Audiobook11 hours
Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients
Written by Ben Goldacre
Narrated by Jonathan Cowley
Rating: 4 out of 5 stars
4/5
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About this audiobook
Medicine is broken. We like to imagine that it's based on evidence and the results of fair tests. In reality, those tests are often profoundly flawed. We like to imagine that doctors are familiar with the research literature surrounding 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 industry. We like to imagine that regulators let only effective drugs onto the market, when in reality they approve hopeless drugs, with data on side effects casually withheld from doctors and patients.All these problems have been protected from public scrutiny because they're too complex to capture in a sound bite. But Dr. 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 on a global scale affects us. In his own words, "the tricks and distortions documented in these pages are beautiful, intricate, and fascinating in their details." With Goldacre's characteristic flair and a forensic attention to detail, Bad Pharma reveals a shockingly broken system and calls for something to be done. This is the pharmaceutical industry as it has never been seen before.
Author
Ben Goldacre
Ben Goldacre is a doctor and science writer who wrote the 'Bad Science' column in the Guardian from 2003 to 2011. He has made a number of documentaries for BBC Radio 4, and his first book Bad Science reached Number One in the nonfiction charts, has sold over 500,000 copies. . His second bestselling book, Bad Pharma, was published in 2013.
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Reviews for Bad Pharma
Rating: 4.159884052325581 out of 5 stars
4/5
172 ratings14 reviews
- Rating: 4 out of 5 stars4/5You will look at your pills in a different way
- Rating: 5 out of 5 stars5/5"Bad Pharma" by Ben Goldacre is a scathing indictment of the pharmaceutical industry's unethical practices and their detrimental impact on patients. Goldacre's clear and critical intent is evident throughout the book, as he meticulously uncovers and exposes the many ways in which drug companies mislead doctors and harm patients for profit.
One of the strengths of the book is its thorough research and evidence-based approach. Goldacre draws from a wide range of sources, including academic studies, clinical trials, and industry documents, to provide a detailed account of the industry's misconduct. He presents his arguments with clarity and precision, making it easy for readers to understand the complex issues at hand.
Another strength of "Bad Pharma" is its uncompromising critique of the regulatory system that is supposed to ensure the safety and efficacy of drugs. Goldacre shows how regulatory agencies have become too cozy with the pharmaceutical industry, leading to a system that prioritizes profits over patients. He calls for urgent reform of the regulatory process to ensure greater transparency and accountability.
While Goldacre's message is sobering, he also offers a hopeful message, emphasizing the need for increased public awareness and advocacy. He argues that patients and doctors have a critical role to play in pushing for greater transparency and accountability from the pharmaceutical industry.
In conclusion, "Bad Pharma" is a compelling and important book that provides a clear and critical account of the pharmaceutical industry's unethical practices. Goldacre's clear and critical intent makes this book a must-read for anyone interested in the intersection of healthcare and industry. - Rating: 5 out of 5 stars5/5Bad Pharma is actually a fairly scary book to pick up when you’ve just collected a prescription from the chemist but I’d heard a lot about Bad Science (which I’ve since read) and thought Bad Pharma would be incredibly interesting. I certainly wasn’t wrong.This is pretty much a damaging expose of the pharmaceutical industry’s involvement in modern medicine. Not necessarily their manufacture and distribution of tablets that do improve people’s lives every day but more the unnecessary peddling of drugs that either do very little or are no more effective than drugs already on the market. We’ve all seen the washing powder ads for something ‘new and improved’, only to find out two months later that it’s got one slight miniscule change. How ludicrous would it be if the drug companies did something similar and then got it under patent for 10 years so they could charge incredibly high prices for it? Well, they do.Delving into issues such as pricing, drug trials, suppression of research and trial reports, Goldacre uncovers how strong the hold over our medication is and calls for changes across the board, citing things that patients, doctors, governments, researchers and the drug companies can do.I’m sure Goldacre didn’t make any drug rep friends via this book – and I’m quite sure he doesn’t care. It’s refreshing to read something that is so focussed on what’s right, regardless of the waves it makes. That said, having now gone back and read Bad Science, it’s not really a surprise. This is an absolutely fascinating read for anyone who has had any involvement with our health system or ever taken any medication whatsoever. So, that’s pretty much everyone!
- Rating: 4 out of 5 stars4/5A very thorough but depressing look at the state of modern medicine and the pharmaceutical industry. More technical than his previous book Bad Science, Ben Goldacre makes a difficult subject accessible to a general audience. Looking at issues from drug licensing, to research into existing treatments, to publication bias and drugs marketing. This truly is a global business and as such we get examples from around the world, focussing specifically on the UK and USA. There are suggestions for improvements and issues to campaign on in all areas. Looses one star for being a little bit repetitive.
- Rating: 4 out of 5 stars4/5Goldacre has a way of making complex science subjects accessible to the wider public. His first book, Bad Science, highlighted the way that the media dealt with reporting science, and in this book he concentrates his ire onto the $600 billion global pharmacy industry, now dominated by a handful of behemoths.
And what he reveals is frankly terrifying. He details the way that the industry hides a large majority of the trial data, the way that the legislation requiring data to be published is ignored by companies, and in the EU it is still secret in some cases. There is loads of detail on the way that the data is cherry picked to demonstrate that a particular drug is so much better than the competition. There is lots of detail on the appalling way that the industry is regulated, even though it is very heavily regulated, most of it is ineffective and not enforced, and where the regulation could be improved to help patients and save lives these are not enforced or are not enacted on after lobbying from the industry.
The biggest chapter though is on the marketing that these companies employ. Their budgets for marketing are normally twice the R&D budgets, which gives you some idea of where their priorities lie. He explains how they sponsor various ‘conferences’ and provided sweeteners to medical professionals at all levels, from lunches to flights to what most people would consider bribes. The nefarious dealings of the drugs rep are dealt with too, from the pressure that they put onto doctors to use their medicines and the way that they collect data directly from surgeries and pharmacies. A lot of academic papers are ghost written, and a leading figure puts their name to it, shocking really.
There is some details on NICE, but not a huge amount. He looks at the way that they select the drugs for use in treatment, noting that even they do not have access to all the trail data for each medicine that they consider.
He also writes about how a lot of the drug companies fund patient groups either overtly with cash donations or covertly by funding particular conferences and so on. They have been proven to use them to exert pressure on national agencies (FDA and NICE) to supply the latest drugs regardless of the cost; i.e. £50K spent with a group means that they get their £21k per patient drug treatment approved, even though the trial evidence is not there or is at best not proven to be any more effective than the current items on the market. A real scandal.
Throughout the book he does give suggestions on how the situation can be improved but he does realise that they is an endemic problem and powerful vested interests do hold sway. Even just enforcing the current rules would make a difference, but it seems unlikely at the moment.
The phrase for illegal drugs used to be: Just Say No. Perhaps it should apply to legal drugs too... - Rating: 4 out of 5 stars4/5It is possible to be so cynical that nothing that Goldacre describes is in the least surprising, but at the same time to be interested in the mechanism.Goldacre is currently making the problems described in this book is life's work. The book is meant to persuade people: patients, doctors and workers in the pharmaceutical industry, to make changes for the better. He suggests actions that people in all these groups could take. Some suggestions seem hopelessly naive, but perhaps they are included as satire.Goldacre addresses the book to a lay audience unfamiliar with statistics, using well-chosen analogies to get his point across. He uses identical phrasing throughout the book, to remind those less familiar with statistics, what effect the behavior he is discussing has on the best available knowledge about a particular drug.On a personal note, a near relative of mine nearly died from a adverse reaction to a medication he had been prescribed for bursitis in his elbow. We do not know if previous adverse reactions had been covered up by the industry, or if his reaction made it into the medical literature.
- Rating: 4 out of 5 stars4/5We don't regulate our drugs and the drug companies enough and insist on ensuring that data about the edges of results, I begin to wonder if the drug companies had previous seen the side-effects I suffered with a blood pressure medication and if I could have avoided hundreds of euro in specialist fees in discovering this MYSELF!Interesting look at how drug companies present their goods and how the love of money is indeed the root of many evils. How bias can creep in with doctors and cause them to favour one drug company over another and prescribe their drugs and how this can, often inadvertently, cause harm. There is also a touch of a discussion of overmedicalisation of normal, where drug companies are encouraging doctors to have people on medication, even if they don't really need it. It's a conversation we need to have. Though there also needs to be more testing on the filler in drugs, particularly on generics.
- Rating: 4 out of 5 stars4/5Ben Goldacre is a very angry man, with good reason. In this book he lays out how the pharmaceutical industry has distorted drug research in pursuit of profit, sometimes intentionally, sometimes entirely without malice but with equally devastating effects for patient welfare. This matters because patients are prescribed less effective drugs, or drugs which are outright harmful, at huge financial expense to those paying for the drugs. This isn’t a conspiracy theory book; Goldacre is quite clear that many valuable drugs have come out of the industry, and that most of the people who work in it want to make better drugs. He sets out in detail how and why bias is introduced into both research and prescribing practices, putting it in layman’s terms but linking to the research papers and court documents that back up what he’s saying. He also addresses the failings of the current regulatory system, and proposes ways to improve things — pointing out that unless real controls with serious financial penalties are put in place, even those companies which genuinely want to reform will be under commercial pressure to continue with bad practice in a race to the bottom.It’s a dense and at times exhausting read. But Goldacre has done a decent job of making the issue accessible to a wide audience with a direct interest, from patients to practising doctors and academics. You can skim a lot of the book to get the general gist, or you can read it in details without following the links, or you can dig into research material he drew on and has laid out in meticulous footnotes and citations. He concludes the original edition with practical suggestions about what individual people can do to improve things, often simply by asking questions.I read the second edition, which has a “what happened next” chapter about the reaction to the first edition. As he had predicted, there was a backlash in an attempt to discredit him — but there was also a lot of covert feedback from industry personnel acknowledging the problems and considering how to improve things. While there’s always a “the lurkers support me in email” issue with uncredited sources, he does also offer some examples of companies which have publicly moved to improve transparency.Bad Pharma is an angry but rational examination of a real problem that affects millions of people, including almost anyone reading this review. It’s a worthwhile read, even if it makes for uncomfortable reading for patients, doctors and companies alike.
- Rating: 4 out of 5 stars4/5Ben has alot of good points and appears well researched. It seems a bit alarmist but probably appropriately so. It is an unfortunate state of affairs. Ben also provides suggestions on how to help fix the situation. I recommend the book.
- Rating: 4 out of 5 stars4/5As with Goldacre's previous book, Bad Science, Bad Pharma is a critical review, but now where he scrutinizes Big Pharma and other parts of the medical industrial complex. His exposé is perhaps not that original, but his overview is fine and his suggestions for improvements worth considering for policy makers and others in the medical industrial complex. A bought this book and then ran into Peter Gøtzsche's book "Deadly Medicines and Organised Crime" in its Danish incarnation, and must say I switched to Gøtzsche's book and completed that before continuing with Goldacre's. I found more bite in Gøtzsche's book (he compares the drug industry with the mafia!) and he has the advantage of doing original research in the field, while Goldacre's contribution to the medical literature has been more discussive, - as far as I can determine. But Gøtzsche's and Goldacre's books support each other well in addressing problems with the drug regulation: We are not dealing with a single author which sees problems. We may also take they differences in suggested solutions as a indication that there may be no one simple solution, e.g., should we let the state make clinical trials or would that make a considerable burden on taxpayers? It may relieve the pharmaceutical industry of expensive trials and let the society - perhaps - get more unbiased results.
- Rating: 4 out of 5 stars4/5Not quite as much fun as "Bad Science" being very much more serious and more concerned to build an irrefutable case against the pharma industry and its corruption of medicine. Also while one can laugh at quacks and phoneys this is much closer to home. He argues that there is built in distortion in the way medicine is pushed through the system, evidence is subtly distorted, selective results are given wide publicity so that scientific evidence-based medicine is deeply compromised. So costs are greater than they need be, side effects are suffered which could be avoided, continuous improvement is blocked.
- Rating: 5 out of 5 stars5/5Everyone should read this book. Boldacre shows how trials for drugs and their perceived usefulness can be manipulated - unpublished data and outright data suppression, trials stopped early, trials extended, ghost written journal articles, etc. How doctors are influenced by the drug industry, beginning in medical school and continuing throughout their practice.
Goldacre is himself a practicing physician and this book stems in part from his outrage at having prescribed medications when he thought were safe and effective after reviewing the available published data, only to find that in some cases the drugs were not only ineffective, but worse that nothing. - Rating: 4 out of 5 stars4/5I already knew that the pharmaceutical system was greatly flawed, but Goldacre puts a useful focus to the issues. Enjoyed his Britishisms.
- Rating: 4 out of 5 stars4/5In Bad Science, Ben Goldacre presented many of the flaws with science literacy in the general public. He introduced the major concepts of medical and scientific information with enlightening real world examples (homeopathy used to treat HIV, the MMR scare, etc.) and a healthy dose of humor. It was a wonderful introduction to the field and I use that book as a text book for my introduction to health information class. I had high hopes for Bad Pharma. This book is far more of a jeremiad. I think every point he made needed to be made and I share his ire. But the style I enjoyed so much in his first book was completely absent in his second. I felt like I was being scolded instead of informed, which made this a much more arduous book to complete. I would still suggest this title to anyone who wants to be involved in public health or health policy.