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The Truth About the Drug Companies: How They Deceive Us and What to Do About It Hardcover – August 24, 2004

4.2 out of 5 stars 174 customer reviews

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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 Moe

From Publishers Weekly

In what should serve as the Fast Food Nation of the drug industry, Angell, former editor of the prestigious New England Journal of Medicine, presents a searing indictment of "big pharma" as corrupt and corrupting: of Congress, through huge campaign contributions; of the FDA, which is funded in part by the very companies it oversees; and, perhaps most shocking, of members of the medical profession and its institutions. Angell delineates how the drug giants, such as Pfizer and AstraZeneca, pay physicians to prescribe their products with gifts, junkets and marketing programs disguised as "professional education." According to Angell, the cost of marketing, both to physicians and consumers, far outweighs expenditures on research and development, though drug makers invoke R&D as the reason drug prices are so high. In fact, says Angell, with combined 2002 profits of $35.9 billion for the Fortune 500's top 10 drug companies, the drug industry is America's most profitable by far, thanks to disproportionately high prices, generous tax breaks and manipulation of patents to extend exclusive marketing rights to blockbuster drugs like Prozac and Claritin. Angell mounts a powerful case (and offers specific suggestions) for reform of this essential industry—a case worth bearing in mind as "big pharma" continues to oppose importing cheaper drugs from Canada.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

Product Details

  • Hardcover: 336 pages
  • Publisher: Random House; 1 edition (August 24, 2004)
  • Language: English
  • ISBN-10: 0375508465
  • ISBN-13: 978-0375508462
  • Product Dimensions: 6.4 x 1.1 x 9.5 inches
  • Shipping Weight: 1.2 pounds
  • Average Customer Review: 4.2 out of 5 stars  See all reviews (174 customer reviews)
  • Amazon Best Sellers Rank: #370,724 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

Format: Hardcover Verified Purchase
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.
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Format: Hardcover
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.

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Format: Hardcover
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!
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Format: Paperback Verified Purchase
As a physician, I guess I am one of the people who ought to be defensive about the expose' illustrated here. But I purchased the book already experiencing a good deal of abuse/shenanigans from the pharmaceutical industry, and wondering what else might be going on about which I might expand my knowledge.

From many other excellent reviews here you will know this is a must read! As one reviewer noted, it reads like a novel.....so the fiction lovers out there can delve into its details as well as those of us looking for factual marketing, political and current events reading.

Some additional notes: I'm a hospital-based anesthesiologist, and can assure readers that the tactics described herein are not limited to doctors' offices-type practices. This book does not address the techniques used by the industry to manipulate prices and costs within hospitals, but rest assured, the manipulations are there in a big way: limiting formularies, discontinuing effective and time-proven inexpensive drugs in favor of proprietary ones, marketing to non-physicians (accountants, CEO's) in a position to affect formulary decisions, etc.

There is a singular, but major criticism of this book, and that is the author's conclusion that more government involvement is one solution to reign in the excesses of the industry. This comes after the text's superior review of how government (FDA, NIH, congress-of course) has, in fact, been a major player in creating/perpetuating the problem in the first place! What a preposterous conclusion/how contradictory can one get? After recognizing, say Ted Bundy as a serial killer, would she want him chaperoning her teenage girls, using identical logic?!
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