Sickening: How Big Pharma Broke American Health Care and How We Can Repair It by John Abramson

Sickening: How Big Pharma Broke American Health Care and How We Can Repair It Reviews

• 
  Ell

  This book is exceptional! If you read just one book in 2022, choose this one. It’s an eye-opening look into the sobering statistics and tactics used in the American healthcare system, specifically in regard to pharmaceutical companies. It is information every American should have to empower them to make better decisions regarding their health. The author of this book is a medical doctor and researcher. He has intimate knowledge about the industry he writes about. The information is presented in a very easy-to-read format, is educative, and it keeps the reader turning the pages. It is decidedly not gloom and doom. It’s an earnest dialogue of what has happened and ponderings of how to right the proverbial ship. Five stars.
• 
  Teal Veyre

  Before you read any further: I'm not anti-medication. Medication is important and necessary for many people. THAT is exactly why I'm so passionate about wanting to live in a world where patients can trust what their doctors tell them about drugs. Right now, they can not, because doctors don't even have access to all of the information about the drugs. Shouldn't we all want a world where doctors can actually look at the raw data of clinical drug trials?
  
  This book was written by a doctor, a professor at Harvard Medical School, and an expert witness in many trials where drug companies were punished for intentionally misleading doctors about the benefits and harm of their drugs. Like this Phizer trial:
  https://www.justice.gov/opa/pr/justic...
  
  I swear every time I start talking about the problems with pharma's influence over doctors, people think I'm on some facebook meme QAnon Lizard People other shit. But I am not. Dr. John Abramson is about as legit and mainstream as it gets. Hell, the federal government has called him in to serve as an expert witness against pharma corporations. Sorry, but HOW in the world can I prove my point that pharma does harm, if THIS GUY isn't mainstream and credible enough of a source?
  
  Here is the sad truth of it: Many people can't bear to acknowledge that many medications are dangerous and harmful, because they have family members on those medications. Rather than dealing with their own icky feelings about the fact that they were a part of this, they shut their ears, choosing their own feelings over the long-term health of their family members.
  
  But what if we lived in a world where....
  1) Conflicts of interest between pharma and all medical professionals (doctors, professors in medical schools, and members of all esteemed professional organizations such as the APA) were legally prohibited by law.
  2) Drug trials were conducted independently by the FDA without any funding from pharma. This would not cost taxpayers more money. It would greatly decrease the amount of people on permanent disability. So many drugs cause Akathisthia, dementia, permanent brain damage (I'm looking at you neuroleptics and anti-psychotics more broadly). Drugs would be safer and the harm more openly communicated if we could get pharma influence out of research. Therefore less people on disability and less money spent on their overall health.
  
  
  This is all I want to happen in the world. If pharma didn't influence doctors and control the research, I'm so confident that we would have safer and more effective drugs, and better patient care overall.
  
  Doesn't everyone want that?
  
  Everyone needs to read this book. He delves deep into so many important issues.
  
  Yes, the book is boring AF. Not everything in life is entertaining. Some things are important enough to have some discipline, buckle down, and make yourself focus.
  
  Thank you thank you thank you to Dr. John Abramson for writing this book.
• 
  Donna

  This is Nonfiction/Health/and believe it or not...Economics. First, the title is perfectly appropriate for this one. And it definitely should promote conversation and hopefully change. The message, whether you agree with it or not, is one that needs to not only be heard but researched, debated and thought about.
  
  Now with all of that said, I didn't enjoy this one. I'm not sure if it was the tone of the book or the tone of the narrator, but this one was a struggle to stay with. The author liked his pedestal role in this one, and his pedestal was so high it was hard to develop a positive reaction on my part. So even though it felt 1 star, the light shed on the need for change was much higher than just 1 star. So I'll settle for 3.
• 
  Barbara Clarke

  I have no doubt that John Abramson meant well in writing this book about the role of BigPharma but that's about as much praise as I can muster. And here's why - this is just another book among many where docs, scholars, journalists - all competent - write about the broken healthcare system and then as their answer - well, we patients need to come together and start a movement, get congress off their butts to give two figs about our health and economic destruction from medical bills and poor and/or over treatment. The pharma industry is just one of the many members of the cabal who have a lock on both congress, political leadership, and any possibility for change.
  
  This week, while I was skimming this book - another so what's new? reading experience - I saw Bernie Sanders on Fox News in a live debate with Lindsey Graham over healthcare, etc. Something snapped in me - how totally absurd that since maybe FDR and certainly Truman, congress doesn't think we have enough money to provide a full-on system paid for by taxes rather than making the insurance companies rich and tying people to crap jobs just for benefits. And now, we use benefits against workers forming unions - what a country!!
  
  And now we have VCs "investing" as well. We have billions upon billions for weapons but can't actually admit that the health of constituents is of such great importance, no debate is necessary. This is the height of an absurd cruelty that not even John Abramson can admit to or call out. Instead, he has a weak to-do list like all of the other pundits, who when challenged cough up the joy of Obamacare as some kind of half-baked answer. If I were Obama, I'd ask to have my name removed.
  
  This is all too pathetic and am going to take a break from this kind of book even though as someone who once worked in the industry. I'm always curious to see if anyone has the guts to actually do anything about what we call our world-class system. But all of the usual suspects and more every day are smelling money in the bloody water like the immoral sharks that they are. Oh, right - it would be socialism and we can' have that! Poor Lindsey - I can't wait to see you have the senate door hit you in the butt on your way out.
• 
  Dennis Miller

  Pharma has clearly succeeded in pulling the wool over the eyes of the public. Has Pharma succeeded in doing the same with pharmacists?
  
  John Abramson, M.D., has been one of my heroes since 2004 when his first book “Overdosed America” was published. Unfortunately he is NOT the hero of a lot of pharmacists. As I explained in detail in my book “The Shocking Truth About Pharmacy: A Pharmacist Reveals All the Disturbing Secrets,” a very large number of pharmacists do not like people who write books critical of Pharma.
  
  Pharmacy is different from a true science because we as pharmacists have a strong financial incentive to not question the dominant narrative in our profession--better living through chemistry. Criticizing pills is bad for business. A pharmacist who uses his position in chain drug stores as a platform to promote reform in the pharmaceutical industry is seriously jeopardizing his employment.
  
  In my opinion, very many chain store pharmacists view pharmacy more as a business than a science. I believe you are naive if you view pharmacists as akin to skeptical scientists who have no horse in the race. We make our living by selling pills, not by encouraging people to learn how to prevent illness.
  
  I’m now retired but I worked in chain drug stores for my entire career. Chain store pharmacists feel subtle yet powerful pressure from our corporate bosses to be positive about the pills we dispense. Besides our financial interest in downplaying adverse effects of drugs, there’s the psychological conflict (cognitive dissonance) resulting from trying to juggle the need to be positive about pills with our knowledge that many pills are a double-edge sword. Unfortunately the balance has tilted too far in the wrong direction because of a hugely powerful and corrupt pharmaceutical industry.
  
  Pharmacists seem to believe that the products we dispense are based on science when, in fact, most are based on marketing. Pharmacists are dispensing the products of an industry that routinely engages in lies, distortions, and magical thinking.
  
  Pharmacists increasingly play the role of legitimizing Big Pharma’s products which are, in fact, quite often clouded by very serious concerns such as FDA’s becoming a captive of the drug industry, Big Pharma’s immense clout over the US Congress, and Pharma’s corrupt influence over drug research.
  
  The public’s definition of “safe and effective” is clearly vastly different from the FDA’s definition. This leads to a reality in which commonly prescribed drugs are often linked to tumors and cancers in lab animals (read the Carcinogenesis and Mutagenesis section in the labeling). Black box warnings are too often added to the labeling years after the FDA approved a drug. Drugs are withdrawn from the market due to safety issues that were not discovered in clinical trials.
  
  The FDA is clearly not the watchdog that the public expects and hopes. The FDA represents a clear example of “regulatory capture.” That’s a situation in which an industry that is supposed to be regulated by a governmental entity ends up controlling the regulator. The governmental entity (FDA) which is supposed to guarantee the safety and effectiveness of drugs has in reality been captured by the pharmaceutical industry.
  
  Sixty-five percent of the FDA’s drug regulatory budget comes from Pharma through user fees. According to an official FDA publication (“FDA At A Glance,” U.S. Food & Drug Administration, Office of the Commissioner, Nov, 2020), “Human drugs regulatory activities account for 33 percent of FDA’s budget; 65 percent of these activities are paid for by industry user fees.”
  
  The public is not told that this leads to a situation where FDA employees might feel that they work for or are beholden to Pharma rather than the American people.
  
  In my opinion, this explains why the FDA approved the Alzheimer’s drug Aduhelm despite the fact that 10 of 11 advisory committee members voted that there was insufficient evidence to demonstrate the drug slowed cognitive decline. (The 11th panelist voted “uncertain.”) Three members of the panel resigned as a result.
  
  In my experience, pharmacists are often far less enthusiastic about pills in private conversations with close friends and family in comparison to discussions with pharmacy customers in the drug store.
  
  On the one hand, every day we see a drug circus on TV with Pharma’s annoying, scary, exploitative, and misleading commercials. At the same time pharmacists dispense these pharmaceuticals as if they’re entirely untainted by corrupt commercial interests and purely based on science. Pharmaceuticals are a ridiculous marketing circus on TV but somehow they immediately transform themselves into miraculous remedies in drug stores and doctors’ offices.
  
  To what extent are pharmacists willing accomplices of Pharma’s corrupt practices? And to what extent are they unwitting dupes of Pharma? Have pharmacists been willingly led down the garden path by a nice paycheck? Should pharmacists be shouting from the rooftops that there are many drugs we dispense every day that we’d never take ourselves or recommend for a close friend or family member?
  
  Pharmacy customers don’t know about the settlements (sometimes in the hundreds of millions of dollars) by drug companies for lying and deceptive advertising. Pharmacists seem to act like every drug we dispense is as important and effective as insulin.
  
  Even the manufacturers of insulin, one of the true superstars in the pharmacy, have managed to cloud the halo surrounding this miraculous drug by price gouging. There are very few companies that manufacture insulin so it is ripe for price gouging.
  
  Should pharmacists have a duty to tell customers that a drug they’re taking is currently the target of a class action lawsuit? Should pharmacists investigate and then tell customers what the yea/nay votes were from the FDA advisory panel that voted on approving the drug?
  
  Pharmaceuticals are depicted in magazine advertisements and in TV commercials as if they are all monumental breakthroughs like insulin and penicillin. These ads portray what looks like safe and easy pill solutions for every medical problem. Then everything suddenly becomes much more complicated when information is presented regarding potential adverse effects, warnings, precautions, contraindications, drug interactions, etc.
  
  Most pharmacists seem to be blissfully unaware of and uninterested in books that expose Pharma’s lies, distortions, myths, exaggerations, etc. When pharmacists become aware of those books, they often react with hostility.
  
  One would think that popular pharmacy magazines like Drug Topics and Pharmacy Times would feel it is important to discuss momentous books like John Abramson’s “Sickening.” But the fact that these magazines receive most of their revenue from Pharma advertising means that pharmacists will likely not be aware of books critical of America’s pill circus.
  
  Pharmacists sit passively at in-person continuing education seminars funded by drug companies. Pharmacists don’t ask whether the medical condition being discussed can be prevented by non-drug approaches such as dietary and lifestyle changes rather than by the sponsor’s drug. Indeed, most of the prescriptions pharmacists that fill are for preventable diseases of modern civilization. That’s one of the facts that Pharma most wants to keep hidden from you.
  
  Pharmacists don’t seem to realize the role we’re playing in legitimizing Pharma’s marketing circus. The public probably assumes pharmacists and physicians would blow the whistle if Pharma strayed too far from truth and reality. But, in my opinion, the fact that the prescribing and dispensing of pharmaceuticals facilitate a nice standard of living for health professionals guarantees that most of them will not bite the hand that feeds them.
  
  Pharma refuses to acknowledge how miraculous, wondrous and magical Homo sapiens is, or, for that matter, all living things and all life forms. Pharma will never admit that humans are part of the natural world. Pharma promotes the idea that the human body can be completely understood in terms of chemistry and that people, therefore, need chemical solutions for everything.
  
  We should all laugh at that self-serving and simplistic view of health. We should also laugh at modern medicine’s completely mechanistic and reductionist view of the human body. Modern medicine is, in reality, the monetization of the maladaptation of Homo sapiens in modern society.
  
  The activity of filling proscriptions is mind-numbingly boring and monotonous. It primarily consists of transferring pills from big bottles to little bottles. But the job is extremely stressful in dangerously understaffed chain drug stores because of the potential for making a serious mistake (such as dispensing the wrong drug, typing the wrong directions on the label, overlooking a serious drug interaction or contraindication, etc.), and thereby harming someone.
  
  For many chain store pharmacists, the only nice thing about their job is the salary. In my experience, pharmacists’ top two concerns are their salary and having enough technician assistance on hand. Concerns about the safety and effectiveness of pharmaceuticals are far down the list of pharmacists’ concerns.
  
  Many pharmacists rationalize to themselves that the prestige of modern medicine proves that concerns about drug safety and effectiveness are exaggerated. Pharmacists seem to view their salary in comparison to that of, say, dietitians and nutritionists, as proof that pharmacy is a more important field than nutrition.
  
  Because capitalism rewards pharmacists more than dietitians, pharmacy must therefore be more important than nutrition and more valuable to society. But clearly capitalism wants profits far more than health. Our medical system is about profits, not health.
  
  I hope every pharmacist reads John Abramson’s “Sickening,” but I think that most pharmacists are simply not interested in a critique of the pill business, as long as the status quo provides a nice paycheck.
  
  It is extremely uncomfortable for pharmacists to entertain the possibility that very many of the drugs we dispense are not nearly as “safe and effective” as the FDA claims. Therefore there’s not much hope that pharmacists will be critical of Pharma. “Sickening” provides an extremely important perspective that most pharmacists are not eager to consider or talk about.
  
  Pharmacy would be a much more fulfilling profession if the importance of John Abramson’s perspective were widely acknowledged and practiced. John Abramson is one of my heroes for speaking the truth. I wish he were also the hero of very many pharmacists. Pharmacy would then be a much more honest and gratifying profession.
  
  Dennis Miller, R.Ph., is the author of “The Shocking Truth About Pharmacy: A Pharmacist Reveals All the Disturbing Secrets.”
• 
  Erin McMahon

  This is the perfect book. A critical look at the pharma industry with an awareness of Social Determinants of Health, quality of care, lobbyists' interests, and NCQA quality standards. This could be another day at my client (which is infinitely better than pharma, to be clear).
  
  I also loved the look at Humira and Aduhelm. Roast them.
• 
  Kayla Tornello

  The topic of this book is really important to everyone. It's sickening how much obscene profit the drug companies make while being untruthful with everyone. Americans spend more money on healthcare than other countries, yet we remain in poorer health. Things really need to change! That said, the writing itself just wasn't very compelling. I had a difficult time staying focused and interested.
  
  I received this book from a Goodreads giveaway. Yay!
• 
  Sandra

  Well, another one of those "it's worse than you think" things.
  
  
  https://youtu.be/_5PLf-2FYIM?t=45
• 
  Dennis Miller

  Pharma has clearly succeeded in pulling the wool over the eyes of the public. Has Pharma succeeded in doing the same with pharmacists?
  
  John Abramson, M.D., has been one of my heroes since 2004 when his first book “Overdosed America” was published. Unfortunately he is NOT the hero of a lot of pharmacists. As I explained in detail in my book “The Shocking Truth About Pharmacy: A Pharmacist Reveals All the Disturbing Secrets,” a very large number of pharmacists do not like people who write books critical of Pharma.
  
  Pharmacy is different from a true science because we as pharmacists have a strong financial incentive to not question the dominant narrative in our profession--better living through chemistry. Criticizing pills is bad for business. A pharmacist who uses his position in chain drug stores as a platform to promote reform in the pharmaceutical industry is seriously jeopardizing his employment.
  
  In my opinion, very many chain store pharmacists view pharmacy more as a business than a science. I believe you are naive if you view pharmacists as akin to skeptical scientists who have no horse in the race. We make our living by selling pills, not by encouraging people to learn how to prevent illness.
  
  I’m now retired but I worked in chain drug stores for my entire career. Chain store pharmacists feel subtle yet powerful pressure from our corporate bosses to be positive about the pills we dispense. Besides our financial interest in downplaying adverse effects of drugs, there’s the psychological conflict (cognitive dissonance) resulting from trying to juggle the need to be positive about pills with our knowledge that many pills are a double-edge sword. Unfortunately the balance has tilted too far in the wrong direction because of a hugely powerful and corrupt pharmaceutical industry.
  
  Pharmacists seem to believe that the products we dispense are based on science when, in fact, most are based on marketing. Pharmacists are dispensing the products of an industry that routinely engages in lies, distortions, and magical thinking.
  
  Pharmacists increasingly play the role of legitimizing Big Pharma’s products which are, in fact, quite often clouded by very serious concerns such as FDA’s becoming a captive of the drug industry, Big Pharma’s immense clout over the US Congress, and Pharma’s corrupt influence over drug research.
  
  The public’s definition of “safe and effective” is clearly vastly different from the FDA’s definition. This leads to a reality in which commonly prescribed drugs are often linked to tumors and cancers in lab animals (read the Carcinogenesis and Mutagenesis section in the labeling). Black box warnings are too often added to the labeling years after the FDA approved a drug. Drugs are withdrawn from the market due to safety issues that were not discovered in clinical trials.
  
  The FDA is clearly not the watchdog that the public expects and hopes. The FDA represents a clear example of “regulatory capture.” That’s a situation in which an industry that is supposed to be regulated by a governmental entity ends up controlling the regulator. The governmental entity (FDA) which is supposed to guarantee the safety and effectiveness of drugs has in reality been captured by the pharmaceutical industry.
  
  Sixty-five percent of the FDA’s drug regulatory budget comes from Pharma through user fees. According to an official FDA publication (“FDA At A Glance,” U.S. Food & Drug Administration, Office of the Commissioner, Nov, 2020), “Human drugs regulatory activities account for 33 percent of FDA’s budget; 65 percent of these activities are paid for by industry user fees.”
  
  The public is not told that this leads to a situation where FDA employees might feel that they work for or are beholden to Pharma rather than the American people.
  
  In my opinion, this explains why the FDA approved the Alzheimer’s drug Aduhelm despite the fact that 10 of 11 advisory committee members voted that there was insufficient evidence to demonstrate the drug slowed cognitive decline. (The 11th panelist voted “uncertain.”) Three members of the panel resigned as a result.
  
  In my experience, pharmacists are often far less enthusiastic about pills in private conversations with close friends and family in comparison to discussions with pharmacy customers in the drug store.
  
  On the one hand, every day we see a drug circus on TV with Pharma’s annoying, scary, exploitative, and misleading commercials. At the same time pharmacists dispense these pharmaceuticals as if they’re entirely untainted by corrupt commercial interests and purely based on science. Pharmaceuticals are a ridiculous marketing circus on TV but somehow they immediately transform themselves into miraculous remedies in drug stores and doctors’ offices.
  
  To what extent are pharmacists willing accomplices of Pharma’s corrupt practices? And to what extent are they unwitting dupes of Pharma? Have pharmacists been willingly led down the garden path by a nice paycheck? Should pharmacists be shouting from the rooftops that there are many drugs we dispense every day that we’d never take ourselves or recommend for a close friend or family member?
  
  Pharmacy customers don’t know about the settlements (sometimes in the hundreds of millions of dollars) by drug companies for lying and deceptive advertising. Pharmacists seem to act like every drug we dispense is as important and effective as insulin.
  
  Even the manufacturers of insulin, one of the true superstars in the pharmacy, have managed to cloud the halo surrounding this miraculous drug by price gouging. There are very few companies that manufacture insulin so it is ripe for price gouging.
  
  Should pharmacists have a duty to tell customers that a drug they’re taking is currently the target of a class action lawsuit? Should pharmacists investigate and then tell customers what the yea/nay votes were from the FDA advisory panel that voted on approving the drug?
  
  Pharmaceuticals are depicted in magazine advertisements and in TV commercials as if they are all monumental breakthroughs like insulin and penicillin. These ads portray what looks like safe and easy pill solutions for every medical problem. Then everything suddenly becomes much more complicated when information is presented regarding potential adverse effects, warnings, precautions, contraindications, drug interactions, etc.
  
  Most pharmacists seem to be blissfully unaware of and uninterested in books that expose Pharma’s lies, distortions, myths, exaggerations, etc. When pharmacists become aware of those books, they often react with hostility.
  
  One would think that popular pharmacy magazines like Drug Topics and Pharmacy Times would feel it is important to discuss momentous books like John Abramson’s “Sickening.” But the fact that these magazines receive most of their revenue from Pharma advertising means that pharmacists will likely not be aware of books critical of America’s pill circus.
  
  Pharmacists sit passively at in-person continuing education seminars funded by drug companies. Pharmacists don’t ask whether the medical condition being discussed can be prevented by non-drug approaches such as dietary and lifestyle changes rather than by the sponsor’s drug. Indeed, most of the prescriptions pharmacists that fill are for preventable diseases of modern civilization. That’s one of the facts that Pharma most wants to keep hidden from you.
  
  Pharmacists don’t seem to realize the role we’re playing in legitimizing Pharma’s marketing circus. The public probably assumes pharmacists and physicians would blow the whistle if Pharma strayed too far from truth and reality. But, in my opinion, the fact that the prescribing and dispensing of pharmaceuticals facilitate a nice standard of living for health professionals guarantees that most of them will not bite the hand that feeds them.
  
  Pharma refuses to acknowledge how miraculous, wondrous and magical Homo sapiens is, or, for that matter, all living things and all life forms. Pharma will never admit that humans are part of the natural world. Pharma promotes the idea that the human body can be completely understood in terms of chemistry and that people, therefore, need chemical solutions for everything.
  
  We should all laugh at that self-serving and simplistic view of health. We should also laugh at modern medicine’s completely mechanistic and reductionist view of the human body. Modern medicine is, in reality, the monetization of the maladaptation of Homo sapiens in modern society.
  
  The activity of filling proscriptions is mind-numbingly boring and monotonous. It primarily consists of transferring pills from big bottles to little bottles. But the job is extremely stressful in dangerously understaffed chain drug stores because of the potential for making a serious mistake (such as dispensing the wrong drug, typing the wrong directions on the label, overlooking a serious drug interaction or contraindication, etc.), and thereby harming someone.
  
  For many chain store pharmacists, the only nice thing about their job is the salary. In my experience, pharmacists’ top two concerns are their salary and having enough technician assistance on hand. Concerns about the safety and effectiveness of pharmaceuticals are far down the list of pharmacists’ concerns.
  
  Many pharmacists rationalize to themselves that the prestige of modern medicine proves that concerns about drug safety and effectiveness are exaggerated. Pharmacists seem to view their salary in comparison to that of, say, dietitians and nutritionists, as proof that pharmacy is a more important field than nutrition.
  
  Because capitalism rewards pharmacists more than dietitians, pharmacy must therefore be more important than nutrition and more valuable to society. But clearly capitalism wants profits far more than health. Our medical system is about profits, not health.
  
  I hope every pharmacist reads John Abramson’s “Sickening,” but I think that most pharmacists are simply not interested in a critique of the pill business, as long as the status quo provides a nice paycheck.
  
  It is extremely uncomfortable for pharmacists to entertain the possibility that very many of the drugs we dispense are not nearly as “safe and effective” as the FDA claims. Therefore there’s not much hope that pharmacists will be critical of Pharma. “Sickening” provides an extremely important perspective that most pharmacists are not eager to consider or talk about.
  
  Pharmacy would be a much more fulfilling profession if the importance of John Abramson’s perspective were widely acknowledged and practiced. John Abramson is one of my heroes for speaking the truth. I wish he were also the hero of very many pharmacists. Pharmacy would then be a much more honest and gratifying profession.
  
  Dennis Miller, R.Ph., is the author of “The Shocking Truth About Pharmacy: A Pharmacist Reveals All the Disturbing Secrets.”
• 
  Danielle Murphy

  DNF. Could not stand this misinformation phoney bologna.
• 
  Ty Langford

  Fascinating and terrifying. If the evidence in evidence based medicine can’t be trusted, then what can? As one of the chief medical specialists dragged into the Vioxx case, (a drug theoretically better than traditional NSAIDS because it didn’t cause GI problems) he saw that the Vioxx data was hampered with so there would be no statistically significant increase in strokes in the clinical trial. This proceeded to mean thousands of deaths before it was finally pulled from the market and nobody went to jail. This is just one of extremely many and the first that Dr. Abramson saw. He mentions Neurontin to treat off-label, unstudied conditions because of their clever marketing. Insulin’s newer, “better” varieties that doctors prescribe due to proclaimed benefit but really cause more harm with the steep price tag. OxyContin essentially beginning the Opioid epidemic and the pharma companies knew it would be addictive. Aduhelm for Alzheimer’s where nobody on the FDAs advisory committee voted that it should be approved, but the FDA did anyways. These are just some of the many more examples he mentions about how corrupt and unregulated Big Pharma has become and how it is leading to the U.S. being the least healthy, worst healthcare system of all the top wealthy nations.
  
  Big pharma has such a strong financial, political, and psychological grasp on the American healthcare system that there are drugs they almost exclusively sell in America because they know it won’t be approved elsewhere and because they know Americans are willing to pay. This isn’t to fault the doctors because they simply don’t know better. They go based on the most available and up to date data and have no idea if it’s wrong or they’re being mislead.
  
  The fundamental purpose of clinical research must be to provide optimal care, but right now Big Pharma’s purpose is to serve the financial interests of its investors. With that being said, here are the points where we can improve and dig ourselves out of this grave:
  
  1. Create price ceilings for drugs and care based on the price in other wealthy nations and by creating efficient markets through true competition. (Healthcare for all cannot be achieved until this occurs because otherwise too expensive. Vermont tried without the first step and failed).
  2. Test new drugs against current ones to determine its true efficacy. As of now only 1 in 8 drugs that are released are effective.
  3. Create an independent review board that cannot be influenced monetarily. This can be a government entity that creates a standard review process. Included in this is that all authors, reviewers, etc. get access to all data because right now they don’t (which is absolutely crazy).
  4. Harsher punishments for those who break rules or falsify/hide data, especially if it leads to deaths. Jail time for CEOs would definitely have them be more cautious. That and it would be just given the 16,000 deaths Vioxx caused for example.
  5. Spend more on lifestyle changing “therapies” like giving people money for a gym membership or simply teaching the importance of diet and exercise in schools or to parents. Healthcare only makes up 20% of our health in wealthy countries while socioeconomic status (40%) and lifestyle (30%) have more of the pie.
  
  Unification of doctors, hospitals, common people, and the wealthy alike need to come together to finally tackle this problem. It impacts every one of us, so why not unite and give Big Pharma the finger?
  
  
  
  
  That was long winded, but the American healthcare system is fractured and poor. Occasionally this book can become a little humdrum but as you can see it’s informative. Was originally going to give it a 4 star, but while writing the review I realized how much I got out of it.
• 
  Jane Hoppe

  Remember how we all got whiplash these past two years when Covid maskers said, “Trust the science,” and then the anti-maskers said they were trusting the science? Not knowing which science to trust, we often found ourselves operating in the dark. Well, Dr. Abramson’s exposé of Big Pharma’s inner workings might pull back the medical fog-factor curtain a bit. Although the medicines whose research and marketing he details do not include Covid-related drugs, he does show how “science” often works and why often we can’t point to a definitive answer.
  
  Through four case studies in his book, Sickening: How Big Pharma Broke American Health Care and How We Can Repair It, John Abramson, MD, MSc, shows how Big Pharma controls the medical research agenda. Often their goal is not optimizing health; it is maximizing profits. Profits even come before patient safety. In some cases, no one is asking the right questions—questions that would lead to improved health for the appropriate group of patients.
  
  Furthermore, Dr. Abramson points out that at least for his four chosen examples, Vioxx, Neurontin, statins, and insulin, people tasked with educating physicians and prestigious medical journals are not given access to the real data from research trials. Unknowingly then, physicians relying on clueless peer reviewers prescribe medications based on incomplete and/or misleading information.
  
  The decades-old adage, “Follow the money,” applies here. When scientists who stand to gain financially pay for, interpret, and market “the science,” they can be tempted to manipulate the science. To counter Big Pharma’s undue influence on American medical care, Dr. Abramson encourages grassroots activism. He calls for health-care reform with multiple goals.
  
• 
  Rachel Swisher Ray

  Wonky, but insightful journalism.
• 
  Emily

  Should be required reading, even with two significant flaws
  
  This excellent book should be required reading for all Americans before they are allowed to vote IMO. But sadly, that is as likely to happen as the sort of necessary health care reforms, which is to say not likely at all.
  
  I had two issues though…one, with the way the Women’s Health Initiative was described with regards to HRT. It doesn’t seem like Abramson has reviewed these statistics with the same scrutiny as he gives to other drugs. The WHI study flaws have mostly all been exposed by now and women are now thankfully receiving HRT in ways that will most assuredly improve their healthy lifespan.
  
  Second, Abramson proselytizes vaccines in several places, but never stops to consider that the same faulty clinical trials owned by Pfizer and Merck also powered the vaccine trials. Is it really that illogical to consider that they also suffer from similar “creative” license with the statistics? It seems that the reality is bearing out the Pfizer creed, that all scientific studies are done in tandem with the marketing to support their sales efforts as a primary goal. Why not dig deeper on that topic as well?
• 
  Amanda | whatmandiread

  3.5/5 rounded up
  
  This is really a book about doctors’ relationships with Pharma. As someone in pharma, I was so excited for a book critiquing the pharmaceutical industry’s ways, and if you’re looking for the same, this might not be the book for that.
  
  Let me start out by saying that I did like this book. I found it very informative, insightful, and at some times shocking. I especially liked the information on drug studies and research journals, and the litigation surrounding some drug marketing campaigns. But this was very much so a book about pharma written by a doctor, which is where it strays from what I was expecting. The main focus of this book resides on how doctors have additionally been tricked by pharma and the impact it has had on their prescribing habits. I wish there was more discussion into the history of the relationship between pharma and physician, rather than the small tidbits that were in the book. The book seems to downplay this history greatly and seems to shift the focus entirely on pharma, when the issue is much more nuanced and complex than placing the blame on a single entity (and remember, pharma is a HUGE industry itself - this book tends to focus on pharmaceutical marketing over anything else - and even then, there’s not a lot of discussion on direct to consumer advertising).
  
  The pharmaceutical supply chain and industry itself is much more complex and this book mainly addresses the pharmaceutical industry from the perspective of a physician rather than delving into other aspects of the issues within pharma. Because of this, I found that the subtitle of this book (How Big Pharma Broke Health Care and How To Fix It) isn’t fully indicative of the book’s contents, as the full scope of the industry and its problems weren’t examined.
  
  I also was surprised with the little emphasis on the revolving door policy between private industry and government and honestly, the huge impact of government on the industry in general, including pharma’s donations to some political officials, shedding more light on the lack of price regulation.
  
  Overall, I did enjoy the book, I just don’t think the scope of its contents were are broad as it claimed to be. This is a good book about problems within the medical community when determining best practices and recommended treatments, and how pharma has manipulated data into earning more money, but I had hoped it would get into *how* this has happened, and *why* it isn’t a priority in politics. I was really surprised with the lack of focus on policy changes that could be used to address the issues he did bring up, and maybe even some more insight into other countries and their health systems.
• 
  Jenn

  This book came to me at the perfect time in my life. It's potentially my last week ever as a bedside NICU nurse. I wasn't expecting there to be any content about NICUs in this book, but it echoed every silent thought I've had that has led me to moral burnout in my career. After reading this, I feel a little less crazy about just needing to get out of there.
• 
  Mary Anne

  I heard an NPR interview with Dr. Abramson about this book about a year ago, and I've been interested in reading it since then. This isn't my usual genre, but as I've grown older and focused more on my health, I found the topic of this book to be compelling.
  
  As you might suspect, this book is an argument about the US's reliance on Big Pharma and why it is so harmful to the health and well-being of Americans. The book is split into three sections:
  Health Care American-Style, which focuses on four controversies (Vioxx, Neurontin, Statins, and Insulin*)
  Pharma Means Business, which addresses how Big Pharma's marketing is misleading at best; also gets a little into the FDA and the peer-reviewed medical journals that doctors use to learn about new drugs and medical devices; also some explanation of how much money we're talking about about how much actually goes into research and development
  Moving Forward; the limits of Obamacare and how to implement reforms
  *The timing could not have been better. As I was listening to this book, Eli Lilly announced it would reduce the price of its insulin to $35 a month. Some folks have cited government pressure and a possible upcoming requirement to meet a price cap.
  
  I saw red as I was listening to this book. The first part alone is intensely frustrating, as it addresses specific examples of Big Pharma companies lying about their research and pushing articles that demonstrated misleading or false (especially by omission) evidence of the effectiveness of their drugs. This section also starts to hint at the connection between Big Pharma and peer-reviewed medical journals (many of which are funded by Big Pharma, or their editors and their organizations are funded by Big Pharma; or the articles themselves are written by Big Pharma). Somehow the medical journals don't actually require all of the data to verify their findings through the peer review process, and yet these are the articles that Big Pharma funds, purchases copies of, and then markets directly to doctors. Oftentimes the drugs aren't as effective versus placebos or have nasty side effects.
  
  I'm also reading a book by Bernie Sanders, so you can imagine the mood I'm in when I switch between these books. Dr. Abramson, for his part, isn't calling for a privatization of health care. He is certainly calling for health care reform, but he argues that it can't be done without putting a price cap on prescriptions. Big Pharma argues that a price cap will lower their breakthroughs from research and development. Dr. Abramson calls them on their bluff; they come through with the same number of breakthroughs, and it's really only about how much money goes to their stockholders.
  
  Dr. Abramson's biggest argument here is that there is a ton of conflict of interest in American health care. Big Pharma is a business and is primarily interested in making money. Even when there are court cases and scandals with their drugs and medical devices, they pay such a small sum of money and are somehow still able to sell their products. There's no personal downside to any of the CEOs of these companies or even to the companies themselves. The horrendous control Big Pharma has on health care legislation, peer-reviewed medical journals, insurance, and on our everyday lives is atrocious. While I think Abramson tries to be hopeful about the future, it's really hard to see it (thank you, again, Bernie Sanders). He does make suggestions at different levels, and they seem startlingly uncontroversial. Having a government agency that will request and look over data from drug trials (which the FDA seems to admit it's too busy to do). Actually taking the cost of drugs into consideration before recommending them. Comparing new drugs to what we currently have on the market (especially if the ones currently on the market are just as effective and cost significantly less). Essentially, take out the corruption and focus on the science, with the priority being that we provide people with the best health options possible.
  
  An interesting note from the book was Dr. Abramson saying that our national health had less to do with medications and more to do with healthy lifestyles. He compares our health to other wealthy countries around the world that have universal health care. Folks in those countries might be less medicated, but their health care is also more accessible, and yet their longevity and quality of life is so much better than ours. As I watch commercial after commercial about new drugs, I'm certainly convinced we're a society of "pills will fix it". And I'm not saying medication is bad; I have five prescriptions. But there are other factors worth exploring.
  
  Anyone concerned about reading a book by a doctor (and thus feeling like it might be in another language) can rest assured that I found this book very easy to understand. Dr. Abramson wrote it with a broad audience in mind, and when he did go a little deeper into the science and numbers, he would offer a "here's what this means" explanation. If you're interested in the audio version of this book, Kevin Stillwell is an excellent narrator.
  
  --
  
  PS. If you all ever go to The StoryGraph, let's be friends there!
  Here's my profile.
• 
  Heidi Coopman

  Misses a major point. Prevention of disease through proper nutrition is only lightly touched upon in this book. Focuses on how to manage health care via public cost control programs and leaves out the need for nutrition and lifestyle education.
• 
  Jess

  I would highly recommend this book to every American as it is a very accurate depiction of our current healthcare system. I just completed a course in healthcare economics and this book was exactly aligned with everything I learned. The system put in place to allow for a check and balance system of the drugs prescribed to patients is totally corrupt. Drugs are sold and prescribed without proper clinical trials and if the trials are run the recommending panels do not apply the information because all they care about is the money. Our current healthcare system is saturated with people struggling with obesity, hypertension, diabetes, COPD, and arthritis. Rather than encouraging actual lifestyle changes that are effective the solution is to throw harmful drugs at them that may have little to no effect, aside from lining the pockets of the drug companies and politicians. The drug industry feeds on the general public with advertisements and the fact that people automatically trust the information they are fed rather than doing any independent research on their own. Bottom line - modify your lifestyle to incorporate healthy choices and cut out as many drugs as possible. If you do have to take drugs learn about the efficacy of them during the clinical trials and decide if the benefits outweigh the side effects for you.
• 
  Chris Boutté

  I binged this book out of pure anger. John Abramson has been researching the corruption in the American healthcare system for years, and I was absolutely shocked by all of the details I learned. I’m pretty up to date on how corrupt all of this is and how it screws over and kills many Americans, but this book informed me of so much more.
  
  With Abramson’s background in medicine, he shined a light on so many medications that are pushed by doctors even though they’re not as effective and often dangerous. This happens due to corrupt research that’s paid for by Big Pharma, and it’s really disgusting. Doctors are none the wiser because they’re getting research that they don’t know has a conflict of interest.
  
  In addition to all of the issues with medicines and surgeries that Abramson covers, he discusses how Americans die because we don’t have Universal Healthcare. This book is a must-read because I think when more people understand what’s actually going on, we can get closer to some fixes.
• 
  Christina

  Most people know that American healthcare is the most expensive in the world, but produces lackluster results. The cost increases are mostly driven by the outrageous costs of drugs and specialty tests/procedures. This book focuses on Big Pharma, and how they control almost all drug medical research and keep results private, manipulate the results in respected medical publications, relentlessly promote new drugs that do not necessarily produce any better results than older medications, and drive up prices to product astronomical profits by claiming they are needed for more of this same "research". U.S. Consumers are the loser in all of this, paying higher insurance premiums and out of pocket costs for drugs. This book is a call for reform. Sadly, not much progress is being made (example: Insulin prices are still high despite numerous legislative and executive actions to lower them in the last few years).
• 
  Nikki

  Trust the $cience:
  
  "The science is hidden, the published results are often overseen by the study sponsors themselves, and much of the information that reaches health-care professionals has been curated to support the marketing."
  
  The Drug Lords...Pfizer, Moderna, etc. they are corrupt criminals who have paid billions of dollars in lawsuits for knowingly injuring and killing people. The fines are a drop in the bucket for them. $ = corruption, so this is not very shocking. But what is shocking, is the complete trust people have in these criminal companies with their bodies and health. It does not take a rocket scientist to do a bit of research and see that Big Pharma is not out for you or grandma's best interest. They are out for another type of intere$t.
  
  I foresee this author with another book in the future...
  
  Sickening continued: Big Pharma and the censored genocide.
• 
  Jacob Melton

  In this expertly written exposé of the pharmaceutical industry, John Abramson, a physician who has taught at Harvard and has been an expert witness in pharmaceutical industry litigation, provides a clear and concise overview of systemic issues in the drug industry. Through a series of illustrative cases involving drug industry scandal, Abramson provides an accessible, analytical, and balanced approach to his critique and his expertise shows in the way he handles the subject manner. Although discourse surrounding the pharmaceutical industry can be exaggerated and inflammatory, the book engages in critical thought and addresses all facets of a nuanced topic. From issues with clinical data to catastrophic public policy, the cases laid out in this book provide jaw-dropping insights about the crumbling public health infrastructure in the US.