The one-sentence summary

Drug companies mislead doctors and harm patients, so a complete overhaul of the industry is needed.

WHAT THE BOOK SAYS BAD PHARMA

  • This is a hard-hitting book about how drug companies mislead doctors and harm patients.
  • It claims that the pharmaceutical industry is a $600 billion business that is rife with corruption and greed.
  • Informed medical decisions can only be made with good scientific evidence, but trials are biased, with distorted results, and unflattering data is simply buried.
  • Government regulators withhold vital information, and seemingly independent doctor and patient groups are effectively funded by the industry.
  • As a result, patients are unnecessarily harmed, in huge numbers.
  • Missing data is vital because it adds to understanding, so it is a scandal that so many aborted or unfinished trials are never reported anywhere.
  • To generate a ‘positive’ result in a trial, a drug only has to be better than a worthless placebo – usually a sugar pill of some kind. The drugs are often tested on low- or no-income people in a ‘mild torture economy’.
  • A huge proportion of so-called academic papers are ghost written by non-experts, and funded by drug companies. As such, an unknown, but probably large, proportion of the literature could be horribly wrong. An amnesty should be called so everyone can come clean about this, and so understand what is technically accurate and what isn’t.

WHAT’S GOOD ABOUT IT

  • Systematic reviews find every trial and piece of data on a topic and score them neutrally to give a truly accurate view. These are time-consuming and fairly rare, but they can be done, and they generate a ‘blobbogram’, where deviations from the mean can be seen easily.
  • Drugs are often tested on ‘ideal patients’ – perfectly healthy people – but this is misleading because true patients are unwell, and so may be prone to more complicated reactions and side effects.
  • Randomised trials should be used where it is unclear which treatment is better, but these are almost never conducted.
  • 25% of the cost of a drug is spent on marketing – astonishingly, twice as much as on research and development. So we always pay more than necessary for drugs.
  • Marketing convinces healthy people that they are patients, and it influences doctors whether they claim it does or not.
  • Hilariously, Clomicalm claims to be the ‘first medication approved for the treatment of separation anxiety in dogs.’

WHAT YOU HAVE TO WATCH

  • Not much. It is something of a polemic but the research is convincing.