I either bought a copy of this for my Dad and read it after him, or he gave me his copy. I read it during law school, sometime in either 2005 or 2006. The rise of "me too" drugs and how Big Pharma has essentially captured the patent office are stories from this book that are still prominent in my mind.

Very interesting commentary, albeit dated, on the US pharmaceutical industry. However, evidence against the industry is somewhat repetitive, does not fully take into account the capitalistic nature of the society, and offers limited to no solutions on how to practically reform the system, but rather a brief suggestion on an ideal solution. This is one of the most complex industries, complicated by conflicting stakeholders including patients, society, investors, regulators, politicians, etc. A comprehensive reform, as witnessed by the recent attempt of repeal and replace of ACA, is sure to be complicated and rather difficult.

Livro escrito por uma das pessoas que antigamente era responsável pela publicação de artigos cientificos numa das mais conceituadas revistas médicas.
Uma critica á Industria Farmaceutica, que apesar de focar essencialmente o problema de saúde americano, deve ser lida por todos para um melhor esclarecimento de como essa Industria funciona.É uma chamada de atenção importante para uma realidade nossa também, pois apesar de estarmos algo protegidos com o controlo de preços somos confrontados com a pressão farmacêutica.
Os temas estão muito bem distribuidos. A autora aborda desde a concepção do medicamento até aos genéricos de uma forma clara e critica. Não esquecer que acima de tudo é uma critica pessoal ao sistema de saúde americano, que é bem diferente do portugês.

Recomendo.

This book should be read by every person to understand how "big Pharma" is ripping them off and making their health worse, not better. Canada so far it appears to have resisted the influence but if the voting public is unaware we could end up in the same boat.

You can clearly sense on which side the author is on. She's on the right side, of course, but it would be nice to not be so obvious.

really good insight. Wish so much of it wasn’t still so relevant, but great insight.

Certainly an excellent expose on the dangers of the American pharmaceutical industry, allowing them to control everything from the "impartial" research, to the FDA's legislation of these drugs, to patent protection. I think, even 9 years later, the facts still hold true.

America's drugs are charged the most of all the developed countries for probably the least amount of gain.

Nobody who reads this book will want to take a pill ever again. Dr Angell exposes the modern legal drugs trade for what it is, so deeply rooted in profit lust and political corruption, it's got nothing to do with curing disease and everything to do with making truckloads of money. Drug companies cry poor, yet they charge exorbitant prices for their products, drag out their patent rights as long as possible, and prevent the medicine being distributed more cheaply in poorer countries that desperately need it - all while they make even higher record profits every year. They spend a lot of time developing nearly identical drugs for trivial conditions like colds (because they can sell a lot), but hardly ever produce treatments for rare disorders, on which they might only break even. Despite claiming that they need to charge high prices to conduct research, they do almost none, instead piggy-backing on taxpayer-funded universities and research organizations, so their research is basically free. They pay doctors with "educational" seminars in exotic locations and provide them with misinformation so the medicos choose their drugs every time and even prescribe them for illnesses for which they were not designed, and on which they have minimal effect. Although I have been wary of the drugs trade for many years, this was the book that provided me with the evidence to back up my suspicions. Read it and be informed: despite being a few years old, and American in focus, it's still applicable around the world today - you will understand much better how you get your medicine and make better choices.

Great book! Several times it made me sick and sadly at the same times I wasn't surprised. I would highly recommend this book to anyone and loan it out to who ever wants to read it.
It is pretty dry at a lot of times, with a lot statistics and info about specific companies, but it's not that bad. You'll be glad you read it.

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)

Eye-opening and compelling reading. I'd have given this book five stars, except for three things: (1) I'd like to read an updated edition, since this was written nearly a decade ago, (2) Angell's stubborn refusal to capitalize "Big Pharma" throughout the book, and (3) there's one assertion that the author makes that I just can't get behind.

I acknowledge that I'm not a doctor, but as an educated medical consumer, I don't buy the idea that individual differences are meaningless and there's no use for new, different "me-too" drugs. Why, then, are race and sex differences in a drug's performance noted in the prescribing information? Personal anecdata: the first two antidepressants I tried didn't work for me at all, and one made me worse; the third worked like a charm. If individual differences didn't matter at all, wouldn't the first medication have helped me?

My doubt on that one point pervaded my reading of this book, but I still found it to be worthwhile reading.

This book teaches you a lot about the flow of money in the Drug Industry. The author, a former editor of the NEJM, knows her stuff but has her own axe to grind -- she wants socialized medicine. The problem with the system now is largely government interference. The government protects and nourishes the drug companies (corporate welfarism) while people demand more care without feeling the cost via govt. services (medicare etc). But this book makes me rethink many of my beliefs simply by overwhelming me with facts -- I love books like that.