Marcia Angell, Editor of New England Journal of Medicine, 1979-2000 and author of the article, "The Truth About the Drug Companies," New York Review, Marcia Angell, July 15, 2004.
Turtles All the Way Down: Vaccine Science and Myths, Anonymous (Author), Zoey O'Toole (Editor), Mary Holland J.D. (Editor, Foreword), 2022.
50% or more of the income from the FDA and CDC comes from vaccines.
In her 2009 article "Drug Companies & Doctors: A Story of Corruption", published in The New York Review of Books magazine, Angell wrote:
...Similar conflicts of interest and biases exist in virtually every field of medicine, particularly those that rely heavily on drugs or devices. It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.
CRITICISM OF THE FOOD AND DRUG ADMINISTRATION
Commenting on the 1992 Prescription Drug User Fee Act which allowed the Food and Drug Administration (FDA) to collect fees from drug manufacturers to fund the new drug approval process, Angell has stated,
It's time to take the Food and Drug Administration back from the drug companies...In effect, the user fee act put the FDA on the payroll of the industry it regulates. Last year, the fees came to about $300 million, which the companies recoup many times over by getting their drugs to market faster.
CRITICISM OF U.S. HEALTHCARE SYSTEMem
Angell has long been a critic of the U.S. healthcare system. The American healthcare system is in serious crisis, she stated in a 2000 PBS special: "If we had set out to design the worst system that we could imagine, we couldn't have imagined one as bad as we have." In the PBS interview, she urges the nation to scrap its failing healthcare system and start over,
Our health care system is based on the premise that health care is a commodity like VCRs or computers and that it should be distributed according to the ability to pay in the same way that consumer goods are. That's not what health care should be. Health care is a need; it's not a commodity, and it should be distributed according to need. If you're very sick, you should have a lot of it. If you're not sick, you shouldn't have a lot of it. But this should be seen as a personal, individual need, not as a commodity to be distributed like other marketplace commodities. That is a fundamental mistake in the way this country, and only this country, looks at health care. And that market ideology is what has made the health care system so dreadful, so bad at what it does.
CRITICISM OF THE PHARMACEUTICAL INDUSTRY
Angell is a critic of the pharmaceutical industry. With Arnold S. Relman, she argues, "The few drugs that are truly innovative have usually been based on taxpayer-supported research done in nonprofit academic medical centers or at the National Institutes of Health. In fact, many drugs now sold by drug companies were licensed to them by academic medical centers or small biotechnology companies." The pharmaceutical industry estimates that each new drug costs them $800 million to develop and bring to market, but Angell and Relman estimate the cost to them is actually closer to $100 million. Angell is the author of The Truth About the Drug Companies: How They Deceive Us and What to Do About It.
In her 2004 article "The Truth About the Drug Companies", published in The New York Review of Books, Angell wrote,
The combined profits for the ten drug companies in the Fortune 500 ($35.9 billion) were more than the profits for all the other 490 businesses put together ($33.7 billion) [in 2002]... Over the past two decades the pharmaceutical industry has moved very far from its original high purpose of discovering and producing useful new drugs. Now primarily a marketing machine to sell drugs of dubious benefit, this industry uses its wealth and power to co-opt every institution that might stand in its way, including the US Congress, the FDA, academic medical centers, and the medical profession itself. (Most of its marketing efforts are focused on influencing doctors, since they must write the prescriptions.) If prescription drugs were like ordinary consumer goods, all this might not matter very much. But drugs are different. People depend on them for their health and even their lives. In the words of Senator Debbie Stabenow (D-Mich.), “It’s not like buying a car or tennis shoes or peanut butter.” People need to know that there are some checks and balances on this industry, so that its quest for profits doesn’t push every other consideration aside. But there aren’t such checks and balances.
Richard Friedman, director of the psychopharmacology clinic at Weill Cornell Medical College, and a regular contributor to the New York Times science pages, criticized Angell's views as unbalanced. "Dr. Angell is now doing pretty much the same thing the industry she assails has done, just the converse. Pharma withheld the bad news about its drugs and touted the positive results; Dr. Angell ignores positive data that conflicts with her cherished theory and reports the negative results.”
VIEWS ON ALTERNATIVE MEDICINE
Marcia Angell is also a critic of the current categorization of alternative medicine. In a 1998 NEJM editorial she wrote with Jerome Kassirer, they argued:
- It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine — conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted.
