A hit job on the drug companies
10/11/2004, Volume 010, Issue 05

By Robert Goldberg

Books in Brief

The Truth About the Drug Companies: How They Deceive Us and What To Do About It by Marcia Angell (Random House, 305 pp., $24.95). The promotional materials proclaim this a "deeply disturbing book." And it is. The Truth About the Drug Companies is a hatefest. Angell, former editor of the New England Journal of Medicine, thinks the pharmaceutical industry is nothing but profiteering corporations that spend money marketing me-too products instead of trying to make medical breakthroughs.

About the facts, Angell is often wrong. She claims, for instance, that prescription drug costs are the "fastest growing part of the health care bill," though, in fact, hospitals are. Where she isn't wrong, she simply distorts or ignores contrary facts. She claims it costs $100 million to develop a new drug, an estimate she got from a Nader group--and she rejects the estimate of $802 million published in the leading peer-reviewed economic journal, because "economic and finance theories are not required to accord with most people's experience, as they would be in the natural sciences."

The Truth About the Drug Companies also claims there is no real evidence that any one drug is better than another or that most medicines really do much at all. And Angell goes as far as to say: "the idea that patients respond differently to me-too drugs is merely an untested and self-serving hypothesis." Rather, she says, "one or two drugs will do" for most medical conditions. Thereby, she ignores recent work by economist Frank Lichtenberg who found that for each additional dollar spent on newer medicines, total health care spending is reduced by $6.17.

Finally, Angell asserts that every breakthrough drug started without drug company involvement. She claims that Gleevec, the first cancer drug to target cancerous cells without side effects, was developed without any real input from Novartis, the company that makes the product. Angell says that Brian Druker, a cancer researcher at Oregon Health and Science University, said that Novartis showed little interest in the cancer compound until he discovered its tremendous properties. The real story--from the Journal of the National Cancer Institute--reflects the risky and collaborative nature of drug development, which requires massive capital and biopharmaceutical know-how to turn discoveries into effective treatments. An academic researcher and private company, working together, launched a revolution in the treatment of cancer. You wouldn't know it by reading Angell.

Angell wants government to control all drug research and drug prices. She wants the government to prohibit any new drug from coming to market unless it can be shown to be better than the ones already there. If you read her book, you can't help thinking that if drug companies disappear we won't miss them. But The Truth About the Drug Companies is not truth at all. It reminds me of what Mark Twain once wrote: "I am not one of those who in expressing opinions confine themselves to facts." Twain wrote fiction. Then again, so has the former editor of the New England Journal of Medicine.

--Robert Goldberg

© 2004 The Weekly Standard

About Robert Goldberg: articles, bio, and photo