Drugmakers' huge profits let them influence every part of the health care system, and they overstate the benefits of new treatments and understate the risks, Daniel Hoffman writes. Therapeutic decisions are based largely on the results of clinical trials, most of which are funded by drugmakers. Physicians are also influenced by speaker fees, research grants, conference trips, dinners and equity shares, Hoffman writes. Drugmakers also can have a voice in the formal clinical guidelines that come from medical societies, Hoffman writes.

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