Bad Pharma by Ben Goldacre

The subtitle to this discussion is ‘How drug companies mislead doctors and harm patients”.

When you go to your doctor, “you want the treatment that has been shown, overall, in fair tests, to be better than all others.” The question is, how does your doctor decide what medicine to use? This book tells you, unfortunately, that doctors must make decisions despite being denied access to all the investigative data by trial sponsors and a failed regulatory process in the face of overwhelming marketing pressure.

I think this book is mistitled. While it focuses on big pharma, it really outlines just how badly the medical research-corporate-government complex has failed patients. The doctor-patient relationship has devolved to the doctor being a figurative personal shopper who has to sift through incomplete information to find the best buy when it comes to treatments.  That’s hard to do when, say, 50 trials for a drug are conducted, maybe half get registered at ClinTrials.gov, of which only 25% find results favorable to the sponsoring company while the other 75% of the studies never end up in print. Why? Who’s to blame? Journal editors? Ghostwriters? The peer review process? Marketing arms of big pharma? Academic reward systems? Payers?

There is more than enough blame to go around.

The problem is that everyone involved knows that the system is broken, but no one seems willing to take responsibility and certainly no one is in control.

For people outside of medicine, this book will probably cause the blood of many to boil. To those inside medicine, it’s probably just business as usual that, unfortunately, can be fatal leading to unnecessary premature death. This copiously referenced book lays out hundreds of breadcrumbs for the reader to dig further.

Dr. Goldacre is a UK general practitioner who also wrote Bad Science, which I will find a way to read. Found this book on the same table as Naked Statistics, recently reviewed here at MRB. Check out Goldacre’s blog at www.BadScience.net. Sure looks like big pharma, government, and other stakeholders in this mess aren"t all that keen to fix things as they have too much invested in the status quo. Goldacre advocates a ground up swell by patients to make demands of the people they pay. A well informed person when it comes to healthcare should sprint to a store (or Amazon.com) and get this. And make sure to have a ready supply of omeprezole (Prilosec) on hand, not Nexium. Get the book to find out why Thomas Scully, the head of Medicare/Medicaid, says, "Any doctor who prescribes Nexium should be ashamed of himself."

East Coast Don