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FROM THE
PUBLISHER
During her
two decades at The New England Journal of Medicine, Dr. Marcia Angell had a front-row seat on the growing corruption
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
with and increasingly failed to keep up with spiraling prescription drug
prices. Now, in this new book, Angell exposes
the truth of what the pharmaceutical industry has become - and argues for
essential, long-overdue change.
FROM THE
CRITICS
David Tuller - The Washington Post
The Truth
About the Drug Companies: How They Deceive Us and What To Do About
It, by Marcia
Angell, a former editor-in-chief of the New
England Journal of Medicine, provides the broadest overview and the most
thorough context. Her voice is always authoritative, sometimes testy and
often brimming with anger and frustration at what she views as
drug-company shenanigans.
Janet Maslin - The New York Times
Dr. Marcia
Angell is a former editor in chief of The New
England Journal of Medicine and spent two decades on the staff of that
publication. If much of that time was devoted to reviewing papers on
pharmacological research, it must have been spent in a state of
near-apoplexy.
Her new book
is a scorching indictment of drug companies and their research and
business practices. "Despite all its excesses, this is an important
industry that should be saved - mainly from itself," she
writes.
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. Agent, Martel Agency. (On sale Aug.
24) Forecast: Time called Angell one of the 25
most influential Americans, and with the high cost of drugs making
front-page news, her book should find a receptive audience. Copyright 2004
Reed Business Information.
Library
Journal
With the
recent controversy over Medicare reform for prescription drugs, there
couldn't be a better time for a coherent book on the state of the
pharmaceutical industry. Angell, the former
editor in chief of the New England Journal of Medicine, offers an impassioned expos of how money is really spent by
this gigantic and immensely wealthy industry. Angell looks at the role of academia in drug research,
how the FDA is impacted by the industry, and how pharmaceutical companies
influence medical education and research. She devotes a large part of her
book to an analysis of recent U.S. legislation that, while
well meaning, has actually been a tremendous financial boon to the
pharmaceutical industry. Angell concludes with
practical suggestions on how the industry and our governmental policies
can be reformed to bring the profits of this necessary industry to a more
reasonable level. Every registered voter should read this book; highly
recommended for public libraries. [See Prepub
Alert, LJ 4/1/04.]-Tina Neville, Univ. of
South Florida at St. Petersburg Lib.
Copyright 2004 Reed Business Information.
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A
reviewer (lfrench@stlawu.edu), Dr. Larry G. French,
December 23, 2004, 
Does
Random House Uitlize Peer
Review?
The big
pharma companies are easy to beat up on.
Why? most of us pay out of pocket for some
or most of these services. Docs escape a critical eye because we as
a society do not worry about wasting this limited resource as
insurance picks up the tab. Hell, we don't even complain about
sitting on hold for an hour or more for a 10 min. appointmnet. I did medicinal chemistry research
for my PhD and now teach organic chemistry and medicinal chemistry
at a liberal arts college in NY. I read this book expecting balance
- I was mistaken. The public's general chemophobia and scientific illiteracy is easy to
parlay into a revolt against a chemical based industry which has
done more to improve the quality and longevity of life as any. I
have a few questions and requests for the good doctor. 1.How may new drugs have Stanford, MIT, Caltech
and the Ivy's brought to market in the last 50 years? (or NIH for that matter). 2. Is it not somewhat
satisfying that an economic superpower, who otherwise brings up the
rear as far as per capita expenditures on third world development
and aidis concerned, can at least
contribute by paying what the market will bear for pharmaceuticals?
3. There are many valid concerns given voice in your book. Why not
work behind the scenes and with your compatriots in the medical
profession to rectify these and advance the public welfare, rather
than resorting to hyperbole and fear to sell books? 4. Please
actually speak with some patients who have had their lives
transformed by advances in psychopharmacoligical agents. You exude a Ludite-like disdain for this area of medicine.
5. Look again at the reasons for Phase 4 testing and post market
surveillence. Hopefully one day genomics
will allow a quick and economical way of finding the 1 in 500,000
patients who are endanger of an untoward effect associated with use
of a pharmaceutical. Until then, this is the only option
available.
B.T.
O'Neill, a concerned citizen, September 17, 2004, 
Jeopardizing
the future of medicine
I can’t
believe that the former editor of the New England Journal of
Medicine would know so little about the discovery of drugs and would
jeopardize the future of medicine by publishing this book. As a
pharmaceutical researcher for 22 years, I have to say I am appalled
by many of her claims. A pharmaceutical company brings together
numerous scientific disciplines under one roof to create molecules
that are tested as possible treatments. The work is challenging,
frustrating, expensive but occasionally rewarding. If you look on
the National Institutes of Health (NIH) web site you will see that
our government doesn’t agree with assertions that taxpayer money is
the key driver in drug discovery. In 2001, Congress requested the
NIH evaluate the extent to which taxpayer funding had been involved
in discovery of novel drugs. NIH responded that of forty-seven
FDA-approved drugs that sold over 500 million dollars in 1999, the
NIH has patent rights to only four. Furthermore, all four were
co-developed in a partnership with a major pharmaceutical company
that also invested millions of their dollars in clinical studies and
paid royalties to the NIH. The recently published clinical studies
of Merck’s Zocor and Vioxx, which illuminated deficiencies in their
profile compared with other members of their class, show how
important it is to have multiple drugs within a disease area. The
clear differences among so-called “me-too drugs” should be explained
rather than exploited as she does in this book. As an M.D., Dr Angell should be helping researchers get the
message out to a scientifically illiterate public who will depend on
medical break-throughs in the future. She
has let all of us down.
Mike.nyc
(mrbarr@medscape.com), Repentant 'med ed' professional,
August 25, 2004, 
former NEJM
editor 's revolutionary manifesto ROCKS!
Dr.
Marcia Angell puts the full punch of her
20 years as New England Journal of Medicine editor behind this
riveting and hard-hitting analysis of all that has gone wrong (and
why) with the U.S. pharmaceutical industry over the past 20-odd
years. Tracing the origins of this deleterious detour to a rash of
pharma friendly legislation during the
Reagan years (and continuing through both the Clinton and Bush 43
administrations), her tour-de-force analysis combines extensive
research and illuminating case studies with an impassioned fervor
that cannot fail to leave you asking, 'Where do I sign up?' In the
final two chapters she summarizes both the problems we're up against
as well as her prescriptions for reform. Several of them, such as
her call to repeal both the 1992 Prescription Drug User Fee Act and
the 2003 Medicare reform bill, are certain to ruffle more than a few
feathers. For anyone who is troubled by the out of control greed,
corruption and hypocrisy of this vital industry, Angell's book is a user's guide, a call to arms
and a must read all in one.
Also
recommended: Merrill
Goozner: “The $800 Million Pill: The Truth
Behind the Cost of New Drugs”; David Healy: “Let Them Eat Prozac:
The Unhealthy Relationship between the Pharmaceutical Industry and
Depression” |
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