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The Truth About the Drug Companies: How They…
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The Truth About the Drug Companies: How They Deceive Us and What to Do… (edition 2005)

by Marcia Angell

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315564,533 (4.25)3
During 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.… (more)
Member:obijuan1
Title:The Truth About the Drug Companies: How They Deceive Us and What to Do About It
Authors:Marcia Angell
Info:Random House Trade Paperbacks (2005), Paperback, 319 pages
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The Truth About the Drug Companies: How They Deceive Us and What to Do About It by Marcia Angell

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English (4)  German (1)  All languages (5)
Showing 4 of 4
In the five years 1998 through 2002, 415 new drugs were approved by the Food and Drug Administration, of which only 14 percent were truly innovative. A further 9 percent were old drugs that had been changed in some way that made them, in the FDA’s view, significant improvements. And the remaining 77 percent? Incredibly, they were all me-too drugs – classified by the agency as being no better than drugs already on the market to treat the same conditions. Some of these had different chemical compositions from the originals; most did not. But none were considered improvements. So there you have it. Seventy-seven percent of the pharmaceutical industry’s output consisted of leftovers.

Marcia Angell is perhaps best known for her outspoken objections to the use of placebo controls in the testing of low-dose antiretrovirals for the prevention of maternal-fetal transmission of HIV in the developing world during the 90’s. Her now infamous editorial in the New England Journal of Medicine sparked a major controversy, and ultimately resulted in Angell’s retirement from the Journal. In The Truth About the Drug Companies, Angell takes aim at big Pharma and their deceptive practices here at home.

Angell’s primary target here is the R&D myth that drug companies invest billions of dollars into the production of new, life-saving drugs, and that strong patent laws are required in order to protect the ability of Pharma to continue to produce these invaluable outputs. In fact, the largest portion of Pharma’s spending appears to go to marketing, in the form of direct-to-consumer advertising, continuing medical education, and direct-to-physician advertising (often disguised as something else) – all in support of me-too “blockbuster” drugs which offer minimal improvements over already-existing treatments. And at the other end, most of the basic research which goes into the discovery of new molecular entities is funded publicly – through the NIH and non-profit research organizations. Drug companies come in at the back end – buying copyrights to data which was generated through the use of public funds, then patenting the final product and selling drugs back to Americans at outrageous prices.

I have mixed feelings about this book. On the one hand, Angell is preaching to the choir insofar as I tend to agree with her substantive positions regarding industry influence on the medical profession, the testing and marketing of me-too drugs, the invention of new diseases and drug markets, and the unmitigated mess that has been made since the passage of the Bayh-Dole Act and the Medicare Prescription Drug Benefit. On the other hand, I found Angell’s arguments often sloppy and under-cited, with many of her factual claims undermined by her heavy rhetorical style. Much of Angell’s writing comes off as mere vitriol, which is frustrating since although my familiarity with the material helps me to know that she is right, her approach to the topic undermines her credibility – I would imagine especially with those who are inclined to disagree with her or who aren’t as familiar with this literature. There’s no need for the heavy-handed approach Angell takes: truly, the facts can speak for themselves, and her arguments would be better served if she could present them more objectively, and with less exaggeration.

The other big problem with this book (and this is no fault of Angell’s, it is just the natural course of things) is that much of the data is already obsolete. This book was first published in 2004, before we could really see the results of the prescription drug benefit pan out; before the financial collapse in 2008; and before the passage of Obamacare. Given all of the important changes which have been implemented since the writing of this book, many of the arguments bear further scrutiny, and the long-term effects of much legislation is, as of yet, unknown. Ultimately, a book worth reading, but I worry about the effect her tone has on her credibility. ( )
  philosojerk | Apr 25, 2012 |
How the medical profession and 'Big Pharma'interact.
  mdstarr | Sep 11, 2011 |
Mostly concerend with shock value, but most of us are unshockable with regard to Rx companies. ( )
  pilarflores | Dec 22, 2009 |
How the medical profession and 'Big Pharma'interact.
  muir | Nov 9, 2007 |
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During 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.

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