Pharma Greed, lies, and the poisoning of America

Gerald L. Posner

Book - 2020

Pharmaceutical breakthroughs such as antibiotics and vaccines rank among some of the greatest advancements in human history. Yet exorbitant prices for life-saving drugs, safety recalls affecting tens of millions of Americans, and soaring rates of addiction and overdose on prescription opioids have caused many to lose faith in drug companies. Now, Americans are demanding a national reckoning with a monolithic industry.

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Subjects
Published
New York : Avid Reader Press 2020.
Language
English
Main Author
Gerald L. Posner (author)
Edition
First Avid Reader Press hardcover edition
Physical Description
xi, 802 pages ; 25 cm
Bibliography
Includes bibliographical references (pages 541-573) and index.
ISBN
9781501151897
  • Preface
  • 1. Patient Zero
  • 2. The Poison Squad
  • 3. Enter the Feds
  • 4. The Wonder Drug
  • 5. "Could You Patent the Sun?"
  • 6. An Unlikely Trio
  • 7. A One-Atom Difference
  • 8. A "Jewish Kid from Brooklyn"
  • 9. Medicine Avenue
  • 10. The Hard Sell Blitz
  • 11. A Haven for Communists
  • 12. The Puppet Master
  • 13. Fake Doctors
  • 14. A "Sackler Empire"
  • 15. "Be Happy" Pills
  • 16. "The Therapeutic Jungle"
  • 17. "Paint the Worst Possible Picture"
  • 18. Thalidomide to the Rescue
  • 19. The $100 Million Drug
  • 20. Legal but Somehow "Shifty"
  • 21. Targeting Women
  • 22. Death with Dignity
  • 23. "Go-Go Goddard"
  • 24. "Here, Eat This Root"
  • 25. "They Clean Their Own Cages"
  • 26. "Splashdown!"
  • 27. "Tell Him His Lawyer Is Calling"
  • 28. A New Definition of Blockbuster
  • 29. "Kiss the Ring"
  • 30. The Temple of Dendur
  • 31. "Valiumania"
  • 32. Swine Flu
  • 33. "Black River"
  • 34. "Everything Can Be Abused"
  • 35. The Age of Biotech
  • 36. A "Gay Cancer"
  • 37. "None of the Publics Damned Business"
  • 38. A Pain Management Revolution
  • 39. Enter Generics
  • 40. Selling Hearts and Minds
  • 41. "No One Likes Airing Dirty Laundry in Public"
  • 42. "The Sales Department on Steroids"
  • 43. "$$$$$$$$$$$$$ It's Bonus Time in the Neighborhood!"
  • 44. Talking Stomachs and Dead Presidents
  • 45. "We Have to Hammer on the Abusers"
  • 46. "Giving Purdue a Free Pass"
  • 47. "You Messed with the Wrong Mother"
  • 48. Profits and Corpses
  • 49. Gaming the System
  • 50. Billion-Dollar Orphans
  • 51. The Coming Pandemic
  • 52. "Essentially a Crime Family"
  • Acknowledgments
  • Bibliography
  • Notes
  • Index
Review by Booklist Review

A more apt subtitle might be "Everything anyone wanted to know about the drug industry but was afraid to ask." Emphasis on the "afraid." Fraud, incompetence, conspiracy, avarice: it's all here, and to read best-selling, award-winning Posner's (God's Bankers, 2015) encyclopedic exposé of the pharmaceutical industry and the government's role in its development and regulation is to peer into a Pandora's box of malfeasance, perfidy, and corruption. Explosively, even addictively, readable, Posner's meticulously documented investigation of the historical roots and contemporary state of Big Pharma examines everything from aspirin to Zantac, beginning with the naive use of heroin and cocaine in the 1800s and moving into the opioid epidemic of the 2000s, as government regulatory involvement waxed and waned while the pharmaceutical industry morphed into a monolith that emphasized investor wealth over patient health. Making Posner's corporate history even more topical is its through line following the notoriously headline-grabbing Sackler family as they created and manipulated a medical juggernaut that revolutionized the way pharmaceuticals are developed, manufactured, and marketed. Their role in the current drug catastrophe is unmistakable and byzantine. As this and other drug-related stories continue to dominate the news, who better than a determined and prolific investigative journalist to provide the context necessary to understand and correct the crisis.

From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review

Journalist Posner (God's Bankers) chronicles the historical abuses of the American pharmaceutical industry in this sprawling jeremiad. Beginning in the mid-19th century, when the Mexican-American and Civil Wars caused "an unprecedented surge for antiseptics and painkillers," Posner explains how the addictive nature of opiate-based remedies and lack of government oversight benefitted pharmaceutical pioneers. The race to develop and manufacture penicillin during WWII and the granting of the first antibiotic patent in 1948 launched an era of "wonder drugs" that produced huge profits and drove changes in the way drugs were sold and marketed. Posner places Arthur Sackler, a psychiatrist and medical advertising executive, at the forefront of those developments, documenting his contributions to the groundbreaking rollout of Pfizer's Terramycin antibiotic in 1951; his purchase of drugmaker Purdue Frederick Company; and his tangles with the FBI (for alleged links to Soviet spies) and Congress (for deceptive advertising practices) in the 1960s. Under the leadership of Arthur's nephew, Richard Sackler, Purdue developed and aggressively promoted the painkiller OxyContin in the 1990s, and its rampant overprescription, high dosage recommendations, and easily bypassed "extended release shell" significantly contributed to the opioid crisis. Posner's research impresses, but the blizzard of details often proves more disorienting than enlightening. This door stopper yields damning revelations but would benefit from a sharper focus. (Mar.)

(c) Copyright PWxyz, LLC. All rights reserved
Review by Library Journal Review

Investigative journalist Posner (Hitler's Children) employs extensive, meticulous research in this exploration of the U.S. pharmaceutical industry, tracing its evolution from 19th century nostrums to 21st century billion-dollar drugs. Through it all, he notes the tension between the desire to help humanity and the greed that casts a shadow over the industry. The push to develop antibiotics with the onset of World War II marked the beginnings of the modern industry. After the war, companies focused on searching for new drugs and extending patents on existing ones by making small changes in their composition. Posner also describes the rise of orphan drugs, which are used to treat rare medical conditions, and how they allowed companies to squeeze new money out of drugs previously considered unprofitable. Telling the story of generics, direct-to-consumer advertising, swine flu, Ebola, HIV/AIDS, ineffective government oversight, and the current opioid epidemic, Posner leaves no stone unturned. Threaded through this history of modern pharmaceuticals is the story of the Sackler family of Purdue Pharma fame. Posner uses one family's unscrupulous greed as symbolic of the corruption in big pharma. VERDICT A lengthy, yet fast-paced read that should interest anyone who is watching the rising cost of medicine with dismay.--Caren Nichter, Univ. of Tennessee at Martin

(c) Copyright Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Review by Kirkus Book Review

Of nightmare germs, sleazy dealings, and the big money that fuels the (legal) drug trade.Investigative journalist Posner writes that big pharma "resides at the intersection of public health and free enterprise," sometimes capable of lifesaving acts but often an agent of unbridled greed. The industry emerged in the 19th century with the need to care for wounded soldiers and new strains of epidemic diseases such as yellow fever and cholera. In the early days, firms had a lock on certain broadly applied medicamentsmorphine, in the case of Pfizer. A century later, when physician Arthur Sackler came onboard, Pfizer had just a handful of salespeople; Sackler forged an army of thousands of them, fanning out to sell drugs he had developed, such as Valium, to a waiting audience. In time, Sackler came under federal scrutiny, a bte noire of crusading Sen. Estes Kefauver, who "was bothered by an industry where only a few firms dominated sales and had unfettered discretion to set prices." Moving on to the family-owned Purdue Pharma, Sackler and kin refined techniques of secrecy and underreporting. As Posner notes, it was a firing offense for a salesperson to make notes on visits to doctors in writing, and what went on behind closed doors were all sorts of spoken inducements and rewards for prescribing and overprescribing the firm's products, including OxyContin. Even in Kefauver's time, the U.S. pharmaceutical industry was making many multiples more profit than other sectors of the economy, charging far more to American consumers and insurers than to those in other parts of the world. This was true of the AIDS-battling AZT, "the highest priced drug on the planet." This remains true today, even as Purdue, heavily fined for its role in an epidemic of opioid-overdose deaths, tiptoes into bankruptcy, one ploy in the "complex corporate chess game in which Arthur Sackler excelled."A shocking, rousing condemnation of an industry clearly in need of better policing. Copyright Kirkus Reviews, used with permission.

Copyright (c) Kirkus Reviews, used with permission.