On the side of the angels

Drug truths: Dispelling the myths about pharma R&D

John LaMattina 

Chichester, UK: John Wiley 2009 | 152pp | ?16.95 (SB) ISBN 9780470393185 

Reviewed by Richard Lewis 

The pharma business has been responsible for a great deal of good (and here I confess my bias as an employee of said industry). Why then is it currently held in relatively low regard? This book sets out to provide evidence-based arguments against some of the common misconceptions trotted out in healthcare journals and the media. 

The case histories are almost all based on the author’s experiences at Pfizer. To me, the book would have been much improved by even a minor acknowledgement that the same passionate hopes, dreams and discoveries occur throughout the industry. The book deals with the issues of the cost of discovery, the time to bring a drug to market, the relationship between government-funded research, biotechs and big pharma, and the concerns around the ’invention’ of novel diseases to create a market. There are even welcome sections on failures in development, and why the R&D engine is not producing as much as expected. In a great piece of ironic timing, the author does admit that ’mergers cause disruption and delays’.  

Somehow, this book fails to satisfy; the defence of the status quo is too rigid. In a recent survey, the issue that caused most damage was the handling of clinical trial data, the spinning of moderate data, and the burial of negative findings. This is not addressed, nor the abuses of marketing off-label, or the PR disasters around the protection of intellectual property in the developing world. Even the defence of DTC (direct-to-consumer advertising) seems spun, with insufficient comparison of disease rates and patient knowledge between the US and other countries where DTC is not permitted. 

I would recommend this book to students contemplating a career in pharma, or for limited advocacy purposes. Chemists in pharma will already be familiar with the material. For a clearer vision of the future, I would look elsewhere.