Table of Contents

Chapter 1 Introduction: The Tipping Point Part 2 I. Overview Chapter 3 1. The Good, the Bad, and the Ugly: A Story of Two Medications Chapter 4 2. An Ethical Framework Part 5 II. Specific Issues and Problems Chapter 6 3. The Pharmaceutical Industry and the Free Market Chapter 7 4. Patents, Generic Drugs, and Academic Science Chapter 8 5. Research and Profits Chapter 9 6. Suppression of Research Data Chapter 10 7. The Quality of Pharmaceutical Research Chapter 11 8. The Drug Rep: Historical Background Chapter 12 9. The Drug Rep Today Chapter 13 10. The Influence of Drug Reps: What the Data Show Chapter 14 11. Continuing Medical Education Chapter 15 12. Professional Organizations and Journal Advertising Chapter 16 13. The Industry and the Consumer Chapter 17 14. The FDA: From Patent Medicine to AIDS Drugs Chapter 18 15. The FDA and the Industry, 1990-2004 Part 19 III. Toward Solutions Chapter 20 16. Solutions: The Management and Divestment Strategies Chapter 21 17. Solutions Requiring Enhanced Professionalism in Medicine Chapter 22 18. Solutions Requiring Regulatory Reform Chapter 23 Epilogue: Industry Woes and Professional Opportunities

About the Author

Howard Brody is professor and director for the Institute for the Medical Humanities, University of Texas Medical Branch at Galveston. Prior to this appointment, Dr. Brody was University Distinguished Professor of family practice, and philosophy at Michigan State University, where he also sat on the faculty of the Center for Ethics and Humanities in the Life Sciences; he served as director of the Center from 1985-2000. Dr. Brody completed his residency in family practice at the University of Virginia Medical Center. He received his MD from the College of Human Medicine, Michigan State University, in 1976, and his PhD in Philosophy, also from Michigan State University, in 1977. He currently sits on the board of the American Society for Bioethics and the Humanities, and specializes in ethics and the doctor-patient relationship. He has authored five books, among them Stories of Sickness (2002) and The Placebo Response: How You Can Release the Body's Inner Pharmacy for Better Health (2000). For up-to-date news about the issues covered in Hooked, visit Dr. Brody's new blog.

Reviews

[Brody] aims for the measured cadences of the ethicist . . . calmly laying out the relevant facts and then reasoning from basic principles to determine whether the medicine-pharmaceutical relationship, as it stands now, is an ethical one or not. That Dr. Brody manages to deliver a hundred-odd pages of determinedly objective analysis before he, too, lets the righteous indignation roll should not really be called a failure of methodology: even as he carefully lays out the facts in this impressively comprehensive book, those facts begin to speak damningly for themselves . . . for a detailed overview of this very jagged terrain, if not for a map of the pathway out, a better general guide than this one is hard to imagine.
*The New York Times*

Physicians, policy makers, and the public should thank Dr. Brody for this major contribution to our understanding of the medical profession and the corrupting influence on the profession of its complex relationship with the pharmaceutical industry.
*Philip R. Lee, MD, Stanford University, and author of Pills, Profits, and Politics*

The single best, most balanced, most comprehensive guide to the current difficulties with the pharmaceutical industry that I have ever read.
*Carl Elliott, University of Minnesota*

Dr. Howard Brody has written a powerful book that is relevant to all out practices and questions the relationship between medicine and the pharmaceutical industry.
*The Journal Of Nuclear Medicine, December 1, 2008*

In this extraordinary book, Dr. Howard Brody, a medical ethicist, lays out in great detail what he judges to be Big Pharma's misdeeds and the seduction of U.S. docs. His targets are the influence of company drug reps, the suppression of negative research data, the abuse of patents, phony advertising and weak oversight by the FDA.
*Chicago Tribune*

Thoroughly documented, logically structured, and well written, [Brody's] book offers a good starting point for discussing ethical issues that impact us all. Recommended for all medical and public libraries.
*Library Journal*

I highly acclaim and recommend this book to all physicians, medical students, and those in policy-making positions regarding our broken health-care system...It ought to be required reading for the medical profession as a whole and a call to action to help us regain the public's trust in our integrity, altruism, and professional ethics.
*Explore: The Journal of Science and Healing*

It seems that no stone is left unturned in this 367-page book, which can feel at times overwhelming but is without a doubt, thorough.
*Health Affairs, September 2008*

This book is useful for any medical student or resident who, like me, finds the practice of distributing free pens and lunches a nice perk but an ineffective marketing strategy. Hooked is surely worthwhile for the academic physician-investigator who struggles to win grants, or for the rural practitioner.
*Anesthesia and Analgesia, September 2008*

The densely written book captures one's attention and reads like a nonfiction thriller....I highly recommend this book to anyone who wants to gain a thorough understanding of the relationship between the pharmaceutical industry and the medical profession. This knowledge provides a platform for the development of rational solutions, which are sorely needed.
*JAMA: The Journal of the American Medical Association, (Jama)*

Hooked is a detailed analysis of the relationship between the medical profession and the pharmaceutical industry primarily in the United States. Hooked is well researched and well written. Brody's style is fluent, helping make his arguments persuasive.
*Journal of Value Inquiry*

We still have too many doctors and patients who may be aware of some of the deviances of the pharmaceutical industry, however, consider these to be exceptional and of marginal importance. In fact, if someone reads Brody's book, they will learn that fraud, malpractice, and lying is an inbuilt phenomenon in the system of clinical research, drug regulation, scientific publication, medical training and drug advertisements. What Brody adds to our present knowledge is a systematic collection of recommendations for changing the present malfunctioning status quo. It is good to read Brody's book, and it is good to have his reflections in our minds.
*Metapsychology Online, July 7, 2009*

An extremely timely book, recommended.
*Pediatric Endocrinology Reviews, (Per)*

[Brody] aims for the measured cadences of the ethicist . . . calmly laying out the relevant facts and then reasoning from basic principles to determine whether the medicine-pharmaceutical relationship, as it stands now, is an ethical one or not. That Dr. Brody manages to deliver a hundred-odd pages of determinedly objective analysis before he, too, lets the righteous indignation roll should not really be called a failure of methodology: even as he carefully lays out the facts in this impressively comprehensive book, those facts begin to speak damningly for themselves . . . for a detailed overview of this very jagged terrain, if not for a map of the pathway out, a better general guide than this one is hard to imagine. * The New York Times *
Physicians, policy makers, and the public should thank Dr. Brody for this major contribution to our understanding of the medical profession and the corrupting influence on the profession of its complex relationship with the pharmaceutical industry. -- Philip R. Lee, MD, Stanford University, and author of Pills, Profits, and Politics
The single best, most balanced, most comprehensive guide to the current difficulties with the pharmaceutical industry that I have ever read. -- Carl Elliott, University of Minnesota
Dr. Howard Brody has written a powerful book that is relevant to all out practices and questions the relationship between medicine and the pharmaceutical industry. * The Journal Of Nuclear Medicine, December 1, 2008 *
In this extraordinary book, Dr. Howard Brody, a medical ethicist, lays out in great detail what he judges to be Big Pharma's misdeeds and the seduction of U.S. docs. His targets are the influence of company drug reps, the suppression of negative research data, the abuse of patents, phony advertising and weak oversight by the FDA. * Chicago Tribune *
Thoroughly documented, logically structured, and well written, [Brody's] book offers a good starting point for discussing ethical issues that impact us all. Recommended for all medical and public libraries. * Library Journal *
I highly acclaim and recommend this book to all physicians, medical students, and those in policy-making positions regarding our broken health-care system...It ought to be required reading for the medical profession as a whole and a call to action to help us regain the public's trust in our integrity, altruism, and professional ethics. * Explore: The Journal of Science and Healing *
It seems that no stone is left unturned in this 367-page book, which can feel at times overwhelming but is without a doubt, thorough. * Health Affairs, September 2008 *
This book is useful for any medical student or resident who, like me, finds the practice of distributing free pens and lunches a nice perk but an ineffective marketing strategy. Hooked is surely worthwhile for the academic physician-investigator who struggles to win grants, or for the rural practitioner. * Anesthesia and Analgesia, September 2008 *
The densely written book captures one's attention and reads like a nonfiction thriller....I highly recommend this book to anyone who wants to gain a thorough understanding of the relationship between the pharmaceutical industry and the medical profession. This knowledge provides a platform for the development of rational solutions, which are sorely needed. * JAMA: The Journal of the American Medical Association, (Jama) *
Hooked is a detailed analysis of the relationship between the medical profession and the pharmaceutical industry primarily in the United States. Hooked is well researched and well written. Brody's style is fluent, helping make his arguments persuasive. -- Thomas Harter, 2009 * Journal of Value Inquiry *
We still have too many doctors and patients who may be aware of some of the deviances of the pharmaceutical industry, however, consider these to be exceptional and of marginal importance. In fact, if someone reads Brody's book, they will learn that fraud, malpractice, and lying is an inbuilt phenomenon in the system of clinical research, drug regulation, scientific publication, medical training and drug advertisements. What Brody adds to our present knowledge is a systematic collection of recommendations for changing the present malfunctioning status quo. It is good to read Brody's book, and it is good to have his reflections in our minds. -- Imre Szebik * Metapsychology Online, July 7, 2009 *
An extremely timely book, recommended. * Pediatric Endocrinology Reviews, (Per) *