Originally rejected by the London Review of Books, this post details why Ben Goldacre’s ‘Bad Pharma’ plays right into the hands of. ‘Bad Science’ hilariously exposed the tricks that quacks and journalists use to distort science, becoming a , copy bestseller. Now Ben Goldacre puts the . Bad Pharma (4th Estate, ) is my book about the misuse of evidence by the pharmaceutical industry, especially the way that negative trial data goes missing .

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Stop trials early peeking, major side effects. Nov 11, Bill rated it really liked it.

Bad Pharma: A Manifesto to Fix the Pharmaceutical Industry – Science-Based Medicine

View all 20 comments. For example, blood pressure, or cholesterol measures may be the endpoint measured in a clinical trial, rather than a more meaningful indicator like heart attack, stroke, or death. Whatever our political leanings, everyone is basically a socialist when it comes to healthcare: We don’t have government run healthcare here in the US and no, the Affordable Care Act doesn’t count and there’s so much bullshit surrounding this industry that it boggles the mind. For example, in a journal article published in PLOS Medicineresearchers studied every published trial on statinspjarma prescribed to reduce cholesterol levels.

As background, I’m a GP in NZ, British by birth and training, closer to the start of my career than the end and I don’t see drug reps or attend drug sponsored CME consciously at least; sometimes it can be difficult to tell.

Dodgy subgroup analysis patients. He writes that these positive results are achieved in a number of ways. Goldacre’s style is calm and rational leavened with just a touch of humor.

The vital comparison may be made against a placebo Goldacre gives a harrowing account of how such a trial led to children in India dying when there was a perfectly good drug to treat them or pnarma unusually low or abnormally high doses of the drug — to ensure suitable conclusions as to efficacy and the severity of side-effects.

What are the regulators doing in all of this? Bad Pharma is pharna more sombre and grim — a thorough piece of investigative medical journalism. Big Pharma does develop useful medicines that save lives, but the main goal is to make money.

An afterword sums up his detailed prescription. They might never have found out if the US Justice department hadn’t taken GSK to court for illegal marketing and failing to report drug safety data.

Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

Max Pembertona psychiatrist, wrote in the Daily Telegraph that “this is a book to make you enraged The reasons he has no real accurate knowledge are many, but here are the best: So ultimately this book is for the brave and interested, I think most people in this day and age have a fair amount of cynicism towards the pharma industry in general so specifics may not have as much appeal as Bad Science had in dissolving our eager beliefs in hackery.


To the question of style, we will — as Goldacre himself so often says, to keep his readers hooked — come back later. It appears Tamiflu does help you recover from the flu a few hours sooner than you would on your own, but there’s no evidence it reduces cases of pneumonia or death, which is the reason countries are currently stockpiling it.

First, he brings the methods of scholarly scientific research to pharna critique of the drug companies — that is, he uses the methods they claim to use to test their claims, and finds them wanting. To Goldacre, an author, journalist and physician, this cause is personal. This is a systematic problem for all drug companies.

Moving trials to low cost countries: N Engl J Med. There have been some attempts to address these issues as researchers unveil the depths of these problems, but all of these attempts have gokdacre ‘fake fixes’ in the words of the author.

The shift to outsourcing raises issues about data integrity, regulatory oversight, language difficulties, the meaning of informed consent among a much poorer population, the standards of clinical care, the extent to which corruption may be regarded as routine in certain countries, and the ethical problem of raising a population’s expectations for drugs that most of that population cannot afford.

They look at sample size s of people in your study is better than you and grandmasample location cultural lifestyles are not alikeas well as outside interests or sponsorships and the number-crunching itself. Academic journals I work for one, the BMJ are sent research papers and comment pieces that may not always be written by the academics listed as the authors.

Rosiglitazone was lauded for reducing blood sugar levels in people with diabetes and so for reducing heart attacks. For example, he writes, if four people out of 1, will have a heart attack within the year, but on statins only two will, that is a 50 percent reduction if expressed as relative risk reduction. Publication bias, missing access to raw data and all the other nuisances which might be familiar t Okay, somehow Goodreads didn’t save the last review I tried to write.


Perhaps I’m an old nihilist I’m really in my mid twenties, I swearbut I don’t believe corporations, who’s incentive is profit, will change unless they’re reigned in by government. Because fraud is everywhere, and even in peer-reviewed science, and systematically reviewed science, it still happens. When trials throw up results that companies don’t like, they are perfectly entitled to hide them from doctors and patients, s From the introduction: AstraZeneca changed the drug slightly to get a new patent, not because Nexium is any more effective than omeprazole, but because they wanted to make more money.

With “me too” drugs companies tinker with a product they already sell but that is coming out of patent — it’s a cheaper way of making a “new drug” although its additional benefits may be minimal. Regulators withhold study records that they do have.

Bad Pharma: how drug companies mislead doctors and harm patients

One of the great crimes of health care is that it is dominated by companies whose primary concern is profit, not necessarily our health; these are not the private health providers but drug companies.

Patients who are invited to take part in a trial are advised to ask, among other things, for a written guarantee that the trial has been publicly registered, and that the main outcome of the trial will be published within a year of its completion. Occasionally I felt that too much was, perhaps, being made of small parts of the whole and yet it is because each small part contributes to a system that is demonstrably flawed that they have the importance that they do; I would agree with Goldacre’s contention that each of the flaws needs to be tackled from the smallest to the largest.

They do not publish studies that make their drug look bad or even “as good as.

They also rely on education paid for by drug companies because unusually among professionals they are loath to pay for it themselves. In their forty years of practice after leaving medical school, doctors hear about what works through ad hoc oral traditions, from sales reps, ebn or journals.

Many critics have a clear bias. The problems are outlined in detail in a recent BMJ article [ 4 ] co-authored by Goldacre. Ben Goldacre’s book, Bad Pharma: