Book excerpt: The inside story of how Big Pharma’s relentless pursuit of ever-higher profits corrupts medical knowledge—misleading doctors, misdirecting American health care, and harming our health. The United States spends an excess $1.5 trillion annually on health care compared to other wealthy countries—yet the amount of time that Americans live in good health ranks a lowly 68th in the world. At the heart of the problem is Big Pharma, which funds most clinical trials and therefore controls the research agenda, withholds the real data from those trials as corporate secrets, and shapes most of the information relied upon by health care professionals. In this no-holds-barred exposé, Dr. John Abramson—one of the foremost experts on the drug industry’s deceptive tactics—combines patient stories with what he learned during many years of serving as an expert in national drug litigation to reveal the tangled web of financial interests at the heart of the dysfunction in our health-care system. For example, one of pharma’s best-kept secrets is that the peer reviewers charged with ensuring the accuracy and completeness of the clinical trial reports published in medical journals do not even have access to complete data and must rely on manufacturer-influenced summaries. Likewise for the experts who write the clinical practice guidelines that define our standards of care. The result of years of research and privileged access to the inner workings of the U.S. medical-industrial complex, Sickening shines a light on the dark underbelly of American health care—and presents a path toward genuine reform.