The Pharmaceutical Industry (Opposing Viewpoints), edited by Jamuna Carroll

Although I must admit that (in contrast to most of the books in this series that I have read), there were no perspectives that quite captured my own complicated feelings towards the pharmaceutical industry, this book was a very telling one. One can tell a lot about something from the quality of one’s friends and one’s enemies, and both of them say a lot when it comes to the pharmaceutical industry, not so affectionately labeled as “big pharma” by its critics. For one, the drug industry seems to have no friends it does not pay for. Just about every voice in favor of the pharmaceutical industry in any way was either an ideological or, more often, a paid lobbyist of the drug industry itself. Just about everyone else included here found themselves to be highly critical of the drug industry. When a business is so toxic (in many ways) that it can only have friends if it engages in bribery and corruption to pay for their support, that speaks volumes about its problems. While most of the perspectives included that were critical of the industry were far harsher than I am, and often had some particularly unrealistic economic assumptions, it is hard to deny the fact that just about anyone who is not being paid to support drug companies has at least some critical things to say about them, and the same would be true for me.

Indeed, one of the things that struck me as the most telling about the position of the drug industry is that it is tactical and dishonest to such a degree that it is self-contradictory. Perhaps this is not something that is widely recognized, but if one compares the position of the drug industry on clinical trials and on the regulation of (vastly cheaper) imports from overseas, the drug industry manages to argue both sides against the other, a sign of real dishonesty and contradiction in their position. This reader, at least, was bemused and not very pleased to see paid lobbyists argue out of both sides of their mouth to say that the FDA was qualified to fairly judge and competently regulate clinical trials despite their problematic biases and police advertising and marketing to allow direct-to-consumer as well as (sometimes deeply misleading) marketing that masquerades as professional education for doctors but is incompetent when it comes to regulating the supply of drug imports that would enter this country if it were freely allowed so that patients could buy their medications at wholesale prices rather than the grossly overpriced levels that are to be found in the United States. Likewise, I found it impossible to take the drug industry’s position about why it is that they hire attractive young women to serve as drug reps whose backgrounds are in marketing and who flirt, bribe, and charm doctors but somehow manage not to improperly influence them with any degree of seriousness. Even if it is not clear what needs to be done about the drug business, it is clear that it is a very shady business indeed.

In terms of its contents, this book is about 200 pages long. The book begins with a series introduction about the Opposing Viewpoints series as a whole as well as an introduction to the book itself. The first chapter of the book asks the question of whether pharmaceutical research is safe and unbiased, with six viewpoints provided, providing opposing perspectives on whether clinical trials save or imperil lives, whether drug industry-funded research is biased or not, and whether requiring that clinical trials be registered would ensure patient safety or hinder drug development. The second chapter of the book contains five somewhat odd perspectives on whether prescription drugs are appropriately regulated, with statements that the FDA actively regulates drug safety, two opposing viewpoints on whether or not terminal patients should be allowed access to unapproved medications, a position paper that the FDA should not allow pharmacists to dispense behind-the-counter drugs, and a statement that the FDA’s black box warnings on antidepressants did not cause an increase in youth suicides. The third chapter examines whether pharmaceutical marketing practices are ethical, with opposing viewpoints on whether or not drug detailing greatly influences doctors’ prescribing habits, whether direct-to-consumer drug marketing educates or harms patients, and whether drug manufacturers’ efforts to “educate” doctors are legitimate and ethical or not. The fourth and final chapter of the book then contains three sets of opposing perspectives that deal with the cost of prescription drugs in America, with debates on whether the cost of prescription drugs is justified or outrageous, whether Americans should be allowed to purchase drugs abroad and ship them to themselves, and whether the government should allow price negotiations for Medicare drugs–a benefit that is paid for by taxpayers, it should be noted. Each chapter of the book ends with a periodical bibliography, and the book ends with issues for further discussion, organizations to contact, a bibliography of books, and an index.