I like to think that what I do on this blog is provide “evidence-based” writing on issues of interest to me. These have been predominantly, but not exclusively, related to football, and the assorted machinations and manipulations surrounding Rangers Football Club, and its various owners.
I do write about purely legal things too, aside from the legal aspects of the football imbroglios.
These things are of varying degrees of importance to people. To some football is the most important thing in the world – to others the football side is merely a trivial diversion.
If I was ever to write a book (hah), then I would be proud to have it compared to the volume this post is about.
Whilst there are arguments about the value of the subjects I write about, there is no doubt that the topic of Dr Ben Goldacre’s marvellous book, “Bad Pharma”, is one of huge importance to everyone in the country, and indeed to everyone in the world.
Dr Goldacre, in 365 pages of impeccably sourced text, reveals the scandal of how global drugs companies have, for many years, manipulated and hidden the results of drugs trials; have distorted the results of research so that neither medical professionals nor patients can possibly get a proper idea of the effectiveness and safety of many common drugs; devised ways of extending the patents on drugs by subtle alterations to their makeup, thus costing public health services huge extra sums in costs of medicine; and spend billions of dollars on marketing and promotion which persuades doctors to prescribe medication which will not be the best for their patient.
The drugs companies argue that their promotional and advertising budgets are simply for public information and are not intended to persuade patients to demand the medication, or to encourage doctors to prescribe them. That may be true, but it is similar to the protests of the tobacco companies that it spent so much money simply to encourage existing smokers to switch brands, and that not a penny or a cent of their marketing budgets was meant to have non-smokers take up the habit.
Ben is a best-selling author, broadcaster, medical doctor and academic who specialises in unpicking dodgy scientific claims from drug companies, newspapers, government reports, PR people and quacks. Unpicking bad science is the best way to explain good science.
The key thesis of Bad Pharma is as follows:-
- 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.
- These trials tend to produce results that favour the manufacturer.
- When trials throw up results which do not suit the manufacturer, they are perfectly entitled to hide them from doctors and patients.
- Regulators see more of the data but do not pass this to doctors or patients.
- Academic papers, assumed to be objective, are often covertly planned and written by people who work directly for the drugs manufacturers, without disclosure.
- For some of the most important and enduring problems in medicine, we have no idea what is the best treatment because it is in no one’s financial interest to conduct any trials at all.
Dr Goldacre proceeds to back up all these charges, and more. No one comes out of the book well.
Regulators fail to regulate.
Drugs companies use all sorts of covert and underhand, and in some cases illegal, methods to sell their drugs.
Some medical professionals and academics take the drug companies’ cash for writing or presenting, or even simply allowing their name to be added to, a presentation. (And in no way to do something as vulgar as to promote a drug.)
The media regurgitate, uncritically, stories which benefit the drug companies, in a way familiar to readers of Nick Davies’ “Flat Earth News”. “Churnalism” is rife.
Dr Goldacre points out too how the frequent press stories about patients castigating the NHS for not providing some new, but hugely expensive, “wonder drug” all seem to be of benefit to the drugs industries, and the patients’ groups who pursue these campaigns, such as for the anti-cancer drug Herceptin, are often funded largely by the drugs companies. It is surely mere coincidence that these patients’ groups rarely criticise the drugs companies for the high costs of the drugs they sell.
The largest fines imposed in the American criminal justice system were imposed on multi-national drugs companies.
Yet despite all of this, the pharmaceutical industry continues on its lucrative way, making medical reps, advertisers and PR people rich, and not doing the best for the patients who consume its products.
The problems are industry-wide. All of the major players are accused by Dr Goldacre of misleading doctors and harming patients.
And, as well as being a book which is meticulously referenced, with practical suggestions for readers regarding what they can do to try to make things better, Dr Goldacre is also a fine writer, able to be humorous about these vital issues, without ever losing the point he makes.
Read this book.
Posted by Paul McConville
PS In the interests of full disclosure, I confirm that this post was written by a ghost-writing team of 27 people from the publishers, who presented me with 17 boxes of branded pens and post-it notes, whilst hiding all of the notes from which the post was prepared.
PPS The above PS is a joke.