Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients by Ben Goldacre"Bad Pharma" is the eye-opening expose of the pharmaceutical industry. British physician, academic and science writer, Ben Goldacre follows up his international bestselling book "Bad Science" with yet another enraging investigative book of medical journalism. This insightful book takes you inside a secretive industry that relies on problematic practices for financial gain.This blood raising 448-page book is composed of the following six chapters: 1. Missing Data, 2. Where Do New Drugs Come From?, 3. Bad Regulators, 4. Bad Trials, 5. Bigger, Simpler Trials, and 6. Marketing.Positives:1. Accessible, well-researched book that takes you inside the pharmaceutical industry.2. Doctor Goldacre has great command over a fascinating topic.3. Excellent format. The author lays out his critical arguments of the pharmaceutical industry by sections and provides pragmatic solutions. He is consistent throughout the book.4. Does a great job of explaining key medical terms, and provides a glossary of terms for quick reference.5. Exposes the conflict of interests within the industry...starting with industry-funded trials. Negative results that go missing in action and the danger of exposing people to unnecessary risks. "Because researchers are free to bury any result they please, patients are exposed to harm on a staggering scale throughout the whole of medicine, from research to practice".6. The book provides countless examples involving well known drugs. Interesting stories behind them.7. How the pharmaceutical industry influences doctors through false or misleading marketing, flawed trial designs and how regulators fail to regulate.8. Fascinating facts interspersed throughout book, "We're very complicated animals, but we only have about 20,000 genes, so lots of the building blocks of the human body are used several times over, meaning that something which interferes with one target in the body might also affect another, to a greater or lesser extent, at a higher dose".9. Interesting look at the drug-producing process. The phases of the clinical trials.10. Inside the job of a drug regulator. The process and pressures of the job. "Research reviewing a long series of FDA votes found that experts are slightly more likely to vote in a company's interest if they have a financial tie to that company".11. The reality behind accelerated approval for drugs.12. Exposing fraud. "There are all sorts of things we should be doing to catch outright fraud: better investigations, better routine monitoring, better communication from journal editors on suspicions about papers they reject, etc..."13. How journals overstate results. Manipulating the data. "if you chop up your data in lots of different ways, you can pull out lumpy subgroups with weird findings at will".14. Makes the compelling case for evidence-based medicine.15. The real purpose of drug reps. "This is a huge business: the overwhelming majority of the industry's promotional budget goes on influencing doctors, rather than patients, and about half of that gets spent on drug reps".16. The power of marketing, "when you take a step back from pharmaceutical industry marketing, it is simply a process whereby patients pay money to drug companies, in order for them to produce biased information, which then distorts treatment decisions, making them less effective".17. The author explains what you can do as a consumer. Excellent advice.18. The use of ghostwriters to influence the public."Lilly set a goal of making Zyprexa `the number one selling psychotropic in history', and its emails discuss using ghostwriters to present it in a positive light...".19. How the pharmaceutical industry uses money to buy influence and what is being done around the world to counter. The need for full disclosure.20. Links worked great!Negatives:1. The book repeats many of the same points almost to a fault.2. The prose is dry at times.3. The author could have done a better job of espousing some of the great science that resulted in quality of life medication. The focus and tone of the book is almost exclusively critical. "Although this book is about problems, my goal is that pharma should be adequately regulated and transparent, to the extent that academics can feel positive and enthusiastic about collaboration with it".4. No formal bibliography, must sort through notes.In summary, a real eye-opening book worth reading. Doctor Goldacre exposes an industry that needs to be reformed for the well being of humanity. The focus of the book is to identify problems within the pharmaceutical industry and to provide pragmatic solutions with the ultimate goal of serving humanity. The book's main ideas are repeated almost to a fault but the book is an invaluable expose of an industry that risks the well being of humans for financial gain. I highly recommend it!Further suggestions: " Bad Science: Quacks, Hacks, and Big Pharma Flacks " by same author, " Deadly Spin " by Wendell Potter, " The Panic Virus " by Seth Mnookin, " The Emperor of All Maladies " by Siddhartha Mukherjee, " The Immortal Life of Henrietta Lacks " by Rebecca Skloot, " Merchants of Doubt " by Erik M. Conway, " Science Under Siege: Defending Science, Exposing Pseudoscience " edited by Kendrick Frazier, and " Lies, Damned Lies, and Science: How to Sort Through the Noise Around Global Warming, the Latest Health Claims, and Other Scientific Controversies (FT Press Science) " by Sherry Seethaler.

Evidence based medicine is a term held near and dear, but evidence based research, studies etc. are not based on anything positive- all the so-called evidence is distorted in dozens of crucial stages including drug regulation and laws supposed to protect people. 1) New drugs are not needed, just more expensive and/ or replacements of less new dangerous drugs, or don't work well. 2) Data is purposely skewed to favor benefits. Bad trial data is lost or unreported. 3) Tests on humans are done in third world countries with less than ideal patients for the purpose of the drug 4) Regulators do not do their job as there is a big financial conflict of interest. 5) Doctors are either fooled or paid to push these drugs 6) Most doctors don't even know the difference between Relative Risk and Absolute Risk- big problem as this is the main way that drug's benefits are falsely increased and risks reduced- but it is all just distortion or statistics.The big problem is that nobody in the industry wants to do anything about it. And if they try then they will be lambasted and thrown out of their medical society. We see the same thing happening with politics today- speak up and you are finished.There are many more 'tricks of the trade' that are either deliberately used or become convenient loopholes in every stage of a drug's production and marketing that get used by scientists, regulators, academics and doctors either knowingly, knowingly with the acceptance of money or increased job status to further their interests.Medical journals, for example are not published or edited by the serious scientific minds that we are led to believe- these magazines are either literally owned by the pharma companies themselves or bought with different forms of bribery.The process from a drug's invention (usually a "me too" copy of a molecule) to it's marketing is filled with loopholes that have zero concern for the health or well being of the patient. In fact most drugs since the 1970s are only "invented" as a means to make more profit.This book more than confirms my fears, doubts, and criticisms of medicine I've had my whole life, experienced and studied. And it is a very good reference for all the claims. As the author states, the main reason why people are so impressed and willing to be herded like cattle to slaughter when it comes to trusting medicine, is due to the fact that most people hate effort, especially when it comes to dry material and understanding statistics and systematic review. If it can't be explained in one sentence then most people are not interested.The bottom line is that health is your main concern and drugs will never ultimately save you- only your diet and lifestyle can do that. Yet I am all too convinced that most people do not want to be helped- they just want to remain either helpless victims or they are just too stubborn to put the change and effort in to at least help their own situation, but becoming more aware of their own body and health,. Just like alternative medicine-another group of dubious individuals- people love to swallow a miracle pill and just let their faith guide them without ever gaining any genuine awareness of reality. That is fine with me- this is a free society to so what you please- just that the drug and supplement industry are not transparent, so that the majority of effortless people will unfortunately be misled and as a result suffer much harm, as we see with this health crisis.At best we can look forward to the missing data becoming published in the public domain so that people can at least look at it. But few will do this. And, sadly, even IF the pharma system corrects the dozens of problems that mislead doctors and harm patients, most of the drugs that people take are based on the old system anyway.I have little faith is any system, and am committed to helping people yes, but as Jesus said, "You have to save yourself".2000 years later George Carlin added, "Ya gotta wanna"

This is another well researched and written work by Dr Goldacre. In Bad Science he showed us some of the tricks the pharmaceutical companies get up to in order to sell their drugs. In this book he reveals far more.I haven't read it all yet but am disgusted by the 'criminal' ways the drugs companies routinely hide research data that shows their drugs either don't work properly or could have potentially life threatening side effects.It certainly makes me wonder how those companies are now massaging the data surrounding their Covid 19 vaccines. Everybody needs to know the full truth and that means seeing all the data not just the data they choose to show us.Prescription drugs kill people. In fact they are the third largest cause of death in the US and Europe. This will continue to happen until the drugs companies are more honest, transparent and open about their drugs and research practices. If they were to spend as much money on research and development as they do on pushing their drugs in any way they can to doctors and health services we may be a lot further on with effective treatments for our diseases.This book needs to be read by everyone. Anyone who is sick plus their doctors, politicians, regulators and anyone who works in the health industry. They all need to know what they are dealing with so that they can assess the risks more accurately.Buy and read this book today.

I read Goldacre's book 'Bad Science' some time ago and read this one in the context of the fast development of the Covid vaccines with little safety data available. I knew of some of the scandals around drugs being developed where the manufacturers had been forced to pay significant fines and/or withdraw certain drugs from the market.As Goldacre points out, it isn't just drug companies but also regulators who are implicated. As a doctor, Goldacre wants to know that the drugs he is prescribing are effective in use and with manageable side effects. This book reveals that the reality is that pharmaceutical companies hide a lot of information or manipulate it, and that regulators license drugs which aren't effective and with data on side effects "casually" withheld from doctors & their patients. He describes flawed trials, ridiculously small trial sizes, or those with unrepresentative participants. Of course, these trials invariably produce results favourable to the manufacturer. If they don't show the results the manufacturer wants they won't be published. Goldacre describes a litany of problems - withheld trial data, bad trials with distorted data, information about side effects withheld from regulators, a low regulatory bar for new drugs. We hear of academics compromised by their involvement with pharmaceutical companies which fund most research. Evidence from a review of publications suggest that industry-funded trials are more likely to produce a positive outcome. We may also think that NICE, when deciding what drugs should be used in the NHS, are making their evaluations with all relevant data - they aren't. Disconcertingly, MHRA & the European Medicines Agency don't routinely share information.I was not entirely surprised to read that contracts between pharma companies and universities may contain gagging clauses or provisions which prevent the academics from publishing, discussing or analysing data from the trials they are conducting. Trials can be stopped at any time which can either exaggerate a modest benefit or hide poor results, neither of which is desirable.Aside from these issues, there are other ethical problems e.g. surrounding the selection of trial participants which may have implication for the validity of trials when the drug will be used primarily on a different population. We hear of the use of an experimental antibiotic in Nigeria during a meningitis pandemic - participants were not informed it was experimental or that a known effective drug was available & 11 children died (this was the spark for John le Carre's book 'The Constant Gardener'). Wikileaks revealed attempts by Pfizer staff and US embassy employees to take measures that would result in the legal case being dropped.Goldcare suggests a string of ways in which the system could be improved and indeed some appear to have been adopted. I'm aware that the book is now 7/8 years old but it isn't clear to me that pharma has cleaned up its act. I am writing this review a couple of days after the US courts ordered the US Federal Drug Adminstration to release the data it relied upon to license Pfizer's Covid vaccine - they had asked for 56 years (!) to review & release the information. Interestingly, whilst the Covid vaccine trials continue, the control group has largely disappeared as participants were offered the vaccines. It has become apparent too that contracts for the supply of drugs have placed many restrictions on governments. Ironically, Goldacre has, disappointingly, been silent on the issues around the Covid vaccines: his critique could be valuable. The cynic in me believes that Big Pharma has not given up its murky practices.

Really interesting deep dive into the murky waters of creating new drugs, then how industry conducts trials of them, only to selectively publish depending on the outcomes. Shows how money talks on a massive scale (for what is after all a multi billion dollar a year industry as a collective) wonder to what extent a follow up years on would reveal, have they cleaned up their acts, or does much of the work/promotion etc on new treatments go on behind closed doors still?

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.

This is a mind-boggling expose of just what is going on in the world of pharmaceuticals, medicine,academia, politics and even in so-called regulatory agencies. It is as shocking and disgraceful asthe levels of dishonesty and fraud in banking and finance following the crash of 2008. Everybody shouldread this book, patients, doctors, politicians, academics and regulators. There are clearly many people invery powerful positions who should be held to account and are repeatedly getting away with their failuresand cover-ups, just as they were doing in the banking sector. As somebody holding an academic doctoratemyself one can only despair at the corrupt practices that are going on in the academic world because, along withregulatory bodies these are two institutions in our society where we ought to be able to depend on total honesty,transparency and trustworthiness.