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Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients Hardcover – February 5, 2013
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We like to imagine that medicine is based on evidence and the results of fair testing and clinical trials. In reality, those tests and trials are often profoundly flawed. We like to imagine that doctors who write prescriptions for everything from antidepressants to cancer drugs to heart medication are familiar with the research literature about a drug, when in reality much of the research is hidden from them by drug companies. We like to imagine that doctors are impartially educated, when in reality much of their education is funded by the pharmaceutical industry. We like to imagine that regulators have some code of ethics and let only effective drugs onto the market, when in reality they approve useless drugs, with data on side effects casually withheld from doctors and patients.
All these problems have been shielded from public scrutiny because they're too complex to capture in a sound bite. But Ben Goldacre shows that the true scale of this murderous disaster fully reveals itself only when the details are untangled. He believes we should all be able to understand precisely how data manipulation works and how research misconduct in the medical industry affects us on a global scale.
With Goldacre's characteristic flair and a forensic attention to detail, Bad Pharma reveals a shockingly broken system and calls for regulation. This is the pharmaceutical industry as it has never been seen before.
- Print length448 pages
- LanguageEnglish
- PublisherFarrar, Straus and Giroux
- Publication dateFebruary 5, 2013
- Dimensions6 x 1.25 x 8.5 inches
- ISBN-100865478007
- ISBN-13978-0865478008
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Product details
- Publisher : Farrar, Straus and Giroux; Reprint edition (February 5, 2013)
- Language : English
- Hardcover : 448 pages
- ISBN-10 : 0865478007
- ISBN-13 : 978-0865478008
- Item Weight : 1.25 pounds
- Dimensions : 6 x 1.25 x 8.5 inches
- Best Sellers Rank: #241,157 in Books (See Top 100 in Books)
- #36 in Pharmaceutical & Biotechnology Industry (Books)
- #72 in Scientific Research
- #120 in Pharmacies
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Customers find the book very informative, thorough, and devastatingly clear indicting the perverse incentives of the drug industry. They also describe the book as compelling, clear, and absolutely necessary. Opinions are mixed on the content, with some finding it shocking and riveting, while others say it's not as interesting or scary as Bad Science.
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Customers find the book very informative, well-documented, and readable. They appreciate the statistical facts and wise, carefully thought-out thesis. Readers also appreciate the extensive list of references and thoroughness of the story. Overall, they say the book persuasively explains how pharmaceutical money, rather than unbiased clinical trials, largely influences the market.
"...And it is a very good reference for all the claims...." Read more
"...He is consistent throughout the book.4. Does a great job of explaining key medical terms, and provides a glossary of terms for quick..." Read more
"...He is careful to document and cite references...." Read more
"This is an incredibly deep and thorough look at the falsity and outright fraud being perpetrated through "scientific" studies and drug trials...." Read more
Customers find the book compelling, well written, and easy to understand. They also say it's an incredibly deep and thorough look at the falsity and outright.
"...The book is written in an easy to access language, and so it reads well...." Read more
"...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...." Read more
"...His writing is direct, succinct, lively and engaging. He is careful to document and cite references...." Read more
"This is an incredibly deep and thorough look at the falsity and outright fraud being perpetrated through "scientific" studies and drug trials...." Read more
Customers have mixed opinions about the content. Some find it shocking, riveting, and eye-opening, while others say it's not as interesting as Bad Science. They also say the subject and practices described are insidious, convoluted, and perverse.
"I've been a nurse for almost thirty years. There were very few surprises in the narrative; most of the problems the author discusses are well known..." Read more
"...The book is BORING...." Read more
"...Well-argued, credible, and supported by lots of research - and rather scary, frankly." Read more
"...and redundant, the same info could have been presented much more concisely and convincingly in half the space or less...." Read more
Customers find the emotional tone of the book disturbing, depressing, and whiny. They also say the tone is breathless and dogmatic for their taste.
"...had to put it down several times before finishing it, disturbing and depressing and complicated as it made me feel...." Read more
"...The tone is a little breathless and dogmatic for my taste, and some points are oversold, but this book should be of interest to customers and to..." Read more
"Good points but too whiny. I prefer to read the same information from a more positive view." Read more
"A technical read -- interesting because it is so depressing...." Read more
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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"
The book is written in an easy to access language, and so it reads well. He does repeat himself a bit, so one more round of editing and cleanup before release would probably have been a good idea. Some readers on amazon.co.uk have criticised this, but I don't see it as an issue.
You don't need to have a degree in medicine or a higher degree in general to understand the issues Ben highlights.
Ben Goldacre runs the Bad Science website (badscience dot net) and has previously written the book Bad Science. Where Bad Science was an attack on quackery and pseudo science, and his website to a large degree has dealt with the same topics, this book is a critical look at the pharmaceutical industry. As such it ought to silence those that have attacked Ben Goldacre for being in the pockets of the Pharmaceutical industry over time.
Ben Goldacre has done society a big favour by writing this book. I definitely recommend reading it if you want to understand more about how US and European health care works and what can be done to improve it in the future.
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Way back when the FDA lowered by half (repeat: by half; i.e. by 50%!!) their estimate of how much blood cholesterol was dangerous and needed to be lowered with widespread use of statins, I became a thorough going skeptic of the FDA and the industry as a whole. Goldacre took a detailed look at the industry, the doctors who are (unknowingly, or unthinkingly, or otherwise) co-opted by pharmaceutical companies with big budgets, and the shoddy and sometimes intentionally misleading "studies" that purportedly prove the effectiveness of the drugs they are shilling to the unsuspecting public and the "look the other way" FDA and other agencies which are supposed to protect us from this charlatinism. Nobody comes out of this analysis clean and lilly white. Quite the opposite.
Goldacre is not a doomsayer, but he is certainly a whistle blower. Whether this has any effect on doctors in England, Europe, the States, or here in Canada is an open question. My gut feeling is: No, it will have little effect. But we patients might be able to have some influence. We can give our doctors this book and encourage them to read it. The tough job is to convince them that you are NOT inditing them by giving them the book. Many doctors are likely to take offense my your doing this. So... send it to them by mail with no (or a bogus) return address.
Even if 75% of what Goldacre says is wrong, it is still a big concern, and getting bigger. Everyone who cares about their health should read this, and then take extra precautions when doctors suggest drug treatments. Look more closely. It's up to us.
In "Bad Pharma" lernen wir nun, dass auch in dieser vieles, sehr vieles im Argen liegt. Ben Goldacre führt uns ein Gesundheitswesen vor, das von den Geschäftsinteressen der Pharmaindustrie gesteuert wird und das Wohl der Patienten weitgehend aus den Augen verloren hat. Hier einige Gründe für dieses Desaster:
Die medizinischen Testreihen, in denen neue Medikamente an Versuchspersonen und Patienten ausprobiert werden, werden ganz überwiegend von der Pharmaindustrie finanziert und kontrolliert. Das führt nicht nur dazu, dass systematischen und statistischen Manipulationen, die gewünschte Effekte übertreiben und unerwünschte Nebenwirkungen herunterspielen, Tür und Tor geöffnet wird, sondern dass ganze, für das betreffende Medikament weniger schmeichelhafte Testreihen überhaupt nicht veröffentlicht werden. Es fehlen daher die Erkenntnisse aus mindestens der Hälfte aller Untersuchungen, Erkenntnisse, für die Versuchspersonen und Patienten ihre Gesundheit, wenn nicht gar ihr Leben riskiert hatten.
Auch die Fachzeitschriften, in denen diese Testreihen veröffentlicht werden, sind finanziell von der Pharmaindustrie abhängig: Ein Unternehmen, dass teure Anzeigen schaltet, wird man tunlichst nicht mit Artikeln verprellen, die unschöne Nebenwirkungen eines seiner Superprodukte zum Thema haben. Und die Zeitschriften tolerieren weiterhin stillschweigend das Ghostwriterunwesen, bei dem die Koryphäen von den Unikliniken zu den veröffentlichten Artikeln kaum mehr als ihren Namen beitragen.
Für Marketing gibt die Pharmaindustrie etwa doppelt so viel aus wie für Forschung und Entwicklung. Dabei handelt es sich z. B. die "Weiterbildung" von Ärzten in 5-Sterne-Resorts an den schönsten Orten dieser Welt, aber auch um die Heerscharen von Pharmavertretern, die Ärzte mehr oder weniger nachdrücklich (und nachgewiesenermaßen sehr erfolgreich) von den Vorzügen ihres Sortiments überzeugen. Hier steht das Ziel der Industrie, ihre Produkte möglichst teuer zu verkaufen und ihren Aktionären Freude zu machen, in klarem Konflikt mit dem Interesse des Patienten, die beste Behandlung zu bekommen, und auch mit dem Interesse der Krankenkassen, das Geld der Versicherten nicht für neue, teurere Medikamente zu verschleudern, die nicht besser sind als die Generika, die sie ersetzen sollen.
Es gibt inzwischen in vielen Ländern halbherzige Ansätze, all diese Praktiken durch geeignete Regelungen zu einzudämmen, aber selbst diese werden von den zuständigen Behörden bisher kaum oder gar nicht nicht umgesetzt.
Das Beunruhigendste ist aber, dass praktisch alle Medikamente, die heute verschrieben werden, mit diesen höchst evidenzverfälschenden Methoden auf den Markt gebracht wurden. Es wäre für die Beteiligten also nicht damit getan, sich ab sofort ethisch und juristisch korrekt zu verhalten, sondern es muss alle Evidenz der Vergangenheit auf den Tisch, die jetzt noch unter Verschluss gehalten wird. Überhaupt ist "Bad Pharma" voller Vorschläge, wie Abhilfe geschaffen werden kann, und auch uns Lesern, ob wir nun Ärzte und Patienten oder Verantwortliche der Pharmaindustrie sind, gibt Goldacre zu jedem Thema konkrete Ratschläge, wie wir dazu beitragen können, diesen übelriechenden Sumpf trockenzulegen: Wenn wir nichts tun, werden sich "die da oben" nicht bewegen.
Für den leidlich informierten Leser ist nicht alles, was hier zusammengetragen wurde, neu und überraschend, aber als hervorragend recherchiertes und vorzüglich geschriebenes Kompendium für die Missstände bei Entwicklung und Anwendung von Medikamenten ist "Bad Pharma" wohl einzigartig. Ohnehin macht die Tatsache, dass so vieles allgemein bekannt ist, sich aber trotzdem kaum etwas ändert, alles eigentlich noch viel schlimmer.

