Prescription Games: Money, Ego and Power Inside the Global Pharmaceutical Industry

John H. Gryfe is an oral and maxillofacial surgeon practising in
Toronto.

By this millennium’s onset, the 80 global-wide “majors” in the
pharmaceutical industry had shrunk to 35. As the author notes, “seven
of the top-ten largest companies in the year 2000 started the previous
decade with a different name.” By 2010, the competitive field will
likely have shrunk to 12. A reduction in participants guarantees
increased profits for the shareholders, but not necessarily similarly
recognizable benefits for consumers. How this dichotomy continues to
play out is the major theme of this well-organized and carefully
researched book.

As Robinson relates, the flawed thinking that allowed the thalidomide
disaster in the 1950s, has resurfaced, in various forms, in the
subsequent five decades. Drug industry indiscretion motivated by the
ever-present profit expectation has led to blindness in some patients
with cardiac arrhythmias, liver dysfunction deaths in mild diabetics,
and heart valve problems in unsuspecting dieters. The drug giants
continue to influence hospital and university research through grants
and donations heavily wrapped in cloaks of publication censorship and
academic appointment. (Even the hallowed halls of the American FDA and
its Canadian counterpart, HPPB, have not remained impervious to the
pharmaceutical sleight of hand.) Rather than the elimination of the
world’s most devastating diseases (malaria, dengue fever, etc.), R & D
dollars are being directed to searches for improved management of
diabetics and cholesterol-saturated consumers in the affluent West.

In Prescription Games, Robinson, the author of previous books on
organized crime (The Merger) and questionable business practices of the
rich and famous (Yamani: The Inside Story), provides a lucidly written,
thoughtful, and deeply troubling account of drug giant duplicity.