The $800 Million Pill: The Truth behind the Cost of New Drugs

by Merrill Goozner (Author)

Editorial Reviews

From Publishers Weekly
In this fascinating critical look at drug and biotech companies, Goozner pulls
back the curtain on the process of new drug development and answers two
important questions: "where do new drugs come from?" and "what do they cost to
invent?" Using case studies that recount the discovery, development and eventual
commercialization of a number of significant drugs, including Epogen and the
AIDS cocktail, Goozner dismantles the pharmaceutical industry’s assertion that
drug prices must be kept high in order to stimulate cutting edge research. The
cost of each new discovery averages $800 million, industry officials have
claimed. But Goozner argues that citizens are already paying much of that bill:
taxpayer-financed medical research, he finds, has played a major role in each
important medical discovery. Goozner convincingly argues that new drugs get into
the hands of the sick not thanks to drug and biotech companies, but to the
passion of dedicated scientists—in both the private sector and the public. A
former Chief Economics Correspondent for the Chicago Tribune and an
award-winning journalist, Goozer writes with skill and elegance, incorporating
anecdote and history in a way that enlivens his research and makes his book an
engrossing read. Though the issue of drug costs has been discussed extensively
in the media, Goozer’s study puts all the political chatter, news coverage and
analysts’ reports into a context where they finally make sense.

From the New England Journal of Medicine, July 22, 2004
The pharmaceutical industry claims that it can continue playing a key role in
the development of new weapons against disease only if Americans pay prices for
medicines that yield very high profits. It also claims that price controls would
cause the stream of new products to dry up. Merrill Goozner, a former chief
economics correspondent at the Chicago Tribune, comes to a conclusion that is
very different from the views espoused by the drug companies. He does so on the
basis of a detailed review of the development of drugs to combat cancer and the
human immunodeficiency virus, a description of the early successes of therapies
developed by the biotechnology industry, and a review of the economics of
"me-too" products, such as H(sub 2) antagonists, proton-pump inhibitors, and
allergy medications. He believes that the private sector's main role is to
develop and commercialize therapies that are based on knowledge generated by
independent researchers in academia and in government. In his opinion, high
prices and big profits are not the key ingredients in pharmaceutical
breakthroughs. On one hand, this book gives the reader lots of interesting and
useful background about the people and organizations involved in expanding
medical knowledge and in developing drugs. On the other hand, it falls short of
what I expected from the title. It is not a detailed forensic accounting of the
true cost of developing individual drugs as compared with industry claims.
Indeed, the only real discussion of the $800 million pill (the alleged average
cost of developing a new drug in the United States) comes in a brief review of a
study by the Tufts University Center for the Study of Drug Development that was
first published in 1991 and then updated in 2001. There is a brief rebuttal from
other organizations in the penultimate chapter of the book, but for a reader
looking for definitive "proof" or data, this book falls short. Written in the
typical style of investigative journalism, the book comes across as an author's
attempt to prove a point, rather than an impartial scientist's effort to answer
a question. Goozner repeatedly comes back to one central theme: that medical
innovations start with dedicated and passionate people, most of whom are not
employed by the pharmaceutical industry, who are investigating scientific
questions. Without these dedicated scientists, none of the innovations described
in this book would have occurred. In other words, the development of drugs is
not exclusively driven by high profits but, rather, is a collection of efforts.
Goozner goes on to suggest some very useful methods for improving the process of
drug development with the support of government-funded research (e.g.,
randomized trials comparing new and existing products, such as the
Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial,
known as ALLHAT). Although the approach Goozner uses in this book is not
scientific, I think he makes a persuasive case. The passion of individual
scientists pursuing an activity they truly enjoy, not the profit motive, has led
to the major technological advances of the past century. I will end by saying
that I am not one who enjoys reading books slowly. I often skim. In order to
read a book from cover to cover, I have to find it truly interesting. I can tell
you that I read every word of this book. Allan S. Detsky, M.D., Ph.D.

Product Details

Paperback: 303 pages
Publisher: University of California Press; 1 edition (October 10, 2005)
Language: English
ISBN-10: 0520246705



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