Sickening How Big Pharma broke American health care and how we can repair it

John Abramson

Book - 2022

"The inside story of how Big Pharma's relentless pursuit of ever-higher profits corrupts medical knowledge, misleading doctors, misdirecting American health care, and harming our health. The United States spends an excess $1.5 trillion annually on health care compared to other wealthy countries -- yet the amount of time that Americans live in good health ranks a lowly 68th in the world. At the heart of the problem is Big Pharma, which funds most clinical trials and therefore controls the research agenda, withholds the real data from those trials as corporate secrets, and shapes most of the information relied upon by health care professionals. In this no-holds-barred exposé, Dr. John Abramson -- one of the foremost experts on the ...drug industry's deceptive tactics -- combines patient stories with what he learned during many years of serving as an expert in national drug litigation to reveal the tangled web of financial interests at the heart of the dysfunction in our health-care system. For example, one of pharma's best-kept secrets is that the peer reviewers charged with ensuring the accuracy and completeness of the clinical trial reports published in medical journals do not even have access to complete data and must rely on manufacturer-influenced summaries. Likewise for the experts who write the clinical practice guidelines that define our standards of care. The result of years of research and privileged access to the inner workings of the U.S. medical-industrial complex, Sickening shines a light on the dark underbelly of American health care -- and presents a path toward genuine reform."--

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  • Introduction
  • Part I. Health Care American-Style
  • 1. Vioxx: An American Tragedy
  • 2. Neurontin: Fraud and Racketeering
  • 3. The Truth About Statins
  • 4. Insulin Inc.: The Exploitation of Diabetes
  • Part II. Pharma Means Business
  • 5. As American Society Goes, So Goes American Health Care
  • 6. How Doctors Know
  • 7. Manufacturing Belief
  • 8. Market Failure in Medical Knowledge
  • Part III. Moving Forward
  • 9. The Limits of Obamacare
  • 10. The Key to Meaningful Reform: Fix the Knowledge Problem
  • 11. Reform from the Bottom Up
  • Afterword
  • Acknowledgments
  • Notes
  • Index
Review by Library Journal Review

Abramson (Overdosed America) shines a light on the questionable and unchallenged practices of drug companies that guarantee immense profits at the expense of misleading physicians about drug efficacy. The author makes use of his background in pharmaceutical industry research to highlight myriad ways in which both doctors and patients are susceptible to misleading information about drug benefits. Via Abramson's detailed narratives, readers will learn about pharmaceutical industry abuses (e.g., the overprescribing of statins for managing cholesterol; unreasonable prices for insulin, which is cheap to produce) and their negative impacts on patients and health care delivery. Some readers may wish Abramson offered solutions beyond government regulation, but most will be satisfied by his call to work together across industries to provide affordable health care. VERDICT Readers interested in learning about the pharmaceutical industry (plus the ways drugs are introduced to healthcare providers, and the deceptions that get particular drugs into a patient's treatment regimen) may find themselves galvanized by what Abramson reveals.--Rich McIntyre Jr.

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Review by Kirkus Book Review

A family physician and Harvard Medical School lecturer exposes the sordid tactics big pharma uses to jack up drug prices and con doctors about the facts they need to provide good care. Abramson makes a powerful case that, over the past 40 years, profiteering drug companies have played an outsized role in two crises: the soaring costs of health care and America's plunging "healthy life expectancy," ranked 68th in the world in 2019. Linking the problem to a corporate shift to chasing profitability untethered from social responsibility, the author shows how corporations have hijacked sources of information doctors once could trust, such as medical journals, educational conferences, and lectures. The corruption began in the 1990s, when drug companies took control of clinical trials from academic medical centers; 6 out of 7 trials are now funded commercially by sponsors who have no obligation to show their data to medical journals. In an especially alarming chapter, Abramson shows how repeated changes in insulin have made it vastly more expensive for people with diabetes with little--if any--benefit. Companies have also withheld or manipulated facts about statins and popular drugs like Trulicity and Humira, which costs $78,000 per year. "Humira became by far the best-selling drug in the United States," writes the author, "despite the fact that the manufacturer's own study showed that it was no more effective as a first-line therapy for rheumatoid arthritis than methotrexate, which costs 99.5 percent less than Humira." Abramson proposes worthy long-term solutions to the crisis, such as transparency about clinical trial results. But this book, the best on prescription drugs since Katherine Eban's Bottle of Lies (2019), should also have high short-term value for patients, whom it might embolden to question their doctors more aggressively about whether there's an equally effective substitute for a drug with a sky-high price tag. A blistering, persuasive critique of the harms done when drug companies hide the truth about their drugs. Copyright (c) Kirkus Reviews, used with permission.

Copyright (c) Kirkus Reviews, used with permission.