BIG PHARMA HOLDS ALL AGES IN ITS THRALL

Generation Rx How Prescription Drugs Are Altering American Lives, Minds
and Bodies By Greg Critser, Houghton Mifflin; 308 Pages; $24.95

Big Tobacco, you're done, it's Big Pharma's turn to fry.

Last year, the former editor in chief of the New England Journal of
Medicine, Dr. Marcia Angell, turned the heat on Big Pharma with the
publication of her measured yet scalding disclosure, "The Truth About
Drug Companies." Then, in the wake of the Vioxx recall, Newsweek
published a brief article describing how such an unsafe drug slipped
through the Food and Drug Administration safety net and "left patients
confused, drug companies defensive and government officials at odds
over how to fix the problem." And now, "Fatland" author Greg Critser
torches Big Pharma in his timely book, "Generation Rx: How Prescription
Drugs Are Altering American Lives, Minds and Bodies."

Simply put, we are a nation on drugs; half of all Americans take at
least one prescription drug daily, and of that half, 1 of 6 pop three
or more per day. That statistic ought to have some shock value, but
the truth is, we all know several people taking one or more
prescriptions daily. How did we become a nation of pill poppers -- we,
whom Critser has aptly labeled Generation Rx?

Certainly, some of the blame must be affixed to America's work-based
culture. Americans sacrifice much at the altar of productivity and
performance, including health. In lieu of lifestyles more conducive to
health and well-being, Americans have come to rely upon pills to stay
in the game. Thanks and blame go to Big Pharma, marketer of the pills
that help fuel our culture's frenetic work pace and high expectations,
and in the process has elevated itself from a stodgy flat-lined
industry to Wall Street darling.

Critser investigates Big Pharma's rise and finds that its success
wasn't wholly earned by novel offerings of effective products or
caring for its customers. Its success had more to do with persuading
Washington bureaucrats to lower and sometimes obliterate barriers put
in place to keep consumers safe and protect them from being swindled.
First, Big Pharma persuaded policymakers to drop the requirement that
advertisements include a time-sapping list of all of a drug's side
effects. This ruling popped the cork off the genie's bottle and
released a swarm of drug commercials on television viewers. The
commercials worked; last year, 8.5 million Americans asked their
doctors for a drug by name.

Then, as Critser points out, the Bayh-Dole Act was passed by Congress
in 1981, which made it easier for companies to use research
discoveries originated from publicly funded laboratories. Thus,
instead of incurring research and development costs, Big Pharma now
enjoyed the option of buying patent rights from National Institutes of
Health scientists for lucrative drug discoveries. However, the savings
are rarely passed down. In fact, consumers are charged twice for R&D
costs: first as taxpayers funding NIH research and again as customers
for phantom R&D costs used to validate a drug's hefty price tag.

More such maneuverings followed that effectively "unbound" (as Critser
titles his first chapter) Big Pharma even as they hamstrung FDA
regulators. While Critser covers some of the same ground as does
Angell's 2004 book, he was able to include the recent Vioxx recall,
which makes for a perfect cautionary tale of Big Pharma greed at the
expense of consumer safety. But where Critser truly breaks new ground
is in the following chapterhat divulges Big Pharma's targeting of age
groups, or "pharmaceutical tribes."

Members of "The Tribe of High Performance Youth" have no time for
feeling blue because in this day and age, competition heats up early
in life. So for kids and teenagers there's the "California Cocktail":
Ritalin, Neurontin (an anti-epileptic prescribed off-label for bipolar
disorder) and Wellbutrin (an antidepressant). However, the brain's
frontal lobes aren't fully matured until age 30, a fact that raises
the question, will such drugs permanently affect a child's later
ability to think and feel? Critser quotes an expert on child
psychopharmacology, Dr. Glen Elliott. " 'The problem,' he said, 'is
that our usage has outstripped our knowledge base. Let's face it,
we're experimenting on these kids without tracking the results.' "

The "Middle-Year Tribe" members feel compelled to maintain or boost
productivity on the one hand while staving off the aging process on
the other. For us, Big Pharma proffers pills for heartburn, high
cholesterol, high blood pressure, depression or all of the above. Most
desperately, we fend off entering into the last tribe, the "Tribe of
High-Performance Aging." Naturally, members of this final tribe strive
to maintain independence and to extend their lifespan. They continue
taking their "middle-year-tribe" pills, but they might also add
prescriptions for osteoporosis, prostate disorders, rheumatoid
arthritis and diabetes.

All these pills add up. Nothing is for free, and when it comes to
prescription drugs, we know that from the bottom of our pocketbooks.
But there's another, if somewhat hidden, cost to all these
prescriptions. Livers, kidneys, lungs and stomach all struggle to
process so many drugs, but they frequently get overwhelmed and begin
to fail. According to one expert on liver disease quoted by Critser,
"In the United States drug-induced liver disease is the most common
cause of acute liver failure." As yet, there is no medical initiative
to deal with the serious and sometimes fatal problems associated with
taking multiple pills.

In light of last year's hormone therapy findings and the Vioxx
scandal, public outrage over FDA ineptitude and Big Pharma greed is
already on simmer, and "Generation Rx" might just be the incendiary
needed to bring it to a roiling boil. "The stakes are high," Critser
concludes. "It's your money and your life."

Julie Mayeda is a writer in Oregon.