Product Description
During her two decades at The New England Journal of Medicine, Dr. Marcia Angell had a front-row seat on the appalling spectacle of the pharmaceutical industry. She watched drug companies stray from their original mission of discovering and manufacturing useful drugs and instead become vast marketing machines with unprecedented control over their own fortunes. She saw them gain nearly limitless influence over medical research, education, and how doctors do their jobs. She sympathized as the American public, particularly the elderly, struggled and increasingly failed to meet spiraling prescription drug prices. Now, in this bold, hard-hitting new book, Dr. Angell exposes the shocking truth of what the pharmaceutical industry has become–and argues for essential, long-overdue change.Currently Americans spend a staggering $200 billion each year on prescription drugs. As Dr. Angell powerfully demonstrates, claims that high drug prices are necessary to fund research and development are unfounded: The truth is that drug companies funnel the bulk of their resources into the marketing of products of dubious benefit. Meanwhile, as profits soar, the companies brazenly use their wealth and power to push their agenda through Congress, the FDA, and academic medical centers.Zeroing in on hugely successful drugs like AZT (the first drug to treat HIV/AIDS), Taxol (the best-selling cancer drug in history), and the blockbuster allergy drug Claritin, Dr. Angell demonstrates exactly how new products are brought to market. Drug companies, she shows, routinely rely on publicly funded institutions for their basic research; they rig clinical trials to make their products look better than they are; and they use their legions of lawyers to stretch out government-granted exclusive marketing rights for years. They also flood the market with copycat drugs that cost a lot more than the drugs they mimic but are no more effective.The American pharmaceutical industry needs to be saved, mainly from itself, and Dr. Angell proposes a program of vital reforms, which includes restoring impartiality to clinical research and severing the ties between drug companies and medical education. Written with fierce passion and substantiated with in-depth research, The Truth About the Drug Companies is a searing indictment of an industry that has spun out of control.From the Hardcover edition.

Amazon.com Review
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

CUSTOMER REVIEWS (Average Customer Rating: 4.0 based on 90 reviews)

Goldberg reviews The Truth About the Drug Companies by Robert M. Goldberg (NYS USA)

5 Stars
November 08, 2009
Anyone who has used or currently uses or who may need to use pharmacutical products in the future, ought to read Marcia Angell's comprehensive study and conclusions about the industry that produces them and their lobbyists, the regulatory agency (FDA) that should oversee them, and the Congress that directs and funds the FDA and should be working in out interest. WOW!

A Decent, Entertaining Read but Not Five Stars by The Agnostic Apatheist (New York, NY)

3 Stars
August 02, 2009
Dr. Angell's book has some good and disappointing points that I wanted to share. First, the good points. The book is easy to read and a reasonably educated person could breeze through its pages with in one or two days. Thus, Dr. Angell's unhampered writing style is compendable, especially given the fact that most scientists are horrible at conveying their message to a general public. Her book also confirms my own impressions of the pharmaceutical industry from over ten years as a health care provider and five years as a clinical reviewer for new drugs and contract negotiator within the managed care industry. For example, she is correct that there is very little innovation in the industry. She is also correct that pharma wields considerable influence over politicians and uses their clout to manipulate laws, rules, and regulations to their favor. I've witnessed this first hand. I've also observed pharma offer deep rebates to PBM (Pharmacy Benefits Management) companies to favor their branded drug over equally effective generic competitors. The consumer pays more for the brand, but the PBMs pay less by favoring the branded product on their formularies or even placing the generic on a higher tier (i.e. making it more expensive). But while I share her general assessment of the industry, there is also much to disagree with. Perhaps my biggest complaint with her book was her poor understanding of fundamental economics. She demoralizes the pharmaceutical industry as if it is their obligation to offer their products at affordable prices. She seems to think that the pharma companies can price their drugs at will or that the CEOs of these companies make millions of dollars by exploiting consumers. Pharma is in business for one reason - profits - and they can charge top dollar for their products because the demand is there. In fact, it's simple supply and demand. Yet Dr. Angell seems to ignore this fact, instead opting to engender emotional outrage from her readers, many of whom are probably as ignorant of basic economics as she is. She also suggests that pharma engages in minimal R&D itself, while claiming to charge high prices to recoup R&D costs. But R&D costs and efforts do not have to be spent by the pharma company itself. In other words, someone had to spend money on the initial R&D. Even if the pharma company purchases the rights from that person (or other company) the price it pays is partially a reflection of that initial R&D, and pharma will want to recoup those costs when it releases its product to the general market. Overall, I still think the book was a decent, entertaining read but I do not think it deserves more than three stars. For those interested in this general topic, I suggest reading "Pills, Profits, and Politics" or "Doubt is their Product". The former is an older book, but it shows you a historical and more comprehensive view of the intertwining of pharma with the political machine. The latter is not specific to the pharmaceutical industry but tackles the general issue of industry's influence on politics and attempts to confuse scientific findings by engendering doubt in the public mind.

A must know for everyone by Sarah A. Hilton (Dallas, TX)

5 Stars
April 26, 2009
The Truth about the Drug Companies: How they deceive us and what to do about it by Dr. Marcia Angell is a harrowing account of the deceit, corruption and exploitation that has become rampant in the pharmaceutical industry in the past fifty years. Once an industry based on the improvement of quality of life worldwide, Pharmaceutical Research and Manufacturers of America, the combined drug companies more often referred to as PhRMA, has become an industry driven solely by profit. Angell reveals that in 2002, "the combined profits for the ten drug companies in the Fortune 500 ($35.9 billion) were more than the profits for all the other 490 businesses put together ($33.7 billion)" (11). These profits far exceed the costs of research and development, once the most important part of the industry. Through collusion and deception, PhRMA has used our desperation for innovative new drugs and dependence on drugs so many of us use as a means to maximize profit. The book exposes many of the secrets of PhRMA for the general public, in an attempt to raise awareness and hold the industry accountable for the abandonment of their original purpose: the public's well being. Gone are the days of unbiased trials and controlled testing. PhRMA's influence is far reaching, from hundreds of political lobbyists, monetary contributions to research development at universities and hospitals, and even a considerable influence over the National Institute of Medicine (NIH). Angell reports that "senior NIH scientists (who are among the highest paid employees in the government) routinely supplement their income by accepting large consulting fees and stock options from drug companies" which could drastically bias their reports on the clinical drug trials taking place within the NIH (104). With so many of these major institutions accepting monetary gains and royalties from PhRMA from sold patents of drugs, Angell raises the question of how can the public trust clinical trials taking place in a contaminated environment. A more recent development that the book reveals is the creation of for-profit testing centers, developed for the sheer purpose of catering to the industry's need for quick and desirable results. Furthermore, the industry uses gimmicks which directly defy the ideals behind clinical trials and the scientific method. Frequently, only younger subjects are used in trials, even when the medication would be targeting an older population, due to their tendency to have fewer side effects. Most often these new drugs are not new at all, but "me too" drugs which are versions of drugs already on the market with slightly changed components. According to Angell, the industry avoids placing these "me too" drugs up against rival drugs, but instead tests them against placebos only. Unfortunately, this is all the FDA requires to show effectiveness. If the drug companies test these drugs against their similar counterparts, the dose of the rival drug is often considerably less or administered incorrectly in order to bias the results in the new drug's favor. "Me too" drugs are the prime example of the complete lack of innovation that is prevalent within the industry. PhRMA is reluctant to disclose the true amount of their income that goes to research and development, as most of their money is spent on mass media advertising. Exceptionally few drugs are innovative and new and they rarely come from the industry itself, but instead are purchased. Several government policies enable the drug companies through giving them exclusive rights to newly developing drugs in the NIH. In fact, it is our tax dollars that pay for this research, as well as growing Medicare costs, and yet the cost for drugs is rising while the production of innovative medicine slows to a halt. Instead the industry continues to mass produce "me too" drugs posing as more effective versions of the drugs already on the market. These drugs are widely and continually used by the masses. Some examples are Claritin, a popular drug for year-round allergy relief; Prozac, a widely used antidepressant and the original selective serotonin reuptake inhibitor; and Prilosec, a drug for the treatment of heartburn. Their "me too" versions, Clarinex, Zoloft (although there are many for Prozac), and Nexium, have conveniently appeared on the market as the original versions' patents were about to expire, potentially cutting into the industry's earnings. Angell sheds light on the reforms the government must make to change the industry. She includes new regulations of the lengths of patents, which prevent the public from using the generic form of the drug as well as cause the industry to rush through testing in order to maximize the length of the patent. She suggests changing the policies that allow the industry to use tax-payer's dollars to fund their own agendas. Furthermore, she exposes the fact that the industry is directly responsible for enormous amounts of political funding. The CEO of Bristol-Myers Squibb reportedly gave over 200,000 dollars to the Republican Party in 2000. Clearly, our government has a vested interest in the pharmaceutical industry, but not one that is beneficial to the public. Ultimately the change in the industry will be up to us, the consumer. Becoming educated is the first step. No longer should we simply accept whatever drugs we are prescribed, but instead read the literature behind them, ask questions of our doctors, and not fall prey to the mass-media advertising which pervades our society. It's time to be skeptical consumers and citizens. We have the right to know what goes on behind the closed doors of PhRMA and as well as the right to know if our government representatives are accepting campaign contributions from the industry. The industry is not just a tool to make money; the investors behind each company should not be their primary concern. Angell's book points out that PhRMA is well on its way to becoming a monopoly and using our many illnesses as a mechanism to charge outrageous prices. This book is extremely informative and useful. There are so many identical drugs on the market masquerading as more effective or less hindering to our lives while charging triple the amount of their generic form. Angell exposes many of these drugs that so many people accept without question. Having the knowledge provided in Angell's book is a tool that every smart consumer needs when dealing with the medical industry as a whole.

a bitter after taste by KK

5 Stars
February 17, 2009
This book is easy to ready and highly relevant for patients and especially doctors. I am appalled at the degree of corruption associated with drug companies.

worthwhile by D&D

4 Stars
October 02, 2008
Yes, it's somewhat repetitive but there's valuable information here, offered by someone who was immersed in the industry for many years. It's just a pity that the only readers of this book are likely to be the already-converted. Everyone should know this information, as well as that contained in similarly worthwhile books like Selling Sickness, Dirty Medicine, Racketeering In Medicine, The Great Cholesterol Con, Heart Frauds, How to Protect Your Heart from Your Doctor, Confessions of a Medical Heretic (amusingly written, by a medical doctor, as well as scandalous), The Medical Mafia (also by a medic, similar theme as Confessions and passionately but badly written), The Truth About Vaccines, Cancer: Why We're Still Dying to Know the Truth, The Cancer Industry, Cancer is Not a Disease, and Why We will Never Win the War on AIDS.

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