three-and-half-stars
Bookmarks Issue: 
13-Nov-Dec-2004
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How They Deceive Us and What To Do About It

A-TurthDrugCompaniesIs Big Pharma robbing us blind? According to Angell, former editor of the New England Journal of Medicine, it is doing just that—and more. Drug companies hold Congress with "an iron grip," help fund the FDA (its overseer), bribe physicians, receive major tax breaks, and finesse patents for popular drugs. To make matters worse, they spend nearly twice as much on marketing as on R&D, keeping the costs of (our unregulated) drugs high and spewing out far more "me-too" drugs (like Pfizer’s Lipitor) than new ones. But, not all’s lost—yet. Angell presents a list of broad reforms, from publicly registering all clinical trials to making the FDA financially independent of Big Pharma. After all, "[d]espite all its excesses, this is an important industry that should be saved—mainly from itself."
Random House. 305 pages. $24.95. ISBN: 0375508465

Boston Globe 4 of 5 Stars
"… a sober, clear-eyed attack on the excesses of drug company power. … The result is a lucid, persuasive, and highly important book." Carl Elliott

Rocky Mountain News 4 of 5 Stars
"The author’s approach to the subject of pharmaceutical companies and their products is measured, thoughtful and clearly written. She offers a wealth of data to back up her claims, and then proposes specific reforms for restoring the industry to its purpose while making prescription drugs more affordable and safer." Verna Noel Jones

New York Times 3.5 of 5 Stars
"If she is accurate in her assumptions about big drug companies’ feistiness and tenacity, Dr. Angell is likely to be on the receiving end of angry rebuttals. … But Dr. Angell’s overall questions about drug companies’ finances, their influence on government regulation and their methods of testing new medicines are enhanced by her dogged, contentious tone." Janet Maslin

Providence Journal 3.5 of 5 Stars
"… a hard-hitting condemnation from an expert witness. … This is an important book." Jeanne Nicholson

Chicago Sun-Times 3 of 5 Stars
"It’s disappointing that Angell didn’t include a chapter on the industry’s relationship with medical journals, which publish influential studies that can make or break a drug. … But while her revelations aren’t new, Angell does an excellent job assembling them into a convincing case against Big Pharma." Jim Ritter

Hartford Courant 3 of 5 Stars
"There is no gray in Angell’s analysis, but there should be in the public debate. … Angell’s reform list is politically unpalatable, but it serves as a starting point for serious discussion." William Hathaway

Wall Street Journal 1.5 of 5 Stars
"As for Dr. Angell’s accusation that the industry has bought off the political process, history argues otherwise. … Her diagnoses are wrong, and her cures are far worse than the disease." Henry I. Miller

Critical Summary

Big Pharma "is taking us for a ride," Angell contends. "And there will be no real reform without an aroused and determined public to make it happen." This expose may arouse readers, but will it help the larger cause? Critics agree that Angell’s passionate, well-researched indictment of the industry’s practice raises important questions. The lack of new insight doesn’t diminish its power, but some critics who applaud Angell’s suggested reforms also see them as unrealistic. Only Dr. Miller of The Wall Street Journal—a former FDA official—condemns Angell for playing down the drug companies’ R&D investment, ignoring the FDA’s high bar of approval, and overemphasizing the industry’s involvement in politics. There might be gray areas, but general consensus is, "the author clearly points the way." It’s just a question if anyone will "heed the warning" (Rocky Mountain News).