Bad Pharma, Professor Ben Goldacre
Dr. Ben Goldacre, Research Fellow in
Epidemiology, London School of Hygiene and Tropical Medicine, ben.goldacre@lshtm.ac.uk,
http://en.wikipedia.org/wiki/Ben_Goldacre
Goldacre is known
in particular for his "Bad Science" column in The
Guardian, and is the author of two books, Bad Science (2008), a critique of irrationality
and certain forms of alternative medicine, and Bad Pharma
(2012), an examination of the pharmaceutical industry, its publishing and
marketing practices, and its relationship with the medical profession.
Ben
maintains that the evidence base
is broken by pharma. In his book he
develops nearly all aspects of how pharma turned medical science into marketing
and gives a few of the consequences. We
have replaced evidence based medicine with marketing. Below is a quote of what
his book Bad
Pharma covers.
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 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 then 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 that everything is
fine after all.
Prof. Ben Goldacre, MD, Bad Pharma, Page
XI, Nov. 2012
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