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

~ (Author) "Alex MacDonald had just escaped from the crowded parking lot at the Garden in Boston, where several thousand children had been screaming happily at "Disney..." (more)
Key Phrases: diet drug case, valve reports, valve disease, Mary Linnen, American Home, New Jersey (more...)

Editorial Reviews

Amazon.com Review

Mary Linnen, 29, was determined to lose 25 pounds before her wedding. In May 1996, her doctor prescribed a combination of drugs known as Fen-Phen. When Linnen complained of dizziness and shortness of breath 23 days after starting the medications, her doctor told her to stop the drugs--but didn't examine her or order tests. Linnen got better for a time, then the shortness of breath and exhaustion returned worse than ever. Her legs and stomach swelled. She collapsed at work. Six months after taking Fen-Phen, Linnen was admitted to the emergency room with primary pulmonary hypertension: the capillaries that sent oxygen to her lungs had thickened and were closing, suffocating her. Her survival expectation after heart surgery was less than four years. Hooked up to a tube in her chest to prevent heart failure, she died three months later.

Dispensing with the Truth: The Battle over Fen-Phen tells the story of the legal battle against the pharmaceutical companies after Fen-Phen's users started dying--some, like Linnen, of primary pulmonary hypertension; others of heart valve damage. Investigative reporter Alicia Mundy weaves a dramatic tale from the development of the drugs to FDA approval to the final litigation. How much did the pharmaceutical companies know about the risks long before most of the deaths? Plenty, according to the evidence Mundy reveals. Although at times the book seems overfilled with details that slow down the drama, if you want the complete, behind-the-scenes story of one of the most famous "profits over protection" cases, this book tells all. --Joan Price

From Publishers Weekly

H"You are going to hear about a diet pill combination that was a craze... one of the most remarkably profitable pharmaceutical undertakings in the history of the United States," said Alex MacDonald, as quoted here by Mundy, in his opening statement during the Mary Linnen case. Beginning with the death of Linnen, a young woman who took Fen-Phen for less than a month to lose a few pounds before her wedding and died of primary pulmonary hypertension less than a year later, Mundy's book reads like a medical thriller. But the story of the lives affected by the flawed obesity drug is all too true: approximately 45,000 women "were believed to have developed one of two different diseases linked to their lungs or their heart from taking the drugs"; 300,000 women were prepared to sue the manufacturer to pay for tests to determine if they were ill. Mundy, an investigative journalist and contributor to both Mediaweek and Washingtonian magazine, looks at all the players, including the victims, the resolute legal team, corporate giant Wyeth-Ayerst (the drug's maker), the elite medical community that defended it and the negligent FDA. It took the discovery of heart valve damage to force the drug off the market. The FDA knew of problems with the drug but for a variety of reasons, from bureaucratic sluggishness to cozy relationships with the pharmaceutical companies, remained silent. Mundy has turned an incredibly complex chain of events into a readable and moving narrative, reminisicent of A Civil Action, that engages the reader as it details these legal and personal battles. (May)Forecast: With so many Americans both overweight and diet-obsessed, St. Martin's is betting on a popular response to this book and is reporting a first printing of 75,000 copies. Elle and Self are giving extensive coverage to Mundy in their May issues, and a lengthy interview on NPR has been arranged. The author will be making appearances in New York City and Washington, D.C.

Copyright 2001 Cahners Business Information, Inc.

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Product Details

• Hardcover: 400 pages
• Publisher: St. Martin's Press; 1st edition (May 11, 2001)
• Language: English
• ISBN-10: 0312253249
• ISBN-13: 978-0312253240
• Product Dimensions: 9.5 x 6.4 x 1.3 inches
• Shipping Weight: 1.6 pounds
• Average Customer Review: 4.3 out of 5 stars  See all reviews (17 customer reviews)
• Amazon.com Sales Rank: #1,056,197 in Books (See Bestsellers in Books)

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Customer Reviews

Most Helpful Customer Reviews

14 of 15 people found the following review helpful:

5.0 out of 5 stars Saucy and outrageous will leave you outraged, May 8, 2001

By A Customer

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.

7 of 8 people found the following review helpful:

4.0 out of 5 stars Important story, well-told, December 4, 2001

By	Dennis Littrell (SoCal) - See all my reviews (TOP 50 REVIEWER)    (REAL NAME)    (COMMUNITY FORUM 04)

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.

4 of 5 people found the following review helpful:

5.0 out of 5 stars A Riveting Page-Turner, August 29, 2001

By	anonymous - See all my reviews

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.