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Rating: 
Summary: Masterful expose, but some blind spots.
Review: A masterful work on the exaggerations by Big Pharma on the cost of developing new prescription drugs. Tells detailed stories of the development of erythropoietin (Epo), Ceredase, Replagal, AZT and triple cocktail for AIDS, Cisplatin, Taxol, Erbitux, sulfanilamide, Tagamet, Zantac, Prilosec, Nexium and others. The stories are easy to understand and back up Goozner's contention that most real breakthroughs in drug development are the result of long years of work by academics or in government labs (NIH), and occcasionally by biotech firms, usually not by the Big Pharma companies.
Goozner confirms others in noting that about 4/5ths of "new" drugs, while being new molecules, are similar to others on the market. This consumes most of Big Pharma's research and sales dollars. He shows that simply purifying a drug to sell one of two isomers (left-handed, say, not mixed left- and right-handed) will get a new drug approval from the FDA (Nexium vs. Prilosec, I think). Sometimes this is valuable for patients, but not always. In ibuprofen it does not matter.
Goozner carefully works out the cost of a typical new drug launch at $100 to $200 million, a lot, but not $800. Many details are explained, such as orphan drugs, and access for compassionate use. Some of the perversions of drug trials are exposed, such as failure to compare a new drug with the best previous one. The limitations of newer NSAIDS (Celebrex, Vioxx) and many anticancer drugs are brought out.
This book has good good academic referencing and a good index. So why only 4 stars? The layout, some of the chemistry and some of the pharmacology.
Each paragraph is a gem of understandable prose. From p229: "As the twenty-first century dawned, the drug industry's search for new drugs to replace old ones coming off patent became frenzied. There were fifty-two drugs with more than $1 billion in sales in 2000, but forty-two were slated to lose their patent protection by 2007. The drugs that account for fully half the industry's sales were on the cusp of low-cost, generic competition. But instead of looking for truly innovative medicines, which are dependent on the maturation of biological understanding and even then are difficult to find, an increasing share of the industry's research and development budgets turned to the search replacement ["me-too"] drugs..." However, I found it hard to read this book for more than 20-40 mintues at a time. There are no tables, graphs, photos, section headings or sub-section headings; it is one continuous mass of text except for chapter headings, most of which are cute, but do not explain what is on the chapter.
Occasionally people are mentioned with no context (Kessler, p145).
Chemically, the most serious error was confusing positional isomers on a benzene ring with left- and right-handed forms of a drug, which depend on the positions of 4 different substituents on a carbon atom (p221). These are called "optical isomers". Only exact mirror image compounds are called enantiomers.
Pharmacologically, Goozner was not aware of the misleading effects of lead time bias (earlier detection on 5-year survival rates in cancer. He overstated the benefits and understated the risks of cisplatin and Taxol, not looking for all-cause death rates. Conversely, he took at face value the claims for anticholesterol and blood pressure drugs, which have very few benefits long-term. He missed that the ALLHAT trial of blood pressure drugs had no placebo (p248), so based on earlier trials that did, no standard drug treatment for moderately high blood pressures is worthwhile. See: Joel M. Kauffman, Bias in Recent Papers on Diets and Drugs in Peer-Reviewed Medical Journals, J. Am. Physicians & Surgeons, 9(1), 11-14 (2004).
Still, this book is a valuable reference to have.
Rating: 
Summary: Definitely worth reading
Review: I found this book fascinating, informative and thought-provoking. It examines how the current system for bringing new drugs to market works, what the short-comings of this system are, and how it could be improved to get more benefit from the money that tax-payers and users of health services (whether by paying directly for drugs or through insurance premiums)contribute.Although this could have become a really dry exercise in economics or a political tirade agains drug companies, instead it contains a series of stories which track the development of some of the major "breakthrough" drugs in recent history. We are introduced to people who dedicated their lives to finding a cure for a single disease and read about the many set-backs and struggles that they had to go through to achieve this goal. The medical information that is explained in the course of these stories was, for me, one of the most interesting aspects of the book
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Summary: A Weiss, author of the BackSmart Fitness Plan
Review: I found this subject very interesting, the book is well thought out and very informative.
Rating:
Summary: Superb, with a clear agenda
Review: I won't discuss the content of the book, as many have already done so. I will merely mention the aspect of the book that struck me the most - Mr Goozner's suggestion that there doesn't need to be a pharmaceutical industry at all. The amount of work that took place at NIH and NIH-funded labs on so many key compounds surprised even me, and I work in Big Pharma clinical development. The perfidy of companies like Burroughs-Wellcome, who resisted working with live HIV after the NIH was ready to hand over a nearly complete clinical program to them for AZT, was breath-taking. The newest industry propaganda website on medical advances (I refuse to provide a link) highlights the development of AZT, Taxol, etc with the implied message that they provided those medicines to the public. Read this, and you won't be able to stomach those Lane Armstrong Schering ads any more.
Rating:
Summary: Highly Recommended
Review: There is so much BS coming out of the pharmaceutical industry these days that it's refreshing to read something that has the ring of truth to it. The author has done his homework.
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Summary: Scamming Of America By Big Pharma
Review: This book tells the truth behind the cost of new drugs. Why do life-saving prescription drugs cost so much? American taxpayers are getting bamboozled by paying for government-funded research with their taxes and then by paying sky-high prices for the drugs resulting from the research.
The first question is why do new drugs cost so much? The second question is how many of these new drugs are truly highly-effective and life-saving?
Rating:
Summary: Highly Recommended
Review: This is a superbly researched and well written book explaining the scamming of America by Big Pharma. We have the only government in the world which allows this industry to price gouge the citizenry. Please read this book and tell your friends. You can find out more about this issue at www.rxsanity.org
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Summary: WHERE ARE YOU WHEN WE NEED YOU, FATHER GREENSPAN?
Review: With prices for drugs going through the roof, you would think Father Alan Greenspan, who claims to be constantly worried about inflation, would be hysterical about this issue. Not!
Many thanks to the author for throwing darts at the true cause of the problem...the drug companies and their backers in Washington.
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