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Bitter medicine

The Truth About Drug Companies: How They Deceive Us and What to Do About It By Marcia Angell, M.D.

On the Take: How Big Business Is Corrupting American Medicine By Jerome Kassirer, M.D. Oxford University Press. 288 pages, $26. Every author should be so lucky.

While Jerome Kassirer and Marcia Angell were holed up in their offices, typing away, Congress launched an investigation into financial entanglements between industry and the National Institutes of Health. Then Pfizer was hit with nearly half a billion dollars in fines for paying doctors hype its anti-seizure drug Neurontin for unapproved--and largely unproven--uses.

Now, New York state attorney general Eliot Spitzer has accused another drug giant, GlaxoSmithKline, of burying evidence that the antidepressant Paxil can trigger suicide. It's great news for Angell's and Kassirer's book sales, bad news for the rest of us. These stories about the unholy alliance between the pharmaceutical industry, researchers, and doctors may have seemed, to the casual observer, like nothing more than isolated blips.

Sad to say--as these surprisingly bare-knuckled books by the last two editors-in-chief at the New England Journal of Medicine make clear--such accounts provide a mere glimpse of the corruption of medical science. In the last two decades, the drug and biotech industries have gained unprecedented leverage over what doctors and patients know--and don't know--about the $200 billion worth of prescription pharmaceuticals consumed by Americans each year. Industry has gained that leverage by funding and, increasingly, controlling medical research.

It has also used its deep pockets to effectively buy the loyalty of physicians in private practice and to sway the opinion of thought-leaders in academia. Grasp the full scope of industry influence over medical science and practice, and it's enough to make anybody think twice before filling a prescription.

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