on the wasteful spending at a casino by those who complain about medical cost and yet he/she seems to see nothing wrong with wasteful spending on promotions to give us more of what we don't need and less of what we do. I would like to know that ALL of us will be protected from an avian flu epidemic and that there IS a cure for cancer and for them to know we DO NOT need another or improved cold remedy, sleep aid or erectile dysfuntion product on the market!! Once the "heart" of the industry stops pumping, it's over. I think it's time to defibulate the industry and think this book can initiate the shock. 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.I loved the book, some of it seemed a bit fragmented, but understood, tis a complex issue. As referenced, it does not suprise me in the least that drug companies account for more than the profits of the top 5 fortune companies. I have met the "wonderful" drug reps, scurrying around with the luggage on wheels and bags of goodies (pens, pads of paper, other gizmos) and "drug lunches". They corner you in the break room, when you are lucky to get a break, before you even sit down, you are forced to sign in and listen to their well practiced lectures in their expensive suits. I would appreciate less of the "goodies" and more research funded by those other than the drug companies themselves or others associated with those companies as discussed in her book. Anther topic I found to be interesting was how R&D is less than advertised and much of the expense is d/t advertising. From my own experience, the fact that a few Zofran cost $400, so you don't vomit is ridiculous! It's interesting to me now to have an idea where this money is going according to this publication. I also enjoyed the section on new medical conditions arising now that were unheard of in the past, PMMD for example. I also found it frightening that, according to the book, drug complanies are promoting to doctors the use of medications for unapproved uses by the FDA, so they will prescribe more of the medication. I thought the discussion in her book regarding cutting off the last leg of unfavorable research findings to publish a fantastic looking study was disgusting (Celebrex anyone?). She talks about why HIV/AIDS meds are so expensive and the impact on people desperate for medications and could die if they don't get them. Again, thank you for writing this- I think that those who idolize drug companies and even those who work for them who are unaware may benefit from your lengthy research on the topic. Let's pick one topic in this book, just to illustrate the lies that is being spread regarding the pharma industry ....

Paraphrasing: Most drugs come from the Universities and tax subsidized government programs and very little inovation comes from the industry itself.

We can analyze this two ways .... the first way is by use of some common sense. Who do you folks think are paid higher, scientists in the Unis and government programs, or scientists in the industry? Who do you think is better equiped, ie. who has better laboratory toys, the Univeristies/government programs or the Industry?

If the industries have smarter scientists and better lab equipment, logic tells you the industry must produce better drugs, no? Besides, when was the last time anything run by the government was actually productive and efficient? Have you been to the DMV lately? Come on!

Marcia saying the Universities and the NIH are more innovative in developing drugs than the Pharma Industry is like saying (using sports analogy) Minor League baseball is better than the MLB. Which players do you think are paid more? Common sense my friends.

That's using plain old logic.

Now the second way, is to actually do some research. Go down the list of drugs and find out where they were discovered. But based on common sense, do we really need to do that?

Just one of the many LIES this book is spreading. Angell has an agenda and is merely profitting from the emotional issue of being unable to afford medicines.

The issue is much more complex than simply BASHING the drug industry.

Some things to keep in mind before you join the bashing:

1. Tomorrow's cures (despite what Marcia thinks) will not be coming from academia, it will come from the Drug Industry. Our children's future are depending on the health of this industry.

2. The drug industry is one the last remaining industries America has. Haven't you noticed, everything is made in China. Keep up the drug bashing and soon your medicines will be coming from India.

3. Why would anybody pay for an unproven, unreliable herbal remedy but will question the value of a drug? Is it really drugs or food or is it more like Casino money or drugs?

4. What would the world be today, if not for the thousands of pharmaceutical professionals who brings us these cures?

SO BEFORE YOU JOIN THE BASHING - Think first. Not emotionally - logically!
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