Book Description
Why do life-saving prescription drugs cost so much? Drug companies insist that prices reflect the millions they invest in research and development. In this gripping exposé, Merrill Goozner contends that American taxpayers are in fact footing the bill twice: once by supporting government-funded research and again by paying astronomically high prices for prescription drugs. Goozner demonstrates that almost all the important new drugs of the past quarter-century actually originated from research at taxpayer-funded universities and at the National Institutes of Health. He reports that once the innovative work is over, the pharmaceutical industry often steps in to reap the profit.
Goozner shows how drug innovation is driven by dedicated scientists intent on finding cures for diseases, not by pharmaceutical firms whose bottom line often takes precedence over the advance of medicine. A university biochemist who spent twenty years searching for a single blood protein that later became the best-selling biotech drug in the world, a government employee who discovered the causes for dozens of crippling genetic disorders, and the Department of Energy-funded research that made the Human Genome Project possible--these engrossing accounts illustrate how medical breakthroughs actually take place.
The $800 Million Pill suggests ways that the government's role in testing new medicines could be expanded to eliminate the private sector waste driving up the cost of existing drugs. Pharmaceutical firms should be compelled to refocus their human and financial resources on true medical innovation, Goozner insists. This book is essential reading for everyone concerned about the politically charged topics of drug pricing, Medicare coverage, national health care, and the role of pharmaceutical companies in developing countries.
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Why do life-saving prescription drugs cost so much? Drug companies insist that prices reflect the millions they invest in research and development. In this gripping exposé, Merrill Goozner contends that American taxpayers are in fact footing the bill twice: once by supporting government-funded research and again by paying astronomically high prices for prescription drugs. Goozner demonstrates that almost all the important new drugs of the past quarter-century actually originated from research at taxpayer-funded universities and at the National Institutes of Health. He reports that once the innovative work is over, the pharmaceutical industry often steps in to reap the profit. Goozner shows how drug innovation is driven by dedicated scientists intent on finding cures for diseases, not by pharmaceutical firms whose bottom line often takes precedence over the advance of medicine. A university biochemist who spent twenty years searching for a single blood protein that later became the best-selling biotech drug in the world, a government employee who discovered the causes for dozens of crippling genetic disorders, and the Department of Energy-funded research that made the Human Genome Project possible--these engrossing accounts illustrate how medical breakthroughs actually take place. The $800 Million Pill suggests ways that the government's role in testing new medicines could be expanded to eliminate the private sector waste driving up the cost of existing drugs. Pharmaceutical firms should be compelled to refocus their human and financial resources on true medical innovation, Goozner insists. This book is essential reading for everyone concerned about the politically charged topics of drug pricing, Medicare coverage, national health care, and the role of pharmaceutical companies in developing countries.
Customer Reviews:
More innovation not less.......2007-01-16
I read on this topic with great interest. My family wrestles with drug costs but, at the same time, can attribute being alive and leading productive lives today because of innovative drugs. I have grandparents on medicare, relatives on chronic therapy for everything from high cholesterol to psychological disorders, and others that pay a significant portion of their income to health insurance and/or drugs.
I think the previous reviews of this book sum it up nicely - even those giving it 5 stars seem to agree that the author has an agenda. This is not a thoughtful research style book with provocative insight (is it me or are these books getting harder to find?).
I will not claim to be a policy expert but here are my thoughts.
Americans are capitalists when it comes to everything but their health. It is here that we become socialists. Is that a bad thing? I'm not sure and I grapple with this question myself. When your health is on the line is it fair that people with more means should have access to better healthcare technology? Nobody seems to argue that wealthy people can afford safer cars, live in safer houses and live in safer neighborhoods - that is what success brings right? But when the only cancer drug option costs more than someone can afford it gets sticky. That said - I see a lot of subsidization to help these people both in the government and private sector (charity). When it's your life or your loved one's life on the line it becomes a very personal and understandably complicated issue.
Scientific progress is "community" based and is progressive. A cornerstone of science is that you learn and advance from others - some will turn these innovations to a business that earns a profit and drives further innovation. I agree that pharma/biotech companies don't discover every drug or every drug target but it is they that have the business model to sustain innovation. The profits of this industry, like other industries, drive further innovation that ultimately benefits us.
Drug development is mostly failure. I don't think many people realize this. When I understood how many failures it takes before a drug reaches the market and that the costs of developing drugs keeps going up I can see why drugs costs as much as they do. Simply put - you are not only paying for that new drug you're taking but for the dozens upon dozen of failures that preceded it. The high profit business model is the ONLY WAY to mitigate this risk. Drug companies make huge profit margins but they also invest a greater percentage of their profits back into research and development than any other industry.
Pharma companies have killed their image with all of those "feel good" direct to consumer ads. Shouldn't a doctor prescribe the best drug for each situation based on risk/benefit? And shouldn't these decisions be based on the best facts known at the time and the clinical judgment of the physician? I don't get direct to consumer advertising UNLESS it is purely educational and does not mention or allude to any drug by name. I can understand that when a therapy is available to treat a disease under diagnosed or is emergent that the fastest way to spread the word is through mainstream media.
Even expensive drugs are cheaper than surgery or staying in the hospital (or being institutionalized). It's widely known that for every dollar spent in drug costs you save about 8 dollars in other medical costs.
Bottom line for me is this. I want more innovation. I want my family and friends to get better drugs and avoid the hospital and live better with less pain and suffering. I'm afraid of over regulating the pharma industry simply because I trust the market more than I trust the government. I'm convinced that the pharmaceutical industry has done a hell of lot more to improve human health than it has done to harm it and will continue to do so assuming we don't destroy the business model. Not everyone will be able to afford the latest drugs - but that is where private charity and some government regulation make sense. Don't kill the goose that laid the golden egg because the golden egg is expensive.
Show me the money!.......2007-01-04
From the title, you think that you would walk away from this book disgruntled with big pharma. This was not the case (for me at least). This book chronicles a few big name drugs and the work put in to discovering them. In the end I walked away with my support thrown to the pharmaceutical industry and not the average joe. Book was quite redundant and featured more name dropping than a class roster. Easy to understand for those without a science background but could have been 100pages shorter.
Not coherent.......2005-04-14
The subject material, while interesting, is unfortunately presented in a redundant and disorganized fashion. The book reads more like a collection of stories than as a coherent whole.
Ignorance is bliss.......2005-04-01
Sometimes a writer's bias is so transparent that you don't even need to develop a rebuttal. You simply acknowledge his bias and respect his right to express his extreme, albeit twisted, view of the world.
Goozner is an economist, I majored in economics in both undergrad and grad school, the rest of my education is in chemistry, molecular biology, business and law. He writes about academic research, I have worked at National Laboratories and well known universities. He writes of the pharmaceutical industry, where I spent nearly a decade. And he writes about the biotechnology industry, where I spent another decade. Amazingly, all my life I have spent discovering and developing drugs. So I think I can say I read this book not as a layman, although at times it seemed to be written by one.
I usually enjoy books that are critical of things. They have a tendency to keep us honest and make us all too aware of our faults. But this book, while laudable for its story telling and historical walkabout, did not really get to a point where it stood on firm ground. So in the end, it was so overstated in its extremism, I could not take it seriously. Any good point that could have been made was underminded in its credibility by statements at times so braced by sheer nonsense, I felt bad for the author. I never did take this book seriously.
Goozer is one of those folks that does not believe the constitution is correct to provide protection to inventions through patents. Nor does he seem to believe in capitalism. Rather, he posits that pure open academic research is all that is needed to develop drugs. To him, the Bahy-Dole Act was a license for the pharmaceutical industry to steal from academia.
He would have us believe that all the great drugs developed today really come from academia. If you believe that, then you believe that the internet, as we now know it, including Amazon.com itself, came 100% from academia. Well no Mr. Goozner, Netscape founders and developers of Mosaic did indeed develop their "inventions" at the University of Illinois, but it took good old capatilism and $$ to turn all that into sophisticated products and tools. That is called fundamental research, basic research, being developed into marketibal products. The goal of academic research is not to develop marketable products, it is to further knowledge. The Bayh-Dole Act briged that basic research to the marketplace and last year alone, "academia" made $4 billion from license fees it recieved from those crooks that stole their technology and passed it off as their own after faking an $800 million investment.
The tens of thousands of industry scientists that spend decades developing drugs based on technology licensed from academia should be insulted by a book claiming they had no role in developing the product. I know I am, and I was in academia once.
Lots of things in his book are just plain wrong. To many to list. No need to, because his fundamental thesis is wrong to. I don't question his telling of all the history though, just his conclusions from it.
Lets take the $800 million. He tells us it costs only $100 million and not $800 million to develop a drug. Well, that is not quite what that number means. The $800 million is the cost for the one drug that made it to market, and the 50 that failed in research. That is called an absorbed cost. You see, the vast majority of drugs that are developed never see the pharmacist's shelf. I worked on one such drug that was abandoned after my company spent over $50 million developing it. Now if you are a stockholder, you think you might want a return on your investment. That one successful drug is it.
If we follow Mr. Goozner to the end of his diatribe, we would find that he literally expects the entire drug industry to be a non-profit industry. Well then, since Amazon.com was created from technology that came from academia, it should declare non-profit status and give away all its profits.
What could have been a strong calling to task on the pharmaceutical industry turned out to be nothing more than the fringe, almost socialist, views of an anticapitalist.
Finally, for an economist I was amazed that he managed to oversimplify how the pharmaecutical industry makes development decisions with all his "me too" drug conclusions. If I have to explain that one I am afraid I am going to have to hop on my pro Posner/Pareto/Coase pedistle and preach, which I don't want to do. That takes me back to my first statements. This author is bias against patents, capitalism, and a little uninformed about science (when he tried to be one, he made it obvious why he is not one). But I did like the walk through history, enough to ignore the misleading filters through which me wanted us to view that history. I gave him an extra star for that one. If you are a social engineer or igorant, you might like this book. If you are at all informed, it will leave you like a parody, amused and nothing more.
Scamming Of America By Big Pharma.......2005-01-17
This book tells the truth behind the cost of new drugs. Why do life-saving prescription drugs cost so much? American taxpayers are getting bamboozled by paying for government-funded research with their taxes and then by paying sky-high prices for the drugs resulting from the research.
The first question is why do new drugs cost so much? The second question is how many of these new drugs are truly highly-effective and life-saving?
Book Description
Organizational encounters with risk range from errors and anomalies to outright disasters. This collection of essays addresses the varied ways in which modern organizations understand, process and deal with risk. Contributions by leading experts on risk management illustrate the complex organizational and social dimension of risk management, reminding the readers that effective handling involves much more than the application of technique.
Download Description
Organizational encounters with risk range from errors and anomalies to outright disasters. In a world of increasing interdependence and technological sophistication, the problem of understanding and managing such risks has grown ever more complex. Organizations and their participants must often reform and reorganise themselves in response to major events and crises, dealing with the paradox of managing the potentially unmanageable. Organizational responses are influenced by many factors, such as the representational capacity of information systems and concerns with legal liability. In this collection, leading experts on risk management from a variety of disciplines address these complex features of organizational encounters with risk. They raise critical questions about how risk can be understood and conceived by organizations, and whether it can be 'managed' in any realistic sense at all. This book is an important reminder that the organisational management of risk involves much more than the cool application of statistical method.
Book Description
Rediscover the economic potential of growing Ribes cultivars in the United States and Canada!
Currants, Gooseberries, and Jostaberries: A Guide for Growers, Marketers, and Researchers in North America explores the biology and history of growing these small fruits as commercial crops in North America. This book provides authoritative information on the potential risks and profits of establishing a currant or gooseberry farm and offers step-by-step details for cost-effective set-up, maintenance, and post-harvest activities. This book will be a reliable reference for prospective growers and Ribes researchers.
Currants, Gooseberries, and Jostaberries presents in detail the necessary components of successful Ribes culture farming, including:
site and soil selection
design of planting site
plant propagation
cultivar selection
cultural practice
pest and disease management
harvesting and marketing
The book supplies the latest production figures for Ribes crops worldwide to help you choose which crops to grow. It also contains detailed information on fruit biochemistry, allowing you to market to human health industries. Currants, Gooseberries, and Jostaberries is the first North American publication to focus exclusively on Ribes culture in more than 50 years. It's your one-stop resource for up-to-date information this side of the Atlantic Ocean.
Currants, Gooseberries, and Jostaberries provides you with tables, figures, and appendices, such as
a table of the state regulations governing the importation and growing of currants, gooseberries, and jostaberries as listed by the Department of Agriculture
calendars of what you need to do throughout the year to prepare, plant, and manage Ribes crops
a list of cultivars available in North America
tables of suggested parentage for currants and gooseberries to breed for improved fruit and juice quality, disease resistance or frost resistance, or improved mechanics for harvest
a site selection checklist
an enterprise budget showing typical costs of producing currants and gooseberries for sale in the market
Customer Reviews:
Great book.......2007-02-06
This is a great tool for any coach or athlete who wants an edge over the competition. I am currently a Division one athlete at a top program and this book is still a great tool.
101 reasons i liked 101 defensive back drills.......2000-10-30
Whether your a coach looking for some new drills to show your players, an offseason athlete looking for ways to train and improve yourself, or just a football fanatic who just loves the game and wants to know more about it,you'll want this book. 101 drills for defensive backs shows drills to improve your strength, speed, agility,and technique to become a better defensive back. There are various drills for strength and condition that every defensive back should use. Being a defensive back myself, i totally recommend you buy this book.
101 reasons i liked 101 defensive back drills.......2000-10-30
Whether your a coach looking for some new drills to show your players, an offseason athlete looking for ways to train and improve yourself, or just a football fanatic who just loves the game and wants to know more about it,you'll want this book. 101 drills for defensive backs shows drills to improve your strength, speed, agility,and technique to become a better defensive back. There are various drills for strength and condition that every defensive back should use. Being a defensive back myself, i totally recommend you buy this book.
101 reasons i liked 101drills for defensive backs.......2000-10-30
Whether your a coach looking for some new drills to show your players, an offseason athlete looking for ways to train and improve yourself, or just a football fanatic who just loves the game and wants to know more about it,you'll want this book. 101 drills for defensive backs shows drills to improve your strength, speed, agility,and technique to become a better defensive back. There are various drills for strength and condition that every defensive back should use. Being a defensive back myself, i totally recommend you buy this book.
Product Description
Football drills
Amazon.com
The origins of the word "mortgage" are Old French and translate roughly to "death pledge." Rob Roy takes a radical approach here to help the reader understand how mortgages work; explains clearly how, if you have a mortgage already, you can maximize your equity sooner and save tons of money; and how, if just starting the process of acquiring a home for yourself, there are clear alternatives to a standard bank mortgage that will save you massive amounts of money, time, and financial headaches.
Roy covers the following subjects in detail: the grubstake--the essential financial asset that will stay with you for life; how to find land that you love and can afford; how to seize control of the house-building process; how to clarify and simplify your ideas of what you really need; and how to construct a low-cost home. Included in the book is Roy's own personal story of mortgage-free living, as well as those of others. His wry humor makes for an entertaining read, and his ideas, examples, and advice are clear-headed, logical, and hopeful. His financial calculations and charts are clear and imminently sensible while being real eye-openers. Your banker may not want you to read this radical book, but it amounts to a guided, rational plan for home ownership and financial liberation, and will no doubt soon be considered a classic. --Mark A. Hetts
Book Description
This is a banker's worst nightmare—a book that tells you how to live without being enslaved to financial institutions.
Chelsea Green has produced a formidable series of books on innovative shelter. But every alternative building strategy, no matter how low-cost or environmentally benign, requires a complementary financial strategy. the accepted path is to go hat-in-hand to a big financial institution, such as a bank, to borrow a lump sum that is repaid over many years. By the time the loan is repaid, the homeowner will have paid several times the original amount in interest.
The literal meaning of "mortgage" is "death pledge." Author Rob Roy is offering an escape route from a lifetime of indentured servitude. Mortgage-Free! Radical Strategies for Home Ownership is a complete guide to strategies that allow you to own your land and home, free and clear, without the bank. Included is detailed advice about:
Clarifying and simplifying your notions of what's necessary
Finding land that you love and can afford
Taking control of the house-building process, for the sake of sanity and pleasure
Learning to take a long-term perspective on your family's crucial economic decisions, avoiding debt and modern-day serfdom.
Customer Reviews:
READ ME! Home ownership and mortgage freedom is the American dream.......2006-11-15
Let's face it. It is the American dream -- having no mortgage and owning the property that you have. The book describes how to live within your means and being happy. Other urban places that people pay millions of dollars for a condo might find their busy lives as something to live for, but an equal amount of unhappy people in urban places are committing suicide because they don't know how to get out of the hole. Buying land cheap, building a cabin, and living in it is the best way to go, especially with cheap wireless Internet these days.
Other recommended titles that helped me purchase land cheaply:
Investing Without Losing (ISBN: 0978834607 NOT on amazn, on other stores)
Excellent resource for those who want to live debt free!.......2006-10-11
Very encouraging to know that it can be done. Rob gives a lot of useful info on how live mortgage free. My husband and I are going to do it!
I'm halfway through - and already I can tell this book's a keeper!.......2006-09-20
So I was reading today our of "Mortgage-free, radical strategies for home ownership." I like the book, the author gives a pretty round view on ways you can get away with doing exactly what the title tells you. Almost all of his ideas start out with you gathering up a grubstake and buying a piece of land - which is okay, but I can't even afford the land I want, so that's a bit of a problem for me. Perhaps I should think more modularly and buy a small piece and acquire more adjacent to it when I have more cash.
Anyhow, today he discussed underground homes. That was an interesting subject - basically this is just taking house berming to the maximum and setting your house down so far that once you backfill around the home, the roof is still enough below the original grade that you can plant a living roof - or just cover the damn thing with dirt and let biology ensue, with native plants reclaiming the disturbed environment. Very low environmental footprint - great way to hide from spyplanes and helicopters, but does require some industrial strength digging to get down to to where you need to be, and we've already noted that digging like taht costs money and what's more its not a remote-friendly technology. But, if you had an underground home with a masonry stove you'd be pretty set for whatever the weather could throw at you and I would expect the dwelling to last quite a long time indeed.
He also stressed the importance of being fluid, or rather the foolishness of planning what type of home you want before you've acquired your homesite. So much of what type of home, building technique, power source and siting is dependent upon your homesite and its ammenities, topography, harvestable and recyclable resources that really doing any kind of planning before you're onsite is likely to be more of a hindrance then a help when it comes to getting the best house for your situation. This was something I was already thinking (it is how I've been trained to look at gardening and orcharding: live with the land for a year before planting to find where the plants should go) but it was nice to see it written out elegantly by the author.
I still think I'm leaning towards a strawbale or cordwood dwelling. Cordwood could actually be reasonably remote-friendly and is easier than building a log cabin by a long site. Really you're just going to have to get your cement in - you can handsaw the cordwood rounds for the walls and move them about easily enough. I think I should start small, and get a small piece of land and build a little living shed on it and see what I can do. Like the book says - its better to use the same technique and screw up on a small dwelling at a cost of $500, than on the main house at a cost of $5000.
I'm learning a lot - and I feel the book was definitely worth the purchase price already.
Dominic Ebacher
ebacherdom.blogspot.com
Good General Overview limited in detail.......2005-08-01
Mr. Roy's book is a great primer on thinking about different strategies for owning a home that don't involve the normal process. The book is primarily based on the idea that if one can or wants to live a life outside of the consumerist norm then it is possible to own a home. Primarily, he advocates that the person who wants to own a home and not spend the next thirty years of their lives as an indentured servent to the bank that they should do as much work as they can themselves. Anyone who is interested or willing to do the work in building or renovating a home, has a low income, wants to maintain a simple life but doesn't know where to start will find this book has useful ideas to get you started. Those who desire to live in the best neighborhoods, are uninterested or unwilling to do the work on their own home, or not likely to accept a simple lifestyle will likely scoff at the notions this book presents.
The main thrust of this book advocates that people choose not to participate in the suburban "keeping up with the Jones's" lifestyle. For some this may be a revolutionary idea. This, of course, is not a new idea but is not one that is commonly embraced by Western civilization. For those that are already outside of the consumerist mainstream this book will probably not cover any new ground. He does provide a sensible arguement against the "death-pledge" (the Old French etymology for "mortgage"). There are a great many people that believe that the only way they can ever own a house is through the 30 year loan route. Mr. Roy makes a case that if one has the desire, discipline and patience that they can own a home without going to the bank to get a loan.
The book provides a general set of strategies that are primarily useful in rural area. The author recommends that one lives a simple lifestyle, builds on land that would not be considered particularly valuable by others, the home is built by the owner using as many salvaged (inexpensive but high quality) materials as possible, and that the builder reduces as many living cost as possible. One example of cost reduction is the use of some sort of temporary structure on the property while the home is being built in order to reduce or eliminate the cost of renting or paying on a mortgage in another home.
The book provides a good overview of methods that have been used to achieve home ownership in rural areas. It does address the idea of the same sort of idea in urban areas by saying that it's not bloody likely. This reviewer tends to agree with that but others may have differing opinions.
Enpowering Book!.......2005-07-01
As a novice to the idea of mortgage-free home ownership, I found this book very inspiring and enpowering. As one of the other reviewers stated, this is not a book for your typical American consumer. But, if you're ready to step out of that lifestyle towards financial freedom, read this book. It is practical and easy/fun to read. I liked the personal testimonies and the different resources Rob Roy suggests throughout.
For other inspiring ideas, stories, and photos check out "Homework-Handbuilt Shelter" by Lloyd Kahn.
Book Description
This digital document is an article from Countryside & Small Stock Journal, published by Countryside Publications Ltd. on May 1, 1998. The length of the article is 561 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser.
Citation Details
Title: Mortgage Free: Radical Strategies for Home Ownership.
Publication:
Countryside & Small Stock Journal (Magazine/Journal)
Date: May 1, 1998
Publisher: Countryside Publications Ltd.
Volume: v82
Issue: n3
Page: p84(2)
Article Type: Book Review
Distributed by Thomson Gale
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Inside the FDA: The Business and Politics Behind the Drugs We Take and the Food We Eat
Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs
Drugs-From Discovery to Approval
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