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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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