The pharmaceutical industry today finds itself under fire from a broad range of critics: federal and state legislators, doctors, uninsured seniors, activists for the poor, U.S. business and the managed care industry. FRONTLINE producer Jon Palfreman, who spent eight months researching and reporting on the high cost of U.S. prescription drugs, offers his reflections on the powerful and closed pharmaceutical industry and the five most common arguments heard against it.

The pharmaceutical industry agrees that something needs to be done to help seniors and the uninsured obtain acces to affordable prescription drugs. But the industry vehemently opposes any kind of government price regulation that is common in the rest of the world.

Commenting on this issue are: Sidney Taurel, chairman, president and CEO of Eli Lilly; Uwe Reinhardt, an economist who specializes in health issues; Marcia Angell, former editor in chief, The New England Journal of Medicine; Richard T. Evans, pharmaceutical analyst, Sanford C. Bernstein & Co.; and John Kitzhaber, former governor of Oregon.

Concerned that skyrocketing prescription drug costs were hurting its seniors and eating up its Medicaid budget, Oregon created its own version of Consumer Reports to help doctors and consumers make wiser choices about medications. Scientific committees compare drugs for safety, efficacy and price and, through this evidence-based research, develop a preferred drug list, or formulary. It's an approach based not on controlling prices, but maximizing value for money. As of June 2003, roughly 20 states are working on adopting,in some form, the Oregon model.

Here are the views of Sidney Taurel, chairman, president, and CEO of Eli Lilly; Uwe Reinhardt, an economist who specializes in health issues; Raymond Gilmartin, chairman, president, and CEO, Merck; Marcia Angell, former editor in chief, The New England Journal of Medicine; Richard T. Evans, pharmaceutical analyst, Sanford C. Bernstein & Co.; and John Kitzhaber, former governor of Oregon.

Most countries don't allow drug companies to advertise directly to patients. In the U.S., however, the rules were relaxed in 1997 and drug companies no longer had to include warnings about symptoms and side effects, which are required in ads to doctors. Since then, direct-to-consumer television, radio and magazine advertising has increased faster than the industry's other marketing activities -- the bulk of which are still aimed at doctors who have the power to prescribe.

Commenting on the debate over drug ads and marketing are: Sidney Taurel, chairman, president and CEO of Eli Lilly; Uwe Reinhardt, an economist who specializes in health issues; Marcia Angell, former editor in chief, The New England Journal of Medicine; Richard T. Evans, pharmaceutical analyst, Sanford C. Bernstein & Co.; and John Kitzhaber, former governor of Oregon.