The Big Fix: How the Pharmaceutical Industry Rips Off American Consumers

By Katharine Greider

Book Overview

As the pharmaceutical industry invests more and more in the development of new drugs, true breakthroughs are few and far between. Into the breach comes a panoply of product-line extensions and me-too drugs aimed at grabbing market share. The industry plows its high profits back into research, but invests an equal or greater sum in flogging its products in every imaginable venue. Research studies are designed to support marketing claims. Many doctors all over the country get their first information about new drugs from a salesperson. And, increasingly, prescription drugs are pitched to consumers on TV and the internet with images of hope, terror, or chic. Evidence-based practice guidelines, which endeavor to get the right medicines to those who will benefit most, can't be heard over the din.

Having created an unprecedented number of "megabrands" -- blockbuster drugs with huge sales -- and undergone an extraordinary wave of consolidation, some drug companies now find themselves in a precarious position. Patents are expiring on flagship products. In order to sustain the growth Wall Street has come to expect, these companies must produce billions of dollars worth of new revenue -- fast. But can Americans continue to bankroll Operation Grow Big Pharma? Must we swallow the bad with the good?

• Format: Paperback
• Language: English
• ISBN: 1586481851
• ISBN13: 9781586481858
• Release Date: May 2003
• Publisher: PublicAffairs
• Length: 208 Pages
• Weight: 1.15 lbs.
• Dimensions: 0.6" x 5.5" x 8.4"

Customer Reviews

American Road Kill

The U.S. ranks #1 in amount of healthcare spending per person yet 37th in healthcare performance (World Health Organization). We are second-to-last of industrialized countries listed in disabled persons earning capacity (annex to Society-at-a-Glance 2002) and 17th in life expectancy (U.S. Department of Health and Human Services). Editorialist Nicholas Kristoff cites the C.I.A. World Factbook ranking the U.S. 42nd in infant mortality, a "national disgrace....that the average baby is less likely to survive in the U.S. than in Bejing or Havana" (New York Times; 1/12/05). According to Dr. Kenneth Liegner's testimony before the New York State Assembly Committee on Health (11/27/01), a 7-year-old Lyme disease patient was kept alive on expensive medication until, due to insurance company policy, "she died within one month of cessation of intravenous antibiotic treatment." Liegner adds, "Metropolitan Life Insurance Company had an important formative role in the creation of the National Institutes of Health. This raises the issue of possible ongoing undue influence of the insurance industry in setting national public health priorities". On the other hand, although the U.S. is the only industrialized country with no pharmaceutical price cap, "The National Institutes of Health said rules designed to reduce conflicts of interest at the agency went too far. So instead of barring thousands of employees from owning stock in pharmaceutical and bio-technology companies, only about 200 senior employees will be affected...." ('NIH Revises Ethics Rule on Stock Ownership'; USA Today; 8/26/05). So it's not only insurance companies influencing public health policy. Consider these non-profit healthcare CEO salaries buried in the 'Money' section of USA Today: Catholic Healthcare West CEO--$1 mil. + $896,000 expenses/allowances; Memorial-Sloan Kettering CEO--$2.3 mil. "with 2 surgeons making $1.6 mil. each"; Kaiser Permanente's Foundation Hospital outgoing President--$7.4 mil.; and Universal Health Services CEO--$16.2 million dollars in 2003 ('Non-profit Hospitals Top Salaries May Be Due For a Checkup'; USA Today; 9/30/2004). Non-profit funds are procured under the guise of altruism but become organizational charity theft when used for extravagant salaries. The rationalization is that such salaries are necessary to attract leading professionals within a competitive system, and are a drop in the bucket compared to overall healthcare costs. But isn't that a most terrible commentary on America to say the economy demands we act as pigs with the charity money? Tragically, "Right-to-Life" proponents oppose universal healthcare, practicing socio-economic Darwinism in creating more American road kill.

The Big Fix:

This book made it much clearer to me how the pharmaceutical companies operate. Everyone should read this who takes prescription medications. A must read for all!!

Don't be a victim of Big Pharma's greed

Katharine Greider has given you a rare unbiased look inside the pharmaceutical industry. I know several doctors. They all get 4-6 visits a day from drug "detailers." That's where they get virtually all their prescribing information. Forget about older generics that are just as effective. Forget about the thousands of studies published everyday on natural substances which are as effective, much less expensive with no side effects. A study published in the Journal of the American Medical Association in April, 1998 showed that: In 1994, an estimated 2,216,000 (1,721,000 to 2,711,000) hospitalized patients had serious adverse drug reactions (ADRs) and 106,000 (76,000 to 137,000) had fatal ADRs, making these reactions between the fourth and sixth leading cause of death. Do you really think this has improved in the last 10 years? In December, 2003, at a conference in London, Dr. Allen Roses, a senior vice president of GlaxoSmithKline candidly admitted that fully 90% of prescription drugs only work 30% to 50% of the time. Other countries control drug prices...the same drugs from the same companies for which Americans pay exorbitant prices. Despite two laws passed by Congress since 2000, the FDA, under pressure from drug company lobbyists, still prohibits "reimportation" of drugs from Canada and other countries. States and cities are deliberately challenging the FDA to help their seniors get drugs at reasonable prices from Canada. Busloads of seniors travel from New Hampshire, New York, Michigan and Montana to get their prescriptions filled in Canada. Is this a sensible solution? To fully understand the dynamics of this ridiculous situation, read this book. For example, there are no studies to compare the effectiveness of "new" drugs to those already available (and about to go off patent) or to generics. Does this make sense? Most people are unaware that Costco sells the same drug as the local pharmacy at a 30-80% discount. Anyone can use the Costco pharmacy. By law, you do not have to be a Costco member. Call them for a price quote on your next prescription drug. Fight back, America!

Sick, sick, sick

Did you know that when you or your insurance company plunk down big bucks for your Zocor or Zoloft or Zyrtec, you're paying nearly twice as much as the French and Italians and about a third again as much as the Swedes, Swiss, Germans and Canadians? What for? If you believe the pharmaceutical industry, the high price of your prescription is supporting research that could save your life. And so it does, but not nearly to the extent we've been led to believe. In fact, as you'll learn in this well documented new book, much of that research is done on your tax dollar by Uncle Sam, with the drug companies reaping the profits at little or no expense to themselves. Your drug dollars are also paying for 625 industry lobbyists--a contingent larger than Congress itself. You're also subsidizing anti-consumer legal battles, like the one against that Maine law designed to get competitive drug pricing for Medicaid and uninsured patients that was just upheld by the Supreme Court. And all those lawsuits to prevent or stall low-priced generics from getting onto the market after patents expire. And then there's the annual $2.6 billion in consumer advertising--a tenfold increase in just a decade, and all those free samples and other rewards to doctors. Is this how you want your hard-earned healthcare dollars spent? Do you really want the pharmaceutical industry setting America's drug policy? If not, what can you do about it? Reading this excellent book is a very good place to start.

cogent, revealing, compelling reading

If you've ever stood at the pharmacy counter and wondered why the prescriptions you've just picked up cost so much, this book has the answers. Big Pharma - the major drug companies - need to make big profits, and the author explains how they use the money you pay them. She does it without being sensational or shrill, instead calmly laying out the facts of direct-to-consumer advertising, pharma-sponsored conferences, pharma-sponsored research, vacations and coffee mugs and big consulting fees for doctors. I for one had no idea of the extent of their reach, and I find it shocking and enraging. Big Pharma virtually sets the health agenda, and after reading this book I have a clearer sense of how they do it. I hope our politicians pay heed, and start fixing this disaster.