Book Note: The Truth About the Drug Companies
Just completed a book I’ve been meaning to get to for some weeks
|The Truth About the Drug Companies: How They Deceive Us and What to Do About It|
While it’s gotten to be pretty easy to pick on the pharmaceutical industry of late, this laser-focused book does more than just lob a few broadsides. It pretty much eviscerates every one of the major arguments put forth by the pharmaceutical industry for their practices.
The author is Dr. Marcia Angell, who has had a front-row seat having worked on the staff of the New England Journal of Medicine for 20 years – winding up her career there as Editor In Chief in the late ‘90s. It’s hard to over emphasize the gravity of someone of Dr. Angell’s experience and stature writing a book like this that, as far as I can tell, doesn’t pull a single punch. I suppose it shouldn’t be an enormous surprise, She is married to Dr. Arnold Relman whose book A Second Opinion does much of the same for the entire practice of medicine in the US.
|A Second Opinion: Rescuing America’s Health Care|
Though this book is kinds long-in-the-tooth by medical policy issues standards (having been published in 2004) it’s not just a little depressing to note that the fundamentals haven’t changed (although, I should be fair and note that there have been some changes in the margins – will get to those in a bit)
So, what are the big takeaways, just in case you don’t read the book . Well, here are a few:
- By any objective measure, pharmaceutical companies pay *at least* twice as much for marketing and promotion of their products as they do for research and development of products. It might do well for you to really take that in. An industry that constantly bombards you with the holier-than-thou pronouncement of the centrality of their products to life itself, spends at least twice as much in marketing and promotions than it does for the actual science.
- ‘Education’ to physicians and other care providers, is actually nothing more than a form of marketing. Everyone knows this but most choose to remain silent and play along
- ‘Research’ (i.e. many of the clinical trials used to tout the capabilities of drugs) are nothing more than marketing in disguise. This is especially the case for the ‘Phase IV’ trials that take place after a drug has come to market. These trials are almost exclusively biased towards enabling the results to be used as marketing and promotions fodder – not for the purpose of actually determining the effectiveness of the drug or comparing its effectiveness with other treatments.
- The price-fixing of the cost of drugs in the US (brought to you by millions of dollars in lobbing might heaped on your local legislators) is a putrid, steaming pile of excrement that is hard to believe those in charge sit in every day without expiring from the fumes.
Now, to be clear, I’m clearly not against pharmaceuticals, per se. We are able to live longer, healthier lives because of the breakthroughs in pharmaceuticals. There is a point at which one has to ask: are the benefits that are accruing to us now worth the cost?
Not only does Dr. Angell lay it on pharma, she also makes a few, common-sense suggestions for you, the consumer, to consider when encountering the medical care system:
When your doctor prescribes something, ask:
- Where’s the evidence this works at all, or better than another, older, drug?
- Are you getting your ‘evidence’ from the pharma rep, or was there an independently-funded, well-designed clinical trial that proved it was better?
- Do you have any financial ties related to the prescription?
- Ask your elected representatives if they receive contributions from the pharmaceutical industry.
- Ignore direct-to-consumer ads for prescription drugs.