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Bad Pharma: How Medicine is Broken, and How We Can Fix It Paperback – 29 Aug 2013

4.5 out of 5 stars 342 customer reviews

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‘This is a book to make you enraged – properly, bone-shakingly furious – because it’s about how big business puts profits over patient welfare, allows people to die because they don’t want to disclose damning research evidence, and the tricks they play to make sure doctors do not have all the evidence when it comes to appraising whether a drug really works or not. A work of brilliance.’ Max Pemberton, Daily Telegraph

‘This is a brilliant piece of work’ Evening Standard, William Leith

‘This is an important book. Ben Goldacre is angry, and by the time you put ‘Bad Pharma’ down, you should be too.’ New Statesman

‘Nailing the compromise between too much detail and too little, Goldacre’s brilliantly enraging study unpeels how the pharmaceutical giants routinely misrepresent science in their quest for profit.’ Sunday Telegraph

‘What keeps you turning its pages is the accessibility of Goldacre's writing … his genuine, indignant passion, his careful gathering of evidence and his use of stories, some of them personal, which bring the book to life.’ Luisia Dilner, Guardian

‘This is a book that deserves to be widely read, because anyone who does read it cannot help feeling both uncomfortable and angry.’ Economist

‘’Bad Pharma’ will confirm his status as a thorn in the side of the medical Establishment – Goldacre’s detailed research would be hard for any drug-company executive to contradict’ Lois Rogers, Sunday Times

About the Author

Ben Goldacre is a doctor, writer, broadcaster and academic who specialises in unpicking dodgy scientific claims from drug companies, newspapers, government reports, PR people and quacks. His first book, Bad Science, reached Number One in the non-fiction charts, sold over 400,000 copies in the UK alone, and has been translated into 25 languages. He is 38 and lives in London.


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Format: Paperback
This is an impressive book on a serious subject which at times really is a matter of life and death. It can be read by anyone interested in the pharmaceutical industry, and doesn't require any previous knowledge of medicine or even science in general.

The tone is chatty enough to keep you interested, while remaining relatively well structured. I think you will get an idea of whether you would enjoy this book by first watching either of Ben Goldacre's TED talks: if you finish watching them and think "I want to know more" then this book is going to be just the thing for you.

There is no hint of conspiracy theory in this book. Goldacre sticks to a sober recounting of the problems, and he is meticulous about backing up what he says with references, with particular emphasis on systematic reviews, which is important given the subject matter of the book. He never gets into politics, but concentrates on actual, proven real-world harms and benefits.

I also appreciate that despite the massive size of the problems he's describing, he manages to avoid despair and gives recommendations appropriate for the different sections of his readership. I thought the section on conflicts of interest was subtly thought-out and proves that Goldacre is not simply "anti-pharma" and has considered carefully how things could actually be changed in practice.

It's by no means an uplifting and easy read, but it is a fantastic book and fully worth the effort. And who knows, even if you're not a healthcare professional, you may be able to contribute to solving these problems by raising awareness.
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Format: Kindle Edition Verified Purchase
I approached this book with an expectation that it would have a similar feel to Goldacre's book Bad Science, an informative wry view of how bad science and particularly erroneous statistics are used to misinform the public on science and health issues in the media and particularly the popular press. How wrong I was.

This is a tour de force attack on the dishonesty and manipulative behaviour of the drugs industry. It is a serious, dense investigation into all aspects of the ways this industry interacts with the NHS on many levels. It is an indictment of its relationships with health professionals, particularly GPs, academics, professional publications and academic institutions as well as the international medicine regulation agencies.

No punches are pulled and if Ben is not sued by almost every drug company in the next few months one can only conclude that everything in this book is true. That being the case then he is shining a light on a truly terrifying situation.

Every MP with an interest in health issues, every aspiring medic and all GPs should treat this book as compulsory, required reading. As far as patients are concerned it will almost certainly make you think differently when you accept a prescription at your next surgery visit. Its a must for all health campaigners.

It might not be as humorous as Bad Science but it really is a page turner.
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Format: Paperback Verified Purchase
A new drug is developed. You want to find out if it works. How can you tell? The answer is that you count. You take two groups of people with the illness, which you hope your drug will treat. You give one of them the drug and the other with a sugar pill. You count and compare the results. Who gets better and who stays ill in each group? Then you know - as much as one can know for sure - whether the treatment in question actually works.

Well, you do have a good idea if you have done the test fairly. Remember: you must count. If you want to rig the result, then you do not count properly. In science, you must keep a record of the misses as well as the hits. If you want to cheat, then don't count the misses. Only count the hits. Count those who seem to get well after being given your new drug but don't count those who don't. Worse, you don't count bad hits - side effects, for instance, which suggest that your new drug harms rather than cures. Hide unflattering data and only publish the data that make your drug look good.

But that's not all. You can compare your new drug against a placebo as opposed to a decent version of the same drug. You can stop the trial early if you get a run of good results before any bad results spoil things. You can measure surrogate outcomes - i.e. changes in blood pressure - rather than whether people live longer if they get your drug or not. You can pay ghost writers to write up the biased results from your trials and then get academics and medics to rubber-stamp them. You can get your marketing reps to assiduously cultivate doctors who are prepared to promote your particular drug.
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Format: Paperback
Disclosure: I do patient reported outcomes research for top 20 pharma companies

I love science, and I love medicine. Truly, some of the most incredible inventions of our species have been the successful development of amazing compounds from antibiotics and antiretrovirals to insulin and levodopa to modern biologic drugs which help us to lead better lives despite illness. And yet, somewhere along the way, the industry that has arguably done the most to improve life for human beings (in the developed world at least) has taken a curious deviation away from science, and lost its way. As it turns out, marketing is more effective than science in persuading doctors to write prescriptions, and it's cheaper too. Full scale clinical trials are expensive, career-making (or ending), difficult, and time-consuming, and often fail to deliver anything like the transformational benefits that older (now cheap and generic) pills once did.

In this thoroughly researched, engaging, and intensely catalytic account, psychiatrist and truth-seeker Dr Ben Goldacre systematically diagnoses the faults not just with pharma, but with the entire system of evidence based medicine, in which none of us are blameless.

The broad brush strokes are that:

* Pharma builds clinical trials with what can kindly be described as "gamesmanship", systematically biases the literature by with-holding data, drags its feet to comply with transparency measures, ensures its message is heard clearer and louder than anyone else's, and on occasion gets caught doing things it knows it shouldn't.
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