Pharma: Greed, Lies, and the Poisoning of America

by Gerald Posner, Jacques Roy (Read by)

Overview

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.

Product Details

ISBN-13:	9781797101743
Publisher:	Simon & Schuster Audio
Publication date:	03/10/2020
Edition description:	Unabridged
Product dimensions:	6.00(w) x 1.50(h) x 5.00(d)

About the Author

Gerald Posner was one of the youngest attorneys ever hired by the Wall Street law firm of Cravath, Swaine & Moore. He is the author of eleven books, including New York Times bestsellers, and one a finalist for the Pulitzer in History. Posner has written dozens of articles for national magazines and papers and has been a regular contributor to NBC, the History Channel, CNN, FOX News, CBS, and MSNBC. He lives in Miami Beach with his wife, author Trisha Posner.

Jacques Roy is a audio narrator and actor, known for The Lower Angels and Room and Board.

Table of Contents

Preface ix

1 Patient Zero 1

2 The Poison Squad 5

3 Enter the Feds 15

4 The Wonder Drug 25

5 "Could You Patent the Sun?" 40

6 An Unlikely Trio 47

7 A One-Atom Difference 58

8 A "Jewish Kid from Brooklyn" 65

9 Medicine Avenue 79

10 The Hard Sell Blitz 88

11 A Haven for Communists 97

12 The Puppet Master 110

13 Fake Doctors 117

14 A "Sackler Empire" 127

15 "Be Happy" Pills 139

16 "The Therapeutic Jungle" 158

17 "Paint the Worst Possible Picture" 165

18 Thalidomide to the Rescue 174

19 The $100 Million Drug 184

20 Legal but Somehow "Shifty" 191

21 Targeting Women 199

22 Death with Dignity 210

23 "Go-Go Goddard" 218

24 "Here, Eat This Root" 230

25 "They Clean Their Own Cages" 234

26 "Splashdown!" 247

27 "Tell Him His Lawyer Is Calling" 253

28 A New Definition of Blockbuster 262

29 "Kiss the Ring" 270

30 The Temple of Dendur 276

31 "Valiumania" 285

32 Swine Flu 294

33 "Black River" 310

34 "Everything Can Be Abused" 323

35 The Age of Biotech 330

36 A "Gay Cancer" 339

37 "None of the Publics Damned Business" 356

38 A Pain Management Revolution 360

39 Enter Generics 369

40 Selling Hearts and Minds 383

41 "No One Likes Airing Dirty Laundry in Public" 395

42 "The Sales Department on Steroids" 403

43 "$$$$$$$$$$$$$ It's Bonus Time in the Neighborhood!" 415

44 Talking Stomachs and Dead Presidents 422

45 "We Have to Hammer on the Abusers" 435

46 "Giving Purdue a Free Pass" 451

47 "You Messed with the Wrong Mother" 463

48 Profits and Corpses 477

49 Gaming the System 492

50 Billion-Dollar Orphans 502

51 The Coming Pandemic 517

52 "Essentially a Crime Family" 522

Acknowledgments 535

Bibliography 541

Notes 575

Index 765

Editorial Reviews

03/16/2020

Journalist Posner (God’s Bankers) chronicles the historical abuses of the American pharmaceutical industry in this sprawling jeremiad. Beginning in the mid-19th century, when the Mexican-American and Civil Wars caused “an unprecedented surge for antiseptics and painkillers,” Posner explains how the addictive nature of opiate-based remedies and lack of government oversight benefitted pharmaceutical pioneers. The race to develop and manufacture penicillin during WWII and the granting of the first antibiotic patent in 1948 launched an era of “wonder drugs” that produced huge profits and drove changes in the way drugs were sold and marketed. Posner places Arthur Sackler, a psychiatrist and medical advertising executive, at the forefront of those developments, documenting his contributions to the groundbreaking rollout of Pfizer’s Terramycin antibiotic in 1951; his purchase of drugmaker Purdue Frederick Company; and his tangles with the FBI (for alleged links to Soviet spies) and Congress (for deceptive advertising practices) in the 1960s. Under the leadership of Arthur’s nephew, Richard Sackler, Purdue developed and aggressively promoted the painkiller OxyContin in the 1990s, and its rampant overprescription, high dosage recommendations, and easily bypassed “extended release shell” significantly contributed to the opioid crisis. Posner’s research impresses, but the blizzard of details often proves more disorienting than enlightening. This door stopper yields damning revelations but would benefit from a sharper focus. (Mar.)

Publishers Weekly

A withering and encyclopedic indictment of a drug industry that often seems to prioritize profits over patients . . . Pharma reads like a pharmaceutical version of cops and robbers." —New York Times Book Review

“New information, coupled with Gerald’s dogged reporting, sets Pharma apart from all books on this subject.” —The Washington Standard

“Gerald Posner’s unsettling book, five years in the making and buttressed by a trove of documentation, is not only a careful history, it’s also a staggering indictment of pharmaceutical companies. . . . Very readable.” —Christian Science Monitor

“Compelling and enraging . . . An encyclopedic act of reporting.” —Pittsburgh Post-Gazette

“Explosively, even addictively, readable . . . Fraud, incompetence, conspiracy, avarice: it’s all here.” —Booklist (starred review)

“You know the old saying: Timing is everything. That is certainly the case with Gerald Posner . . . . The timing of Pharma is extraordinary.” —Dallas Morning News

"I could not put down Gerald Posner’s Pharma, the definitive story of how one family, the Sacklers, set out to get exquisitely rich on the back of unsuspecting Americans—then blamed the so-called 'abusers' instead of their own highly addictive drug. Posner has unearthed important new material that illuminates our national tragedy, crafting a meticulously reported page-turner that is as juicy as it is clear-eyed." —Beth Macy, New York Times bestselling author of Dopesick

"A shocking, rousing condemnation of an industry clearly in need of better policing." —Kirkus

"Posner has created a medical leviathan for our times." —LitHub

From the Publisher

04/01/2020

Investigative journalist Posner (Hitler's Children) employs extensive, meticulous research in this exploration of the U.S. pharmaceutical industry, tracing its evolution from 19th century nostrums to 21st century billion-dollar drugs. Through it all, he notes the tension between the desire to help humanity and the greed that casts a shadow over the industry. The push to develop antibiotics with the onset of World War II marked the beginnings of the modern industry. After the war, companies focused on searching for new drugs and extending patents on existing ones by making small changes in their composition. Posner also describes the rise of orphan drugs, which are used to treat rare medical conditions, and how they allowed companies to squeeze new money out of drugs previously considered unprofitable. Telling the story of generics, direct-to-consumer advertising, swine flu, Ebola, HIV/AIDS, ineffective government oversight, and the current opioid epidemic, Posner leaves no stone unturned. Threaded through this history of modern pharmaceuticals is the story of the Sackler family of Purdue Pharma fame. Posner uses one family's unscrupulous greed as symbolic of the corruption in big pharma. VERDICT A lengthy, yet fast-paced read that should interest anyone who is watching the rising cost of medicine with dismay.—Caren Nichter, Univ. of Tennessee at Martin

Library Journal

Jacques Roy's consistently clear performance of Posner's audiobook is appropriate for its tone. Posner's research into the pharmaceutical industry is unsparing. Listeners are guided through the history of an industry that routinely seeks profit over public interest. Key details are covered: Why are there so many variants to over-the-counter painkillers? How did Oxycontin become so popular despite demonstrable public harm? Posner's research is exhaustive and provides damning insights. ("Pharma bro" Martin Shkreli was publicly vilified in 2015 for raising a vital drug's cost from $13 from $750, but that price remains unchanged). Roy's approach to this work provides a neutral yet engaging tone for its information on the nature of this controversial industry. S.P.C. © AudioFile 2020, Portland, Maine

JUNE 2020 - AudioFile

Jacques Roy's consistently clear performance of Posner's audiobook is appropriate for its tone. Posner's research into the pharmaceutical industry is unsparing. Listeners are guided through the history of an industry that routinely seeks profit over public interest. Key details are covered: Why are there so many variants to over-the-counter painkillers? How did Oxycontin become so popular despite demonstrable public harm? Posner's research is exhaustive and provides damning insights. ("Pharma bro" Martin Shkreli was publicly vilified in 2015 for raising a vital drug's cost from $13 from $750, but that price remains unchanged). Roy's approach to this work provides a neutral yet engaging tone for its information on the nature of this controversial industry. S.P.C. © AudioFile 2020, Portland, Maine

JUNE 2020 - AudioFile

2020-01-12
Of nightmare germs, sleazy dealings, and the big money that fuels the (legal) drug trade.

Investigative journalist Posner writes that big pharma "resides at the intersection of public health and free enterprise," sometimes capable of lifesaving acts but often an agent of unbridled greed. The industry emerged in the 19th century with the need to care for wounded soldiers and new strains of epidemic diseases such as yellow fever and cholera. In the early days, firms had a lock on certain broadly applied medicaments—morphine, in the case of Pfizer. A century later, when physician Arthur Sackler came onboard, Pfizer had just a handful of salespeople; Sackler forged an army of thousands of them, fanning out to sell drugs he had developed, such as Valium, to a waiting audience. In time, Sackler came under federal scrutiny, a bête noire of crusading Sen. Estes Kefauver, who "was bothered by an industry where only a few firms dominated sales and had unfettered discretion to set prices." Moving on to the family-owned Purdue Pharma, Sackler and kin refined techniques of secrecy and underreporting. As Posner notes, it was a firing offense for a salesperson to make notes on visits to doctors in writing, and what went on behind closed doors were all sorts of spoken inducements and rewards for prescribing and overprescribing the firm's products, including OxyContin. Even in Kefauver's time, the U.S. pharmaceutical industry was making many multiples more profit than other sectors of the economy, charging far more to American consumers and insurers than to those in other parts of the world. This was true of the AIDS-battling AZT, "the highest priced drug on the planet." This remains true today, even as Purdue, heavily fined for its role in an epidemic of opioid-overdose deaths, tiptoes into bankruptcy, one ploy in the "complex corporate chess game in which Arthur Sackler excelled."

A shocking, rousing condemnation of an industry clearly in need of better policing.

Kirkus Reviews