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Bad Pharma: How Drug Companies Mislead…
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Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients (2012)

by Ben Goldacre

Other authors: See the other authors section.

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Ben Goldacre is a very angry man, with good reason. In this book he lays out how the pharmaceutical industry has distorted drug research in pursuit of profit, sometimes intentionally, sometimes entirely without malice but with equally devastating effects for patient welfare. This matters because patients are prescribed less effective drugs, or drugs which are outright harmful, at huge financial expense to those paying for the drugs. This isn’t a conspiracy theory book; Goldacre is quite clear that many valuable drugs have come out of the industry, and that most of the people who work in it want to make better drugs. He sets out in detail how and why bias is introduced into both research and prescribing practices, putting it in layman’s terms but linking to the research papers and court documents that back up what he’s saying. He also addresses the failings of the current regulatory system, and proposes ways to improve things — pointing out that unless real controls with serious financial penalties are put in place, even those companies which genuinely want to reform will be under commercial pressure to continue with bad practice in a race to the bottom.

It’s a dense and at times exhausting read. But Goldacre has done a decent job of making the issue accessible to a wide audience with a direct interest, from patients to practising doctors and academics. You can skim a lot of the book to get the general gist, or you can read it in details without following the links, or you can dig into research material he drew on and has laid out in meticulous footnotes and citations. He concludes the original edition with practical suggestions about what individual people can do to improve things, often simply by asking questions.

I read the second edition, which has a “what happened next” chapter about the reaction to the first edition. As he had predicted, there was a backlash in an attempt to discredit him — but there was also a lot of covert feedback from industry personnel acknowledging the problems and considering how to improve things. While there’s always a “the lurkers support me in email” issue with uncredited sources, he does also offer some examples of companies which have publicly moved to improve transparency.

Bad Pharma is an angry but rational examination of a real problem that affects millions of people, including almost anyone reading this review. It’s a worthwhile read, even if it makes for uncomfortable reading for patients, doctors and companies alike. ( )
  JulesJones | Jan 10, 2015 |
Ben has alot of good points and appears well researched. It seems a bit alarmist but probably appropriately so. It is an unfortunate state of affairs. Ben also provides suggestions on how to help fix the situation. I recommend the book. ( )
  GlennBell | Oct 25, 2014 |
As with Goldacre's previous book, Bad Science, Bad Pharma is a critical review, but now where he scrutinizes Big Pharma and other parts of the medical industrial complex. His exposé is perhaps not that original, but his overview is fine and his suggestions for improvements worth considering for policy makers and others in the medical industrial complex. A bought this book and then ran into Peter Gøtzsche's book "Deadly Medicines and Organised Crime" in its Danish incarnation, and must say I switched to Gøtzsche's book and completed that before continuing with Goldacre's. I found more bite in Gøtzsche's book (he compares the drug industry with the mafia!) and he has the advantage of doing original research in the field, while Goldacre's contribution to the medical literature has been more discussive, - as far as I can determine. But Gøtzsche's and Goldacre's books support each other well in addressing problems with the drug regulation: We are not dealing with a single author which sees problems. We may also take they differences in suggested solutions as a indication that there may be no one simple solution, e.g., should we let the state make clinical trials or would that make a considerable burden on taxpayers? It may relieve the pharmaceutical industry of expensive trials and let the society - perhaps - get more unbiased results. ( )
  fnielsen | Oct 25, 2014 |
From the introduction:
'Drugs are tested by the people who manufacture them, in poorly designed trials, on hopelessly small numbers of weird, unrepresentative patients, and analysed using techniques which are flawed by design, in a such a way that they exaggerate the benefits of treatments. Unsurprisingly, these trials tend to produce results that favour the manufacturer. When trials throw up results that companies don't like, they are perfectly entitled to hide them from doctors and patients, so we only ever see a distorted picture of any drug's true effects. Regulators see most of the trial data, but only from early on in a drug's life, and even they don't give this data to doctors or patients, or even to other parts of government. This distorted evidence is then communicated and applied in a distorted fashion. In their forty years of practice after leaving medical school, doctors hear about what works through ad hoc oral traditions, from sales reps, colleagues or journals. But those colleagues can be in the pay of drug companies - often undisclosed - and the journals are too. And so are the patient groups. And finally, academic papers, which everyone thinks of as objective, are often covertly planned and written by people who work directly for the companies, without disclosure. Sometimes whole academic journals are even owned outright by one drug company. Aside from all this, for several of the most important and enduring problems in medicine, we have no idea what the best treatment is, because it's not in anyone's financial interest to conduct any trials at all. These are ongoing problems, and although people have claimed to fix many of them, for the most part they have failed; so all these problems persist, but worse than ever, because now people can pretend everything is fine after all.'

I've unknowingly read [a:Ben Goldacre|1387272|Ben Goldacre|https://d202m5krfqbpi5.cloudfront.net/authors/1285983498p2/1387272.jpg]'s Bad Science column in the Guardian before, more recently a couple of days ago while researching a particular drug when I found out he was also a psychiatrist. Only a week before I'd remembered seeing this book in a book store and immediately decided to order it.

An extra 2013 update chapter posted on the author's website: http://www.badscience.net/2013/12/free-here-is-the-new-what-happened-next-update...
  Cynical_Ames | Sep 23, 2014 |
Not quite as much fun as "Bad Science" being very much more serious and more concerned to build an irrefutable case against the pharma industry and its corruption of medicine. Also while one can laugh at quacks and phoneys this is much closer to home. He argues that there is built in distortion in the way medicine is pushed through the system, evidence is subtly distorted, selective results are given wide publicity so that scientific evidence-based medicine is deeply compromised. So costs are greater than they need be, side effects are suffered which could be avoided, continuous improvement is blocked. ( )
  vguy | Jul 29, 2014 |
Showing 1-5 of 16 (next | show all)
Goldacre is not a conspiracy minded nutcase who sees bad guys behind every garbage can. No, he sees a system that has, despite some really perverse incentives, produced some blindingly good products. But those incentives also allow life-threateningly poor decisions to be rewarded, and that needs to change.

Goldacre's encouraging outlook is why each chapter ends with a list of what you, personally, can do to help. Questions you can ask your doctor if you are a patient. Things you can do as a doctor. What academics can do, what pharmaceutical companies can do.

Read this book. It will make you mad, it will make you scared. And, hopefully, it will bring about some change.
added by jimroberts | editArs Technica, Chris Lee (Jan 5, 2013)
 

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Author nameRoleType of authorWork?Status
Ben Goldacreprimary authorall editionsconfirmed
Corral, RodrigoCover designersecondary authorsome editionsconfirmed
Cowley, JonathanNarratorsecondary authorsome editionsconfirmed
Lacey, RobertCopy editorsecondary authorsome editionsconfirmed
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Goldacre puts the 600-billion-dollar global pharmaceutical industry under the microscope. What he reveals is a fascinating, terrifying mess.

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