A blistering, persuasive critique of the harms done when drug companies hide the truth about their drugs.

SICKENING

HOW BIG PHARMA BROKE AMERICAN HEALTH CARE AND HOW WE CAN REPAIR IT

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.

Pub Date: Feb. 8, 2022

ISBN: 978-1-328-95781-8

Page Count: 336

Publisher: Mariner Books

Review Posted Online: Dec. 10, 2021

Kirkus Reviews Issue: Jan. 1, 2022

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Gates offers a persuasive, 30,000-foot view of a global problem that, he insists, can be prevented given will and money.

HOW TO PREVENT THE NEXT PANDEMIC

The tech mogul recounts the health care–related dimensions of his foundation in what amounts to a long policy paper.

“Outbreaks are inevitable, but pandemics are optional.” Thus states the epidemiologist Larry Brilliant, a Gates adviser, who hits on a critically important point: Disease is a fact of nature, but a pandemic is a political creation of a kind. Therefore, there are political as well as medical solutions that can enlist governments as well as scientists to contain outbreaks and make sure they don’t explode into global disasters. One critical element, Gates writes, is to alleviate the gap between high- and low-income countries, the latter of which suffer disproportionately from outbreaks. Another is to convince governments to ramp up production of vaccines that are “universal”—i.e., applicable to an existing range of disease agents, especially respiratory pathogens such as coronaviruses and flus—to prepare the world’s populations for the inevitable. “Doing the right thing early pays huge dividends later,” writes Gates. Even though doing the right thing is often expensive, the author urges that it’s a wise investment and one that has never been attempted—e.g., developing a “global corps” of scientists and aid workers “whose job is to wake up every day thinking about diseases that could kill huge numbers of people.” To those who object that such things are easier said than done, Gates counters that the development of the current range of Covid vaccines was improbably fast, taking a third of the time that would normally have been required. At the same time, the author examines some of the social changes that came about through the pandemic, including the “new normal” of distance working and learning—both of which, he urges, stand to be improved but need not be abandoned.

Gates offers a persuasive, 30,000-foot view of a global problem that, he insists, can be prevented given will and money.

Pub Date: May 3, 2022

ISBN: 978-0-593-53448-9

Page Count: 304

Publisher: Knopf

Review Posted Online: April 13, 2022

Kirkus Reviews Issue: May 1, 2022

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Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.

GOOD ECONOMICS FOR HARD TIMES

“Quality of life means more than just consumption”: Two MIT economists urge that a smarter, more politically aware economics be brought to bear on social issues.

It’s no secret, write Banerjee and Duflo (co-authors: Poor Economics: A Radical Rethinking of the Way To Fight Global Poverty, 2011), that “we seem to have fallen on hard times.” Immigration, trade, inequality, and taxation problems present themselves daily, and they seem to be intractable. Economics can be put to use in figuring out these big-issue questions. Data can be adduced, for example, to answer the question of whether immigration tends to suppress wages. The answer: “There is no evidence low-skilled migration to rich countries drives wage and employment down for the natives.” In fact, it opens up opportunities for those natives by freeing them to look for better work. The problem becomes thornier when it comes to the matter of free trade; as the authors observe, “left-behind people live in left-behind places,” which explains why regional poverty descended on Appalachia when so many manufacturing jobs left for China in the age of globalism, leaving behind not just left-behind people but also people ripe for exploitation by nationalist politicians. The authors add, interestingly, that the same thing occurred in parts of Germany, Spain, and Norway that fell victim to the “China shock.” In what they call a “slightly technical aside,” they build a case for addressing trade issues not with trade wars but with consumption taxes: “It makes no sense to ask agricultural workers to lose their jobs just so steelworkers can keep theirs, which is what tariffs accomplish.” Policymakers might want to consider such counsel, especially when it is coupled with the observation that free trade benefits workers in poor countries but punishes workers in rich ones.

Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.

Pub Date: Nov. 12, 2019

ISBN: 978-1-61039-950-0

Page Count: 432

Publisher: PublicAffairs

Review Posted Online: Aug. 29, 2019

Kirkus Reviews Issue: Sept. 15, 2019

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