This was an interesting read. I think her most valid points are the industries high profits and over participation in clinical trials. Since I am sure that no one is bothering to criticize the book I will focus on what I didn't like about it.

First the beginning chapters felt very repetitive to me. This was made worse by the fact every was support by essential a single data point (2002 financial data). I think it would have been much better if these chapters were condensed in a small peer reviewed paper style chapter. In addition to being move objective in tone two decades of data should have been presented showing the raise in prices and profits for the industry following the laws she harps on and that the high profits have been consist for some time not just for 2002. while I am sure these things are both true she doesn't really show either.

Another thing that bothered my about the first few chapters was the implication that most of the research and development is covered by taxes. This was especially irritating since in one passing sentence the author says the industry spends more on research and development then the NIH spends on drug related research. This means that taking basic research to a useful and realizable place is over half the cost. While the industry is making enormous profits they are serving a purpose in bring basic research to market and somewhat quickly. There is a lot of emphasis on spending up the process of making basic research accessible in other research areas. For example look at the materials genome initiative.

I certainly believe that those contacting research can basis it and the industry some be keep at arms length from the actually trials, however about half of the ways the author mentioned the biasing happen seem to be a non-issue to me. Maybe these are things that have changed recently but from my reading for medical journals I see that conflicts of interest are required (also required by the NIH), participate demographics are reported, and dosing and procedures are also given in detail. This means, that at least for the published results, the information is there to check for the bias which should be caught by the journal or the FDA.

I would be interested in seeing an updated version of this book.

A well researched book on the drug industry in United States.

This book details at what length drug companies go to in order to make an obscene amount of profit, even if it puts people health at risk. The best thing we as consumers can do is to stay in good health so we don’t need to take medications as we get older or if that becomes necessary, then do our research before deciding to go on a medication regimen.

After reading this book I am tempted to say, "I would rather die than have another prescription drug," ahem,
one just might.
But why don't you ponder these facts from the book: "The authors obtained FDA (Federal Drug Administration) reviews of every placebo(sugar-coated pill)-controlled clinical trial submitted for initial approval of the six most widely used antidepressant drugs approved between 1987 and 1999 - Prozac, Paxil, Zoloft, Celexa. Serzone and Effexor (all but the last two are SSRIs)...Their findings were sobering. On average placeboes were 80 percent as effective as drugs." Let's hear it for sugar! But jokes aside, how many of us have friends on these meds long term? How many of us are on them?
Here's another, in the USA, "In 2001, drug companies gave doctors nearly $11billion worth of "free samples."" What is it that they say that nothing is never free? It is free for the doctors, but for you as a consumer? Puhlease!
Do you suffer from 'social anxiety disorder' code for shyness - so did I, until I became a journalist and the profession forced it out of me, but psychiatrists have found a handsome new source of income by declaring shyness a disorder, along with attention deficit disorder (what we used to know as normal, healthy, active kids instead of dammit-why-won't-they-stay-still-in-front-of-the-tv!)) So here is what Angell writes: "once upon a time, drug companies promoted drugs to treat diseases. Now it is often the opposite. They promote diseases to fit the drug." So for example, premenstrual tension is now a 'disease' called "premenstrual dysphoric disorder (PMDD)." And then there are the massive profits from the little blue pill that combats erectile dysfunction...
This book, it is brilliantly researched; I was infuriated when I read how pharmaceuticals connive to give people meds they don't need and cost countries billions.
Also read Helen Epstein's brilliant article in the latest NY Review of Books - Phony Flu & Big Pharma.
Enough to make me spend my life at gym and only eat healthy foods. (Oh yes, and please floss, just went to a great dental hygienist today who said that 30% of women who don't floss can anticipate cardiac problems because of the microbes that form in the mouth - I dashed off to the pharmacy for floss and a sonic toothbrush ... but then again...? My view? Prevention is better than drugs)

عندما أقرأ كتبًا كهذه- لا تتوفر لها ترجمة عربية .. أتأكد أكثر بأن الطريق أمامنا نحو فهم العالم لا يزالا طويلاً!

يسلط هذا الكتاب الضوء على ممارسات شركات الأدوية غير الأخلاقية، والمدفوعة بالجشع والرغبة في مضاعفة أرباحها، في الولايات المتحدة الأمريكية. كمية المعلومات الصادمة والفاضحة في هذا الكتاب كفيلة بأن يشيب لها شعر الرأس. ورغم أن الكتاب يتاول مشكلة أمريكية خالصة، إلا أن ما يحصل هناك، لا بد وأن يكون له -بطريقة أو بأخرى- نتائج هنا!

The Truth About Drug Companies (2004) by Marcia Angell describes how pharmaceutical companies manipulate science and US politics in order to make more money.
Angell was on the staff of the New England Journal of Medicine for over 20 years and became its first female editor. She has had extensive experience dealing with and observing how big pharma operates.
The accusations that Angell levels at the drug companies are that they only publish successful trials, game phase 4 trials, manipulate doctors with subsidized ‘education’ that is really a sale pitch, game the US patent system, lobby to ensure that the US government, a major purchaser of drugs doesn’t negotiate hard on price and sets the rules up to maximise profit. The book goes into detail and makes a strong case on each point. The fact that the rest of the world pays substantially less than the US does is very true and quite remarkable.
Angell doesn’t look at how the US insurance system and Medicare and Medicaid encourage people to get more expensive drugs if they are paid for by other people with little contribution from the user but the issue could be added.
The book is a solid, well researched, well reasoned and interesting look at how drug companies have manipulated the system.

Fascinating and disturbing the extent that people will go for money. We either need to improve our ethical maturity as a race or make changes to our government to regulate this kind of behavior (i.e. manipulating the system to take billions of dollars from people for a product that isn't substantially better than what already exists).

Read this ahead of my AstraZeneca application, bamboozled me but it does need a bit of an update. Got the job tho lol

Everyone should read this book. The opportunity cost of the vast wasted value generated by this industry is a key issue in our economy. Consumers must change it. Every voice is important to offset the corruption.

Angell's harsh critique of the pharmaceutical industry is overly one-sided. There are some good take-home points here once the hyperbole is removed.

This book is indispensable. Exposes the lies that the big pharmaceutical companies hide behind and use to justify the ridiculously overpriced drugs they are selling and gouging consumers. The best aspect of this book is that it dispels the myth that drugs are so expensive because of the costly R&D associated with creating brand new lifesaving drugs. The truth is that the most expensive and speculative research is done at the university level, which you've already paid for with your tax dollars going to grants. By the time the drug companies come along most of the initial research has been laid, including whether the drug will be useable (and thus profitable) or not. Fact is the drug companies are way more concerned with coming out with 5 new versions of Prilosec and Claritin, a pathetically miniscule number of the new drugs that come to market each year are truly new, innovative and lifesaving. The author also does a great job of suggesting ways to get our government to crack down on these crooks.

Should be required reading for anyone in medical school.