This review contains plot spoilers. John Prieve described his book, Big Pharma, as “A medical thriller set in the pharmaceutical industry that weaves together fact and fiction into a fascinating tale of greed and power.” I’m not sure about the “medical thriller” part, but I guarantee you will find a greed-ridden reading in this book.
I found Big Pharma to be an easy read and the kind of book that you can carry onto airplanes if you have a few hours to spare and aren’t at the liberty of firing up your company laptop to type up your business plans. Big Pharma can also be a good way for you to strike up a conversation with your seat mate. Unless, of course, you happened to sit next to someone from AMSA’s PharmFree initiative or Public Citizen or who is wearing a No Free Lunch pin, in which case you may be doing most of the listening about how corrupt the pharmaceutical industry is regardless of what Big Pharma described.
Anyway – Big Pharma wouldn’t give you much to counter your seat mate’s arguments of industry greed, deception, and corruption.
Those of us who have worked in “big pharma” and “big biotech” may read John’s book and experience what I experienced: much glee (“I bet he’s talking about {competitor company}; those guys are totally unethical!”), some relief (“I guess other companies did that too…”), a twinge of guilt (“I didn’t know we weren’t supposed to do that…”), and some reproach toward the author (“Isn’t this industry’s reputation bad enough without more fuel to the flame?”). I always thought it ironic at how much the industry restricted its constituents from their public opinions, and the slew of recent books published by ex-industry employees (Reidy’s Hard Sell and Rost’s The Whistleblower) paint a less-than-flattering picture of the drug mothership.
Unlike Reidy’s and Rost’s books, which are reality-based, Prieve’s story is “fictionalized reality” and blends an element of truth into what is mostly a fictional character. I imagine that the protagonist Jack Ford is a composite of many characters whom we may recognize working at our industry, even today: a workaholic and opportunistic person who ignores ethics when they become inconvenient. Indoctrination and repeated brainwashing by Jack’s company, Alsace Pharmaceuticals, has turned someone who started out with stars in his eyes into a convicted felon.
If this sounds a bit far-fetched, that’s because the story’s fictionalization wasn’t as satisfying for me as the bits in the book I know had truly happened (happens?) in the pharmaceutical industry. Those of us who have worked in industry and especially “carried the bag” can identify which parts in the book are based in reality and which are based in fiction. Sometimes I thought the fiction clouded the real juice in the story: dine and dash “programs”, doctors who have played drug companies to extract handsome “side business” incomes, and executives who talk about patient care one minute then ways to manipulate the system the next minute.
My biggest criticism of the book is my bias with the protagonist Jack Ford: I didn’t find him very likeable, and that was before he became an adulterer. It was like having to choose between whom I detested more – Jack Ford or the Alsace Executives who framed him. Although the book evolved through the years of Jack Ford’s career and his rise up in Alsace, I’d have liked to see more “character development” (no pun intended) with Jack, especially in situations where his value system is chipped away by one ethical compromise over another.
There are many pharmaceutical employees today who have faced tremendous internal conflict over what they believe is ethical behavior versus what their executives may be demanding of them. I know that most of our industry’s constituents have very strong sense of ethics and value systems, and they are sometimes forced to choose between toeing the line and sleeping well at night. I wish we had a better representation of these constituents in Big Pharma. It would also give readers who are not familiar with the pharmaceutical industry a palpable sense of conflicts of interest and how this is a very human traita rather than just a drug industry issue.
I hope Big Pharma can open up a dialog within pharmaceutical companies to see how executives can be consistent with their messages and actions.
You can visit John Prieve’s website for more information at http://www.johnprieve.com/.
a New Lessons from Neurontin: An interview with Dr. Michael A. Steinman. October 15, 2006. www.MSLPODCAST.com.