The first two-thirds of the book will be pretty much old news to regular readers of this blog. It rehearses how aggressive marketing replaced the discovery of new and useful drugs as the pharmaceutical industry's main line of work, and how all too many physicians were all too happy to acquiesce in the process so long as their pockets, or stomachs, were well lined. In other words, what has already been written about pretty thoroughly in recent books--even if Petersen was the first to report on some of these events in the NYT.
Things get more interesting in the final third of the book. Petersen starts to detail a list of more distant ripples of the overmarketing of pharmaceuticals--like how many different drugs can now be found in the US water supply; how many deaths per year from auto accidents were actually caused by drivers zoned out on prescription drugs; how little we know about how many deaths per year are actually due to prescription drugs; how readily grade school and high school kids now trade each others' prescription drugs back and forth even as illegal street drugs are going out of fashion among them.
I can probably best give the flavor the the book by summarizing the list of recommendations Petersen makes at the very end:
- Redesign the standard death certificate to make it easier to record prescription drug use as a contributing cause of death. Do many more autopsies to be sure we know what really has caused deaths.
- Outlaw physicians taking any money from the pharmaceutical industry. (If we can outlaw DJs taking money from record companies, says Petersen, why not?)
- Create an NIH-type agency to oversee pharmaceutical research and assure scientific integrity of results.
- Assure that patients receive the full information about drugs, in readily understandable form, before they are prescribed. (Petersen is sure that if patients knew how poorly many heavily advertised drugs really work, they'd refuse many of them.)
- Repeal FDA drug company user fees and generally stiffen the agency's spine to regulate the industry.
- Stop covert drug marketing through celebrity endorsements, ads masquerading as news on local TV, health fairs and screening secretly funded by industry, and industry largesse to non-profit patient advocacy groups without disclosure.
- Do more testing of drivers who cause accidents for prescription drugs and require clear warning symbols on labels of drugs where driving is warned against. Punish docs who fail to warn their patients that they should not drive when taking a drug.
- Throw executives in jail if the company commits fraud--forget the "big" fines that companies now regard as a simple business expense.
- Focus more effort on prevention and less on taking pills after you get sick.