Dr Marcia Angell, a member of Harvard Medical School's Department of Social Medicine, has written a painstakingly researched book on the wiles and ways of what has come to be called “big pharma.” It is a clear exposé of the American drug industry and is written in the impassioned but impeccable prose we expect from a former editor of the New England Journal of Medicine.

Marcia Angell

Random House, $24.95, pp 336 ISBN 0 375 50846 5 Also available as an ebook, $17.95 http://www.randomhouse.com/

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Angell says that $200bn (£110bn; €165bn) is spent annually on prescription drugs in the United States. With the cost rising 12% a year, it is the fastest growing part of America's swollen health bill. In 2002 the average price of the 50 commonest drugs used by elderly people was nearly $1500 for a year's supply. At, say, six prescriptions—not an uncommon number among elderly Americans—that's $9000 a year for one person's drugs. What are the remedies for this unaffordable financial …