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The Big Fix: How The Pharmaceutical Industry Rips Off American Consumers (Publicaffairs Reports) Paperback – May 6, 2003

4.2 out of 5 stars 15 customer reviews

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Editorial Reviews

Review

"a highly informative description of how and why drug companies are such powerful, successful businesses." -- Washington Post Book World, July 13, 2003.

About the Author

Katharine Greider has worked as a newspaper reporter and freelance magazine writer. Her articles, often focusing on health and medical topics, have appeared in a dozen publications from Self to Mother Jones. She lives in New York City with her family.
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Product Details

  • Series: Publicaffairs Reports
  • Paperback: 208 pages
  • Publisher: PublicAffairs; Uitgawe and Revised ed. edition (May 8, 2003)
  • Language: English
  • ISBN-10: 1586481851
  • ISBN-13: 978-1586481858
  • Product Dimensions: 5.5 x 0.5 x 8.5 inches
  • Shipping Weight: 12 ounces (View shipping rates and policies)
  • Average Customer Review: 4.2 out of 5 stars  See all reviews (15 customer reviews)
  • Amazon Best Sellers Rank: #785,042 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

By A Customer on June 2, 2003
Format: Paperback Verified Purchase
Did you know that when you or your insurance company plunk down big bucks for your Zocor or Zoloft or Zyrtec, you're paying nearly twice as much as the French and Italians and about a third again as much as the Swedes, Swiss, Germans and Canadians? What for? If you believe the pharmaceutical industry, the high price of your prescription is supporting research that could save your life. And so it does, but not nearly to the extent we've been led to believe. In fact, as you'll learn in this well documented new book, much of that research is done on your tax dollar by Uncle Sam, with the drug companies reaping the profits at little or no expense to themselves. Your drug dollars are also paying for 625 industry lobbyists--a contingent larger than Congress itself. You're also subsidizing anti-consumer legal battles, like the one against that Maine law designed to get competitive drug pricing for Medicaid and uninsured patients that was just upheld by the Supreme Court. And all those lawsuits to prevent or stall low-priced generics from getting onto the market after patents expire. And then there's the annual $2.6 billion in consumer advertising--a tenfold increase in just a decade, and all those free samples and other rewards to doctors. Is this how you want your hard-earned healthcare dollars spent? Do you really want the pharmaceutical industry setting America's drug policy? If not, what can you do about it? Reading this excellent book is a very good place to start.
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If you've ever stood at the pharmacy counter and wondered why the prescriptions you've just picked up cost so much, this book has the answers. Big Pharma - the major drug companies - need to make big profits, and the author explains how they use the money you pay them. She does it without being sensational or shrill, instead calmly laying out the facts of direct-to-consumer advertising, pharma-sponsored conferences, pharma-sponsored research, vacations and coffee mugs and big consulting fees for doctors. I for one had no idea of the extent of their reach, and I find it shocking and enraging. Big Pharma virtually sets the health agenda, and after reading this book I have a clearer sense of how they do it. I hope our politicians pay heed, and start fixing this disaster.
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Despite the inflamatory title, for which I deducted one star, this book is a compelling read. Whatever side of the drug prcing and access debate you are on, you can learn from Ms. Greider's review of the core issues. She makes the issues entirely understandable and it is actually a fascinating read.
What is clear is that the status quo will not stand. That is, the polical pressure and books like these will force the drug industry to either lower or slow down price increases. If not, then legislative action largely from states, will put a cap on prices through state pricing negotiations with drug companies. This book, despite the insulting title, should be read by all drug company executives. While I doubt it is a "big fix", I have no doubt aggressive drug marketing practices are not all pure and need some revisions soon.
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Katharine Greider has given you a rare unbiased look inside the pharmaceutical industry. I know several doctors. They all get 4-6 visits a day from drug "detailers." That's where they get virtually all their prescribing information. Forget about older generics that are just as effective. Forget about the thousands of studies published everyday on natural substances which are as effective, much less expensive with no side effects. A study published in the Journal of the American Medical Association in April, 1998 showed that:

In 1994, an estimated 2,216,000 (1,721,000 to 2,711,000) hospitalized patients had serious adverse drug reactions (ADRs) and 106,000 (76,000 to 137,000) had fatal ADRs, making these reactions between the fourth and sixth leading cause of death.

Do you really think this has improved in the last 10 years?

In December, 2003, at a conference in London, Dr. Allen Roses, a senior vice president of GlaxoSmithKline candidly admitted that fully 90% of prescription drugs only work 30% to 50% of the time.

Other countries control drug prices...the same drugs from the same companies for which Americans pay exorbitant prices. Despite two laws passed by Congress since 2000, the FDA, under pressure from drug company lobbyists, still prohibits "reimportation" of drugs from Canada and other countries. States and cities are deliberately challenging the FDA to help their seniors get drugs at reasonable prices from Canada. Busloads of seniors travel from New Hampshire, New York, Michigan and Montana to get their prescriptions filled in Canada. Is this a sensible solution?

To fully understand the dynamics of this ridiculous situation, read this book.
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The U.S. ranks #1 in amount of healthcare spending per person yet 37th in healthcare performance (World Health Organization). We are second-to-last of industrialized countries listed in disabled persons earning capacity (annex to Society-at-a-Glance 2002) and 17th in life expectancy (U.S. Department of Health and Human Services). Editorialist Nicholas Kristoff cites the C.I.A. World Factbook ranking the U.S. 42nd in infant mortality, a "national disgrace....that the average baby is less likely to survive in the U.S. than in Bejing or Havana" (New York Times; 1/12/05). According to Dr. Kenneth Liegner's testimony before the New York State Assembly Committee on Health (11/27/01), a 7-year-old Lyme disease patient was kept alive on expensive medication until, due to insurance company policy, "she died within one month of cessation of intravenous antibiotic treatment." Liegner adds, "Metropolitan Life Insurance Company had an important formative role in the creation of the National Institutes of Health. This raises the issue of possible ongoing undue influence of the insurance industry in setting national public health priorities".

On the other hand, although the U.S. is the only industrialized country with no pharmaceutical price cap, "The National Institutes of Health said rules designed to reduce conflicts of interest at the agency went too far. So instead of barring thousands of employees from owning stock in pharmaceutical and bio-technology companies, only about 200 senior employees will be affected...." ('NIH Revises Ethics Rule on Stock Ownership'; USA Today; 8/26/05). So it's not only insurance companies influencing public health policy.

Consider these non-profit healthcare CEO salaries buried in the 'Money' section of USA Today: Catholic Healthcare West CEO--$1 mil.
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