Cover

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pp. 1-1

Title Page. Series Page, Copyright, Dedication

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pp. i-viii

Contents

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pp. ix-x

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Foreword

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pp. xi-xii

...The Milbank Memorial Fund is an endowed operating foundation that works to improve health by helping decision makers in the public and private sectors acquire and use the best available evidence to inform policy for health care and population health. The Fund has engaged in nonpartisan analysis, study, research, and communication since its inception in 1905...

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Acknowledgments

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pp. xiii-xvi

...I was in my fi nal year of high school in England when I decided I wanted to write a book that would help advance the public’s understanding of science. In the years since then, I have benefi ted enormously from the guidance, encouragement, and mentorship of inspirational teachers who have nurtured this commitment, infl uenced my intellectual development, and helped make that book a reality...

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Introduction: Pharmaceutical Politics, Then and Now

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pp. 1-10

...Since the early 2000s, barely a week has gone by without the pharmaceutical industry being in the news. Of particular concern has been whether pharmaceutical companies charge too much for prescription drugs, withhold negative clinical trial data, and produce too many so-called me-too drugs—drugs with similar chemical properties and more or less identical therapeutic functions. Equally alarming...

PART I: FORGING PHARMACEUTICAL RELATIONS

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1. Knowledgeable Relations: The Building of a Pharmaceutical Research Network

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pp. 13-36

...Between 1930 and the early 1950s, the American pharmaceutical industry underwent a transformation. Due to changes in the research and regulatory environments, the industry went from being one dominated by small and medium-sized companies specializing in the bulk manufacture of fi ne chemicals or the wholesale manufacture of pharmaceuticals to one dominated by several large, fully integrated...

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2. Workforce Relations: The Invention of the Pharmaceutical Postdoctoral Fellowship

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pp. 37-58

...American drug companies and their academic colleagues emerged from World War II with a sense of therapeutic accomplishment. Their prewar and wartime collaborations had produced an armory of new therapeutic innovations that included the sulfa drugs (copied from German fi rms), synthetic antimalarial drugs, and broad-spectrum antibiotics. For the fi rst time, physicians had the means to eradicate some, if not all, infectious diseases. Yet, in spite of the therapeutic optimism of the...

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3. Professional Relations: Crafting the Public Image of the Health Care Team

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pp. 59-86

...By the mid-1950s, however, the pharmaceutical industry was the subject of intense government scrutiny as several fi rms, Merck and Pfi zer among them, were accused of fi xing the prices of antibiotics and vaccines, and of engaging in misleading marketing practices. For all its therapeutic triumphs and for all its support among academic researchers, the industry faced a burgeoning problem: public discontent over the cost of prescription...

PART II: ALLIED AGAINST REFORM

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4. Cold War Alliances: Kefauver’s Bid for Pharmaceutical Reform

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pp. 89-120

...By the time Senator Estes Kefauver launched his Senate Subcommittee on Antitrust and Monopoly investigation into the alleged administered pricing in the drug industry in December 1959, the American drug industry was fi nally taking its political troubles seriously. As Kefauver indicated in his opening remarks, the aim of the hearings were to determine whether the antitrust laws as applied to...

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5. Expert Alliances: The Creation of the Drug Research Board

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pp. 121-162

...Passage of the 1962 amendments to the Food, Drug, and Cosmetic Act marked a victory for pharmaceutical reformers. Although the drug industry had derailed much of Senator Kefauver’s reform agenda, the amendments did grant the Food and Drug Administration (FDA) signifi cantly greater authority over the clinical testing, marketing, and distribution of drugs. Recognizing the limits...

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6. Generic Alliances and the Backlash against Regulatory Reform

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pp. 163-192

...In May 1967, Senator Gaylord Nelson launched what would become a decade-long investigation into the American drug industry. Like his reform-minded predecessor, Senator Estes Kefauver, Nelson regarded mandatory generic prescribing as the solution to rising prescription drug and health care costs. Over the course of the next decade, Nelson joined with other pharmaceutical reformers—most notably Senators Joseph Montoya, Russell Long, and Edward...

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Epilogue

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pp. 193-208

...The substance and character of pharmaceutical politics changed little between the 1960s and 2009. Each episode of prescription drug policymaking was shaped by the same alignment of interest groups (brand-name manufacturers and organized medicine on one side; consumer and senior citizen groups, reformist congressional Democrats, and, increasingly, generic drug manufacturers on the other)...

Notes

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pp. 209-266

Bibliography

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pp. 267-282

Index

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pp. 283-294