Excerpt from Generation Rx by Greg Critser, plus links to reviews, author biography & more

Contents

Acknowledgments 

Introduction 
1. UNBOUND 
The Strange and Very American Liberation of Big Pharma 

2. WE LOVE IT! 
How the New Pharma Used Its New Muscle to Create a New . . . You 

3. THE FULL PRICE 
What Living in Pharma's World Means for Our Bodies

4. THE END OF THE GREAT BUFFER? 
Why We Are More Vulnerable 

5. INDEPENDENCE FOR GENERATION RX 
What Can Be Done

A Brief Guide to the Art of Taking Prescription Drugs

Notes

Index

Unbound The Strange and Very American Liberation of Big Pharma

THE MAN IN THE ARENA: WHY PHARMACEUTICAL COMPANIES BECAME SO AGGRESSIVE

In the world of bureaucratic Washington, D.C., few if any possess the gravitas and smarts to get away with quoting Teddy Roosevelt. Lewis Engman, Richard Nixon's 1973 appointee as chairman of the powerful Federal Trade Commission (FTC), was one of the few. A Midwesterner with traditional Republican inclinations, Engman had "the gift," as one friend later put it — people simply wanted to be around him. He was a handsome man, with a broad brow and piercing dark eyes, and he was a social creature, stylishly dressed and coiffed and noticeable on the D.C. cocktail circuit, where he could be seen in the company of many of the president's closest advisers. Engman was a personable, if tightly wound, man as well, comfortable with business types and staff typists alike; when a young FTC appointee named Elizabeth Hanford (later Dole) had a minor accident and ended up in the emergency room on the day she was to be installed, Engman took his entire staff over to the hospital and swore her in while she was still in bed.

More importantly in a town of fiercely guarded opinions and fiefdoms, Lew Engman could take the heat of debate. He seemed to revel in it. Often he intentionally recruited lawyers with whom he did not agree. "The notion," a former staffer recalls, "was that the tension would produce the best resolution." That didn't mean Engman was thwarted very often; yes, he could be imperious and even arrogant, but "he was so personable and passionate that you wanted to agree with the guy." Frustrated with the slow pace of getting anything done in D.C., Engman loved to invoke TR's famous "Man in the Arena" speech. "It is not the critic who counts; not the man who points out how the strong man stumbles or where the doer of deeds could have done better," he would quote, his brow furrowing. "The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood, who strives valiantly, who errs and comes up short again and again, but who knows great enthusiasms . . . so that his place shall never be with those cold and timid souls who knew neither victory nor defeat."

It was an appropriate mission statement for a young man charged with running the FTC, which oversaw the business of the world's most powerful, if at the time troubled, economy. The FTC itself had grown increasingly controversial. For decades the commission had operated somewhat like a European or Japanese finance ministry, not simply policing industry's outright frauds and cons, but also regulating competition itself. The agencies under its purview, from the Civil Aviation Board (CAB) to the Interstate Commerce Commission (ICC), were so cozy with their respective industries that it was all but impossible for an upstart entrepreneur to compete. Traditionally the FTC chairman, in a tacit admission of the powerful regional political interests that had created that coziness, remained mute on the situation. "The policy was never to criticize another government agency," recalls Art Amolsch, who worked for Engman at the time and went on to become the foremost observer of the agency. "That's why the FTC was always known as the Old Lady of Pennsylvania Avenue. It was averse to almost any change and inclined to say no to anyone who dared suggest otherwise."

Copyright © 2005 by Greg Critser. Reprinted by permission of Houghton Mifflin Company.