SICKENING

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.