Customer Reviews

Dispensing with the Truth: The Victims, the Drug Companies, and the Dramatic Story Behind the Battle over Fen-Phen

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Perhaps the most remarkable aspect of this book was the way it made me smile and laugh, in the midst of a story that is frightening and sad. Alicia Mundy is saucy, witty, and an incredible story teller. Reading "Dispensing with the Truth" will cause you to become furious with the drug companies, inspired by the heroic lawyers, and intrigued by the inner workings of the FDA. I felt great disappointment with the drug industry, but at the same time I was hopeful, as the author finds many rays of light. For example, one of the heroes in the book was a med tech in Fargo, North Dakota named Pam Ruff, who pursued a strange coincidence in the echocardiograms of her patients not because she thought she could profit, but because she thought she could help. And then there is the FDA's Leo Lutwak, who risked his reputation and his job to voice his dissent over the approval of the dangerous drugs. I strongly recommend this book if you are looking for a gift for a mother, a sister, a lawyer, or anyone who likes courtroom thrillers.

This is a good read, especially in the beginning, but if you want to go beyond the courtroom drama and the legal aspects of the case, you have to read carefully. (Taking notes wouldn't hurt.) This is a complex story, and one has to admire Alicia Mundy's skill in managing it while spinning out an engaging narrative. She succeeds by concentrating on one case, that of 29-year-old Mary Linnen, an Orchard Park, New York woman, who developed primary pulmonary hypertension (PPH) after using the Fen-Phen drug combination for a mere 23 days. There is no cure for PPH, and the treatments amount to something like sustained torture. Tragically, less than a year after diagnosis, Mary Linnen was dead.

Within her story, Mundy focuses on two main characters. One is the engaging and colorful Alex MacDonald, the lead attorney representing Mary Linnen's estate, who along with many others sued American Home Products, the parent company of Wyeth-Ayerst, the distributors of Pondimin and Redux (one half of the deadly Fen-Phen diet cocktail), for wrongful death; and the other is Leo Lutwak, a well-meaning but ineffectual administrator at the Food and Drug Administration. But I think the real story here is the corporate mentality inside the drug companies that led to the tragedy, and the incompetence at the FDA that allowed it. Although I think Mundy concentrates too much on the lawyers in her narrative (she indicates in the "Acknowledgments" that she was inspired by Jonathan Harr's lawyer-centered A Civil Action), she is still able to give a complete story, but it takes some real effort on the part of the reader to get it all. I had to take notes and flip back through the pages with the aid of the Index to keep Pondimin and its "sister" drug Redux separate from Phentermine, and to realize that it is the combination of Pondimin and Phentermine or the combination of Redux and Phentermine that is the deadly Fen-Phen combo. When one looks deeper it becomes apparent that Pondimin is the brand name for the drug fenfluramine and Redux for dexfenfluramine, the "Fen" in "Fen-Phen."

It's an important part of the story to realize that doctors prescribed Phentermine in combination with Pondimin because Pondimin alone led to unwanted drowsiness while Phentermine "was," as Mundy phrases it on page 39, "after all, a form of <speed>." The logic here, although not mentioned, is similar to that of the hugely successful Sudafed combination of the antihistamine Chlorpheniramine Maleate, which leads to drowsiness, and the nasal decongestant Pseudoephedrine Hydrochloride, which counteracts that effect by speeding up your system.

Still, it's not clear why so people so eagerly gobbled up the Fen-Phen combo. Mundy indicates that part of the reason was a massive advertising and PR campaign spun out by the drug companies--she calls it "Obesity, Inc."--a campaign that made the never-proven claim that over 300,000 Americans, mostly women, die each year from the "disease" of obesity. The drug companies positioned themselves as wanting to save those lives. However, Mundy cites a study on page 155 showing that the long-term expected weight loss from using Fen-Phen was only about three percent above that of a placebo.

To me the most unsettling part of this story is the stupidity practiced by the FDA and by Wyeth in not realizing that Pondimin or Redux in combination with Phentermine was in its effects very similar to Aminorex, an appetite suppressant that caused a major epidemic of primary pulmonary hypertension, killing hundreds of people in Europe during the mid-1960s. (p. 38) Mundy quotes John Restaino, "a young doctor turned lawyer," as saying (p. 198), himself quoting an unidentified Swedish scientist, "When I saw the combination of Pondimin and Phentermine, Fen-Phen, I said, <My God, they've re-created Aminorex!>." (Incidentally, the lack of attribution for some of the text--there are no footnotes--is a disappointment.)

This bit of ignorance, perhaps willful, by Wyeth and the FDA was followed by a frenzy of greed when the drug companies realized the potential profits. This in turn was followed by attempts at obfuscation and cover-up, denial and feigned ignorance, when the deadly side effects became public knowledge. Ironically, it wasn't PPH that finally led to the withdrawal of the drugs, but another, also deadly side effect, that of heart valvular disease, uncovered by two Fargo, North Dakota residents, med tech Pam Ruff and cardiologist Jack Crary. To my mind, their story is the most important part of the book. Their unselfish and courageous work led to the withdrawal of the drugs and saved the lives of untold numbers of people.

Bottom line: this is an engaging read about a preventable tragedy and the triumph of litigation against a big corporation to be ranked with A Civil Action (the book, not the so-so movie) and the Erin Brockovich story.

This book will make you furious, and it will make you think twice (or three or four times) about the drugs you take, especially ones that have only recently been approved by the FDA. Alicia Mundy tells the story very well and has you on the edge of your seat much of the time. I'm not usually much of a one for stories of victims, lawyers, drug companies, and the FDA, but I couldn't put the book down. It reads like a thriller, and the information it contains is especially vital to anyone who has ever taken Fen-Phen. Even if you would never consider taking a diet drug, you need to learn how ineffectual the FDA has become in the face of the super-powerful drug companies. The drug companies involved knew about the serious health risks associated with these drugs and made every effort not to inform doctors and drug users about the potential dangers. Worse yet, they knew that the drug didn't work. And although they were recommending it for long-term use, they had tested it only for short-term use. This book will make you angry, and given that nearly five times as many people have died from the Fen-Phen debacle as from faulty Firestone tires, we should be angry--angry enough to get Congress to put some teeth back in the FDA so that this sort of tragedy never happens again.

I read this book based on suggestion from someone else. I would not have picked it up on my own. But I'm glad I did. It opened my eyes to the "business" of drugs and the profit surrounding it. It shattered my naive belief that a company producing drugs and an organization created to protect my safety would always do the right thing. It also was a good teaching element for how government, business, and the legal arm work in the pharmaceutical industry. At the end I felt for the average person who innocently takes a prescribed product. This book has made me forever wary.

Alicia Mundy weaves a horrific tale of AHP and the FDA that every person should seriously consider. This information is not only applicable to Fen-Phen users, but users of other drugs on the market that are currently under investigation.

This superb publication serves as an important guide for anyone who wants to know how drug companies operate and how trial lawyers help to uncover corporate dirt.

Preying on consumers and health care providers ,drug companies hype the benefits of their drugs, while hiding the dirt about the known dangers of their pills .

While Fen-Phen is now off the market, the manner in which the pharmaceutical companies operate in marketing and selling other drugs remains business as usual !

The book discusses several cases of Fen-Phen, the diet drug. The book goes through the history of the drug, the drug companies efforts to conceal the negative side-effects of the drugs. It continues on through the FDA approval process, how the drug companies paid for numerous studies to prove the drugs were safe and wrote articles and paid doctors to publish the articles in the doctor's names. On come the lawyers to protect the injured victims and the ones for the drug companies. The book even covers the power struggles between plaintiffs attorneys fighting among themselves.

As an attorney, I am inspired to grow my career into Plaintiff's drug litigation because the problems plaguing Fen-Phen will likely repeat.

A great read. Ms Mundy handles vital and complex issues for us with ease. This book is a truely significant contribution to investigative writing. An expose that should not be missed.

It has all of the ingredients of a good thriller, gritty, engrossing, with twists and turns right up to the last page.

Ms Mundy does great honor to the memory of Mary Linnen.

Alicia Mundy has written a nail-biting medical thriller that engaged me from cover to cover. What makes it so disturbing is that it's not fiction--it's a true story! Drug companies knew they were releasing a dangerous drug, the FDA knew it was approving a potential killer, and yet fen-phen was still allowed on the market.

Everyone thinks fen-phen is old news, but that's because the drug companies tried to cover up the truth after women started dying after having heart complications. You must read this book if you've ever taken a prescription drug, if you've ever trusted the FDA to protect your health, and if you want to find out how giant pharmaceutical companies manipulate, harrass, and endanger the public in order to make a profit. The opening story of Mary Linnen says it all.

I couldn't believe the amount of exhaustive research Mundy conducted to write this book. It's really quite amazing. I wish more authors could write books like this one--it's fast-paced and readable, and yet it touches on a subject that affects nearly everyone out there. I highly recommend it!

This is a very well written, well researched book. Following the litigation and the FDA approval of Fen-Phen, it is both shocking and engaging. A much needed expose of drug companies' immoral (and possibly illegal) activities. I would recommend it to anyone interested in the law, in our regulatory process, in medicine, and a broad array of other fields. In short, it's a great read for most audiences.