Bad Pharma examines how the pharmaceutical industry manipulates the medical profession by burying scientific trials, funding flawed research, patronising KOLs and obstructing independent analysis that threatens to damage their profit making commercial objectives.
Bad Pharma by Ben Goldacre
Bad Pharma is the book that prompted the UK Parliament to reform healthcare.
Following on from the success of Bad Science, author and doctor Ben Goldacre exposes the activity of pharmaceutical companies seeking to maximise profits by any means necessary even if this means aggressively marketing products that have little or no scientific benefit for healthcare patients.
Covering everything from missing trial data, flawed regulators, bogus trials and aggressive marketing practices, the author lays out just how far companies such as AstraZeneca, Pfizer, GlaxoSmithKline, Roche and Novartis will go to ensure that they continue to make money from the healthcare systems of the world.
Below are some of the key insights I took from this book:
- The pharmaceutical industry sponsors the vast majority of medical research and takes steps to ensure that positive outcomes are obtained.
- Trials with negative outcomes are routinely left unpublished preventing medical practitioners from seeing a clear picture.
- While prestige medical journals have peer review processes, the bulk of their advertising spend comes from the industry.
- Regulators are also funded by the industry and deliberately obstruct practitioners from accessing full and detailed information.
- Systematic reviews [Cochrane] demonstrate that many novel drugs e.g. Tamiflu have little to no objective benefit for the medical profession.
- Developing new drugs is a hugely expensive endeavour so pharmaceutical companies cut corners to ensure that more drugs come to market.
- Regulators are targeted on how quickly it takes to approve new drugs so will typically undercook their scientific basis or overlook reports of side effects.
- Where trials do take place the industry attempts to cook the books by selecting atypical patients, ending trials early, comparing with poor alternatives and generally not being rigorous enough with scientific detail.
- More generally, medical practice would benefit from larger simpler trials that could be used to effectively demonstrate the potential of novel drugs.
- Marketing budgets exceed R&D budgets at pharmaceutical firms and in many markets there is a consistent push to deregulate the industry to allow for B2C advertising.
- Even in countries where regulation exists, pharmaceutical companies seek to influence professionals with consistent B2B advertising/public relations that deliberately misrepresent their products.
- Since the publication of the book there has been a groundswell of support for reform but also consistent opposition and lobbying at each step to retain the current system.