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Pharma: Greed, Lies, and the Poisoning of America

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Award-winning journalist and New York Times bestselling author Gerald Posner traces the heroes and villains of the trillion-dollar-a-year pharmaceutical industry and uncovers how those once entrusted with improving life have often betrayed that ideal to corruption and reckless profiteering—with deadly consequences. Pharmaceutical breakthroughs such as anti­biotics and vacc Award-winning journalist and New York Times bestselling author Gerald Posner traces the heroes and villains of the trillion-dollar-a-year pharmaceutical industry and uncovers how those once entrusted with improving life have often betrayed that ideal to corruption and reckless profiteering—with deadly consequences. Pharmaceutical breakthroughs such as anti­biotics and vaccines rank among some of the greatest advancements in human history. Yet exorbitant prices for life-saving drugs, safety recalls affecting tens of millions of Americans, and soaring rates of addiction and overdose on pre­scription opioids have caused many to lose faith in drug companies. Now, Americans are demanding a national reckoning with a monolithic industry. Pharma introduces brilliant scientists, in-corruptible government regulators, and brave whistleblowers facing off against company exec­utives often blinded by greed. A business that profits from treating ills can create far deadlier problems than it cures. Addictive products are part of the industry’s DNA, from the days when corner drugstores sold morphine, heroin, and cocaine, to the past two decades of dangerously overprescribed opioids. Pharma also uncovers the real story of the Sacklers, the family that became one of America’s wealthiest from the success of OxyContin, their blockbuster narcotic painkiller at the center of the opioid crisis. Relying on thousands of pages of government and corporate archives, dozens of hours of interviews with insiders, and previously classified FBI files, Posner exposes the secrets of the Sacklers’ rise to power—revelations that have long been buried under a byzantine web of interlocking companies with ever-changing names and hidden owners. The unexpected twists and turns of the Sackler family saga are told against the startling chronicle of a powerful industry that sits at the intersection of public health and profits. Pharma reveals how and why American drug com­panies have put earnings ahead of patients.


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Award-winning journalist and New York Times bestselling author Gerald Posner traces the heroes and villains of the trillion-dollar-a-year pharmaceutical industry and uncovers how those once entrusted with improving life have often betrayed that ideal to corruption and reckless profiteering—with deadly consequences. Pharmaceutical breakthroughs such as anti­biotics and vacc Award-winning journalist and New York Times bestselling author Gerald Posner traces the heroes and villains of the trillion-dollar-a-year pharmaceutical industry and uncovers how those once entrusted with improving life have often betrayed that ideal to corruption and reckless profiteering—with deadly consequences. Pharmaceutical breakthroughs such as anti­biotics and vaccines rank among some of the greatest advancements in human history. Yet exorbitant prices for life-saving drugs, safety recalls affecting tens of millions of Americans, and soaring rates of addiction and overdose on pre­scription opioids have caused many to lose faith in drug companies. Now, Americans are demanding a national reckoning with a monolithic industry. Pharma introduces brilliant scientists, in-corruptible government regulators, and brave whistleblowers facing off against company exec­utives often blinded by greed. A business that profits from treating ills can create far deadlier problems than it cures. Addictive products are part of the industry’s DNA, from the days when corner drugstores sold morphine, heroin, and cocaine, to the past two decades of dangerously overprescribed opioids. Pharma also uncovers the real story of the Sacklers, the family that became one of America’s wealthiest from the success of OxyContin, their blockbuster narcotic painkiller at the center of the opioid crisis. Relying on thousands of pages of government and corporate archives, dozens of hours of interviews with insiders, and previously classified FBI files, Posner exposes the secrets of the Sacklers’ rise to power—revelations that have long been buried under a byzantine web of interlocking companies with ever-changing names and hidden owners. The unexpected twists and turns of the Sackler family saga are told against the startling chronicle of a powerful industry that sits at the intersection of public health and profits. Pharma reveals how and why American drug com­panies have put earnings ahead of patients.

30 review for Pharma: Greed, Lies, and the Poisoning of America

  1. 4 out of 5

    Mona

    A must read for anyone in medical-related profession. This is a very extensive account on pharmaceutical business. Author in great detail reviews developed of particular medications and evolution of the entire industry, starting from the penicillin discovery in 1928, until Saklers empire bankruptcy in 2019. It took Posner 3 years to write this book and length of it can scare many potential readers, but please persevere. It's worth it. The depth of reporter's research, the ability to organize it a A must read for anyone in medical-related profession. This is a very extensive account on pharmaceutical business. Author in great detail reviews developed of particular medications and evolution of the entire industry, starting from the penicillin discovery in 1928, until Saklers empire bankruptcy in 2019. It took Posner 3 years to write this book and length of it can scare many potential readers, but please persevere. It's worth it. The depth of reporter's research, the ability to organize it and present difficult topics in "readable" way is worth admiration. The footnotes were very extensive and helpful. The story revolves around Saklers family's business but personally, I found the most interesting parts being related to history of certain drug discoveries and descriptions of legislative changes which occurred over the last century in the US.  However, there are few things which need to be mentioned.  1. Author has a tendency to wander from the main topic and some less pertinent to the story facts or persons could have been omitted. 2. Another tendency, which I found particularly annoying, were repetitive statements : "author discovered that..."  etc. Posner is an experience writer and this is a beginner's non-fiction author mistake. I personally prefer writes absence in their own books. 3. Book contains lots medications' names and some technical descriptions related to their action. Some may find it boring. Hence, I recommend it particularly to medical /pharmaceutical /biotech professionals. Overall, this is an excellent book. Well researched and well worth your time. 

  2. 5 out of 5

    Jen Juenke

    This book is the definitive guide on the rise of big Pharma. It starts with snake oil salesmen, to the rise of the need of penicilian, it then goes decade by decade highlighting the major/important drug discoveries. The book highlights antibiotics, the pill, Valium, betadine, biologics, and Oxycodone. It focuses upon the Sackler family, specifically Arthur Sackler, not because of the Oxycodone business but because he had his hand in EVERYTHING related to the pharmaceutical business. The book read This book is the definitive guide on the rise of big Pharma. It starts with snake oil salesmen, to the rise of the need of penicilian, it then goes decade by decade highlighting the major/important drug discoveries. The book highlights antibiotics, the pill, Valium, betadine, biologics, and Oxycodone. It focuses upon the Sackler family, specifically Arthur Sackler, not because of the Oxycodone business but because he had his hand in EVERYTHING related to the pharmaceutical business. The book read like a soap opera that left me turning the pages as quickly as I could read them. I was fascinated with the advertising that Sackler came up, the journals, the free pills, everything that Arthur Sackler did, he did it with as many companies and subterfuges as possible. The book ends with the lawsuits against Oxycodone and it leaves the reader pissed that the FDA, DEA, and the US government did not do more to stem the Oxycodone crisis and have not done anything about the rising costs of drug prices. It is well researched, well written, and provides a balanced accounting of the pharmaceutical industry. A great read.

  3. 4 out of 5

    Nancy Mills

    Extremely well researched. The greed, and the collusion between some parts of the government and the big shots in this industry, is mind-blowing. I cannot say it was fun reading about this stuff. But it was certainly enlightening.

  4. 4 out of 5

    Mirek Jasinski

    I knew that pharmaceutical companies were not very ethical in their pursuit of profit, but I never realized the extent. Very good journalistic work, non-judgmental description (with the exception of the title) and thorough research. A very good read.

  5. 4 out of 5

    Rachel

    Come for the history, stay for the structural considerations on the current pandemic (you’ll have to make these yourself but the foreshadowing is there). If you’re curious about the opioid crisis there are books with more details and more personal community stories; if you want the corporate and legislative big picture this is for you.

  6. 4 out of 5

    William (Bill) Fluke

    Much like “big tobacco” during its run up, so so many poor players here that the blame for over use of pills and opioid crisis especially rests with. This book is chalk full of information- credibly researched and cited by the author. The poor players list includes especially: Purdue Pharma, sales reps that push docs to over prescribe, docs that over prescribe and politicians that refuse to regulate and continue to allow abuses. There is a lot to get through in this almost text book like telling Much like “big tobacco” during its run up, so so many poor players here that the blame for over use of pills and opioid crisis especially rests with. This book is chalk full of information- credibly researched and cited by the author. The poor players list includes especially: Purdue Pharma, sales reps that push docs to over prescribe, docs that over prescribe and politicians that refuse to regulate and continue to allow abuses. There is a lot to get through in this almost text book like telling, but some revealing and informative matters that are worth sticking with. Shameful is word that comes to mind when time and time again big pharma overspends on sales and marketing and underspends on R&D- opting to take lives often rather than save lives. Such high MG doses of OxyContin are unexplainable and can’t be defended by a company like Purdue Pharma ( 160mg dose pill? My wife had knee surgery recently and received an RX for a 2mg dose pill that the MD discouraged her to take unless necessary. That is a good MD. A 160mg pill is a set up for OD and abuse. ). People should be jailed ( and not just the street dealers but white collar execs that continue to allow drugs to be overprescribed at the cost of lives). Lastly, to read Chapter 52 “The Coming Pandemic” ( written and published before COVID19 was discovered) is chilling and terrifying given the uncertainty we live in during the time I read this book.

  7. 4 out of 5

    Trey Shipp

    While several books cover the opioid crisis and the Sackler family, this book tells the shocking history of the pharma industry and Arthur Sackler’s early years. Some of the fascinating details include: • Several of today’s largest drug companies began by selling (then-legal) heroin, morphine, cannabis, and cocaine-based medicine for huge profits. • Despite being raised in the 1940s as New York Socialist party members, the Sackler brothers would seek profits without constraint and go on to spend la While several books cover the opioid crisis and the Sackler family, this book tells the shocking history of the pharma industry and Arthur Sackler’s early years. Some of the fascinating details include: • Several of today’s largest drug companies began by selling (then-legal) heroin, morphine, cannabis, and cocaine-based medicine for huge profits. • Despite being raised in the 1940s as New York Socialist party members, the Sackler brothers would seek profits without constraint and go on to spend lavishly on mansions and art. Mortimer Sackler even left the US to lower his taxes. • Arthur Sackler’s campaign to promote Valium in the 1960s made it the first $100 million drug. By the 1970s, it had accumulated more than a billion dollars in sales. • When promoting OxyContin, Purdue Pharma spent an average of $40,000 for every top-tier, prescribing doctor. • In 2002, when the DEA began looking into a spike in overdoses from OxyContin, Purdue Pharma hired Rudy Giuliani and former NYC police commissioner, Bernard Kerik, to escape meaningful regulation. Think of the number of overdose deaths since 2002. Even though this is a long book, Posner breaks it up into short chapters, and it is easy to read. Some readers may feel Posner spends too much time covering the schemes of drug companies to evade safety regulations and inflate prices. But this is the MOST IMPORTANT part of the book that US citizens should know.

  8. 5 out of 5

    Mandy

    Lost me at chapter 8. This book is *incredibly* long which would’ve been fine if it was relevant or interesting, but the marriages of models, the expensive clothes they wore, and what country clubs they were a part of in New York and Palm Beach does not fall under that category in a book about the pharmaceutical industry.

  9. 5 out of 5

    Randy

    The pharmaceutical industry is held in very low esteem by the American public while, at the same time, Americans take pills at a cost of between 300 and 400 billion dollars per year. Before 2000 only ten drugs sold a billion dollars worth each per year. Now there are over 100 potions in the billion dollar a year category. So, the story of Pharma is a story of money, not the story of improved health. It’s a pretty sad story and author Gerald Posner, lawyer turned investigative journalist with a l The pharmaceutical industry is held in very low esteem by the American public while, at the same time, Americans take pills at a cost of between 300 and 400 billion dollars per year. Before 2000 only ten drugs sold a billion dollars worth each per year. Now there are over 100 potions in the billion dollar a year category. So, the story of Pharma is a story of money, not the story of improved health. It’s a pretty sad story and author Gerald Posner, lawyer turned investigative journalist with a long list of book credits, digs in. One can come away with the feeling that Arthur Sackler, his brothers, and offspring who have made hundreds of millions of dollars from oxycontin are the main villains in the complex history of the pharmaceutical industry. They are villains to be sure. If there are other equally heinous characters they don’t get much notice from Posner—just a mention in passing. The story, once the Sacklers appear, provide the arc of this history. The Sackler name might be familiar to anyone who has visited the Metropolitan Museum of Art in NYC. Arthur has an entire impressive wing, the result of a vast collection of Asian art that he assembled with his ill gotten gains. Dr. Sackler in his early days was a Communist sympathizer but capitalism beckoned and he answered the call. He was a PR genius who created a vertical integration of pill producing, advertising and sales of pharmaceutical products and he was involved in all the big ones like antibiotics, birth control, anti depressants and opioids. He was a clever guy who was able to subvert rules governing drug advertising by creating medical journals and publications that printed articles favorable to his products. The Sackler family with oxycontin kills more people every year than guns do. They push oxytocin with a large network of sales reps who earned and earn big bonuses by getting docs to write more scripts. The docs are incentivized with goodie bags and all expense paid trips and speaking fees. It’s really insidious. The book is told in a chronological format starting with the snake oil salesmen who “evolved” into the pharmaceutical industry, an industry that, in my opinion does more harm than good. Posner, even though he focuses on the Sackler empire, doesn’t change my mind. The industry is rotten at the core. It is also brilliantly profitable in the same way that organized crime is profitable. The industry is so rich they can buy off just about anyone who gives them trouble and can hire big guns like Rudy Giuliani, America’s mayor, to run interference for them. Then there is the revolving door that results in the big Pharma essentially controlling the agencies designed to police them. There once was a time when government could crack down on Pharma but those days are past. The money is too big. I highly recommend the book if you can stand it. I have one bone to pick with Posner as he quickly writes off any connection of vaccines and autism. And I’m not quite certain why there is so much focus on the Sacklers. I’m sure there are many more bad dude drug pushers. It’s almost like the rest of the industry sort of gets off the hook through lack of mentions. There’s no doubt the Sackler Family are interesting and still coining money. The rest of the industry might almost give a sigh of relief that the Sacklers are the primary target of this expose.

  10. 5 out of 5

    Glenn Bristol

    You'll have two overwhelming feelings reading this meticulously researched and cited history of the pharmaceutical industry, which becomes a comprehensive chronicle of the causes and bad actors who made the opioid crisis happen in America. The first is that you already know bits and pieces of this story. The 20th century history of the modern pharmaceutical industry has irrevocably shaped modern healthcare, and whether you realized it or not before reading this, you definitely already knew some o You'll have two overwhelming feelings reading this meticulously researched and cited history of the pharmaceutical industry, which becomes a comprehensive chronicle of the causes and bad actors who made the opioid crisis happen in America. The first is that you already know bits and pieces of this story. The 20th century history of the modern pharmaceutical industry has irrevocably shaped modern healthcare, and whether you realized it or not before reading this, you definitely already knew some of the facts involved here. What you might not have known was the historical and regulatory context, and Posner provides that in spades. The second is that the writer of this book clearly knew that if he got a single detail of this story wrong in a way that was legally actionable, this is an industry that would sue him for his last dime. As such, anything remotely controversial that is said in the book either directly cites a source who said it, or cites a legal filing or internal document that backs it up. I particularly enjoyed (for specific values of enjoyed) learning that the Orphan Drug Act, which gained notoriety in public discourse when Martin Shkreli had the audacity to crank up the price of a drug for a rare disease, and also be a huge, raging [choose your own expletive] about it, was being gamed by the pharmaceutical industry within 2 years of its passing in the 1980s, as they used it to chop up the ballooning HIV-positive population into completely fabricated patient groups of AIDS-associated [this or that rare condition], collect tax credits and 7 years of patent exclusivity, only to have their sales teams encourage doctors to prescribe those drugs off label to every single HIV patient they had, as they crank up the price. It is an utterly diabolical practice that has continued with other conditions and drugs to this day, and gives credence to those who responded to Shkreli by saying, don't just pillory him. Recognize that all he did wrong was say exactly what he was doing out loud, which at least makes him more useful than all the other companies doing exactly the same thing silently. There are dozens of similarly damning revelations in this book, and it is a fascinating and easy-to-follow read, even if this is an area of policy and that you have not paid much attention to.

  11. 5 out of 5

    Matthew Gomel

    The book should be required for medical students and all medical professionals! I think this book, PHARMA, is perhaps one of the most important works I have ever read. It thrusts an unvarnished truth about the pharmaceutical industry that is often hidden from view of the public and medical professionals for the simple reason that what is in this book is not taught in medical schools and rarely featured on the news programs. I think it was important to start the story many years ago, because at th The book should be required for medical students and all medical professionals! I think this book, PHARMA, is perhaps one of the most important works I have ever read. It thrusts an unvarnished truth about the pharmaceutical industry that is often hidden from view of the public and medical professionals for the simple reason that what is in this book is not taught in medical schools and rarely featured on the news programs. I think it was important to start the story many years ago, because at the end of the book it really did become clear in my mind that the pharmaceutical industry began as heroin dealers and one could argue little has changed. The historical line might have zigged and zagged, but with the aid of the book its apparent what the motives have always been. I have been following the pharmaceutical industry for many years. Specially with a focus on the information described in great detail in this book such as the circumstances surrounding the topics of opioids, barbiturates, benzodiazepines, amphetamines, vaccines, and drugs such as Vioxx. I consider this book to be the absolute magnum opus on the topic of the pharmaceutical industry. Overall, I can’t thank the author enough for writing this book. This is a treasure for humanity and I suspect will be regarded as such as time goes on. I am confident in my assessment of the importance of this book especially when considering that we are a society heavily intertwined and connected to the pharmaceutical industry. I have been raving about PHARMA to my friends every time I had a epiphany moment while reading, which was pretty much every few pages. I will remember the lesions I have learned in it for the rest of my life. The book should be required for medical students or any medical professional! Probably would make an amazing movie or news special one day. I am giving this book my most highest recommendation for anyone who has ever taken or prescribed a medication. In other words, this book is required reading!

  12. 4 out of 5

    Rick

    Gerald Posner has written the type of book that is so shocking it almost made me sick. Which given what he's just exposed about big-Pharma would be worse because I don't trust them enough to take a pill for it. He does an amazing job sharing how the industry has basically scammed the country by producing drugs in such a way that the profit far and away comes before the person. They have made some amazing discoveries but have done so in such a short-sighted fashion that they may actually be doing Gerald Posner has written the type of book that is so shocking it almost made me sick. Which given what he's just exposed about big-Pharma would be worse because I don't trust them enough to take a pill for it. He does an amazing job sharing how the industry has basically scammed the country by producing drugs in such a way that the profit far and away comes before the person. They have made some amazing discoveries but have done so in such a short-sighted fashion that they may actually be doing more harm in the long-term. The story of the Sackler family seems like something out of the sleaziest family story. He makes it clear they are the worst type of rich who put personal wealth and status above all else. The sections related to them have everything to do with helping themselves and creating a better life while manipulating everyone else usually for their own enjoyment. This is a great piece of work and I'd recommend it to anyone wanting a full examination of the industry and how it does more harm than good.

  13. 4 out of 5

    Theresa Leone Davidson

    This is a long book that can at times be dry, particularly when Posner is naming different medications and their functions, but overall it is so worth the time it takes to read. Some takeaways for me: 1) This is not new but the extent of the avarice of big pharmaceutical companies is even worse than I had imagined. 2) For the conspiracy theorists (anti vaccine idiots) this book will not help your ridiculous cause. 3) The whole oxycodone and related opioid crisis could have been managed much more This is a long book that can at times be dry, particularly when Posner is naming different medications and their functions, but overall it is so worth the time it takes to read. Some takeaways for me: 1) This is not new but the extent of the avarice of big pharmaceutical companies is even worse than I had imagined. 2) For the conspiracy theorists (anti vaccine idiots) this book will not help your ridiculous cause. 3) The whole oxycodone and related opioid crisis could have been managed much more efficiently by the American government much sooner. 4) In case there was any confusion, Arthur Sackler and his family are some of the worst scumbags the world has produced. 5) The history of medications, from Alexander Fleming and penicillin to today is surprisingly fascinating. I would definitely recommend this.

  14. 5 out of 5

    Jenny Blainey

    This is a must read for anyone who wants to understand modern medicine and why we are in the situation we are in in terms of cost of medicines and lack of research in areas of medicine that are severely lacking e.g antibiotics. Posner (and his wife) take the reader right back to the beginning of tonics in the early days of the USA right up to today’s global complex pharma industry. It’s masterful and balanced. Hard reading for those in the industry but necessary to understand how to make better This is a must read for anyone who wants to understand modern medicine and why we are in the situation we are in in terms of cost of medicines and lack of research in areas of medicine that are severely lacking e.g antibiotics. Posner (and his wife) take the reader right back to the beginning of tonics in the early days of the USA right up to today’s global complex pharma industry. It’s masterful and balanced. Hard reading for those in the industry but necessary to understand how to make better choices now. When the global economy is banking on a new vaccine many policy makers would do well to read this and understand what it takes to achieve that goal and the importance of protecting public interest.

  15. 5 out of 5

    Jennifer Sawyer

    This is a great look inside the birth of the role of the FDA and a look under the covers of the opioid crisis. The author does a great job telling this as a story — including readable, not overly-academic — footnotes. I still recommend Bottle of Lies by Katherine Eban for a deep look at generics (as this title doesn’t really dig in to generics like Eban does) but I think this is a great partner title. I’m quite sure that the Sackler family hates this book as it shines a bright light on the impac This is a great look inside the birth of the role of the FDA and a look under the covers of the opioid crisis. The author does a great job telling this as a story — including readable, not overly-academic — footnotes. I still recommend Bottle of Lies by Katherine Eban for a deep look at generics (as this title doesn’t really dig in to generics like Eban does) but I think this is a great partner title. I’m quite sure that the Sackler family hates this book as it shines a bright light on the impact of drug ads and sales techniques on our present opioid crisis.

  16. 5 out of 5

    Vince

    This book contains a lot of original research, and I respect the author for that. And although there are some pretty hard-hitting sections, especially near the end, most of the first 2/3 of the book are a bit of a snooze fest.

  17. 4 out of 5

    Zhuo Zhang

    I cannot say I enjoy reading this book, but that does not mean that it is not a great book as the author has done a through research and written the book in a very serious manner. But it is just too long for me and I lost the interest eventually.

  18. 4 out of 5

    Daniel Weiner

    Really great book. It really focuses mostly on the Sackler family and their role in the opioid epidemic. I enjoyed the chapter on the Orphan Drug act and it's problems and honestly would have liked more info about that, and some ideas about proposed solutions to fix those problems.

  19. 5 out of 5

    Dino

    4.5 stars. Really great content. A bit long at times but well worth the journey.

  20. 4 out of 5

    Paulo Adalberto Reimann

    Excellent approach. Great stories in the time when knowledge was limited but greed was business as usual.

  21. 4 out of 5

    Yelena

    Audio

  22. 4 out of 5

    Matt Cantillon

    Excellent investigative journalism detailing the corporate greed that has fueled the opioid crisis.

  23. 4 out of 5

    Mary Moran

    Excellent research. I was livid reading this from almost the first page. The is more of a criminal industry than the mob was!

  24. 4 out of 5

    Ietrio

    The wailing of a man who loves the way people would die of hunger and diseases and wants more. Reminds me of Stalinists wanting to bring Heaven on Earth through force.

  25. 4 out of 5

    Deana

  26. 4 out of 5

    Patrick Workman

  27. 5 out of 5

    Marie

  28. 4 out of 5

    LovGov

  29. 5 out of 5

    Matt Mahoney

  30. 4 out of 5

    Lisa

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