Drug companies under attack

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THE TRUTH ABOUT THE DRUG COMPANIES: HOW THEY DECEIVE US AND WHAT TO DO ABOUT IT

By Marcia Angell, M.D.

Random House, $24.95, 336 pages

America's pharmaceutical industry is under attack. Critics have pejoratively nicknamed the industry "Big Pharma" (to conjure up an image of it in a line-up next to "Big Tobacco") and characterize it as uncaring, duplicitous, profit-hungry and manipulative. The resentment of the industry is palpable -- whether in my own conversations with relatives and friends (particularly elderly and/or infirm ones) or in Congress, where advocates are demanding the legalization of drug importation from Canada and elsewhere in a desperate (and in the long run, futile) attempt to bring prices down.

Perhaps nowhere does the strident criticism of the industry come together in a "perfect storm" as it does in Marcia Angell's new book, "The Truth About the Drug Companies: How They Deceive Us and What to Do About It."

Dr. Angell comes to this attack with impeccable credentials: She spent years as editor of the prestigious "New England Journal of Medicine," and for that reason alone she is a force to be reckoned with. Her take-home message is this: Big Pharma is depriving poor and middle-class citizens of the life-saving, life-enhancing drugs they deserve by charging exorbitant fees -- and making people choose between having food in the refrigerator or medicine in the cabinet.

Further, she opines that the industry, which describes itself as innovative and research- and development-oriented, actually produces few new drugs, only pumping out "me too" or copycat versions. Dr. Angell recommends radical measures: in effect, that the government take over the industry and treat it as a public utility.

Her arguments, however, are contradictory, inconsistent and often in error. For example:

She claims in the same breath that a) essential life-saving medications are withheld from needy people by greedy companies, and b) people are unnecessarily medicated, that drugs do not work, and there are no truly innovative drugs out there. Which way is it? Are drug companies saving lives with spectacular new drugs or are they not?