A searing indictment of “Big Pharma” offers specific recommendations for change.

British pharmaceutical industry consultant Rees (Supply Chain Management in the Drug Industry, 2011) takes aim at the fundamental manner in which drug companies do business in a book that calls for nothing less than a massive overhaul. Tracing big pharma’s emphasis on blockbuster drugs to an early 1980s marketing war between two stomach-ulcer drug brands, the author demonstrates that patents have continued to drive drug companies’ business strategies today. Their approach, Rees writes, has “involved finding a promising patented compound (Find It), placing it into a development pipeline intended for regulatory approval to market (File It), and then marketing the approved product with the utmost verve and vigor (Flog It).” The book delves into exactly how pharmaceutical companies operate (it is quite similar in Europe and the United States), exploring the inner workings of the industry via text and diagrams. One of the more remarkable aspects exposed is the fact that big pharma companies “have little or nothing to do with operations in the distribution network”; in fact, only three distributors in the United States control about 80 percent of the market. This, according to the author, is typical of big pharma: “Today, hardly anything hasn’t been outsourced to some extent.” Of larger consequence is the fact that the failure rate in drug development remains so high: “For every 250 compounds that enter the development pipeline, 249 fail to reach their destinations.” Unfortunately, the solution to this pervasive malaise is “to adopt a totally different approach toward product development,” Rees writes. This is perhaps where the greatest strength of this deft volume emerges. In addition to his own suggestions for change (including recommending that regulators require “companies to obtain licenses to develop drugs beyond the prototype phase” and “postmortems on all failed drugs to establish what went wrong”), the author makes extensive use of interviews he conducted with numerous professionals, offering their input as expert witness statements. This technique immediately legitimizes the author’s perspective and makes the book far more powerful than if it were written in his voice alone. This is not an empty diatribe—it is a necessary wake-up call for an industry apparently blinded by profit. 

A thoroughly researched and considered industry critique that includes substantive, visionary ideas for rehabilitation.