Peter Gøtzsche is in angry man. When you read his book it becomes clear why. In the book he documents with many examples the unhealthy relationship between the major pharmaceutical corporations on one side, and FDA and EMA, the universities and the medical doctors on the other side. It is an incestuous and downright corrupt relationship.
The author lives what he preaches, as he is a member of the Danish group Doctors without Sponsors, and he is clearly very knowledgeable and experienced. He has managed to produce a page turner here, and he doesn't pull his punches when he gives examples with names of doctors that have "prostituted" themselves and have become paid shrills for the industry, a fact they try to hide.
Reading the book you learn about the great crime Merck committed doctoring the data on Vioxx, which in the book is estimated to have cost 130,000 lives. You learn how the DSM manual is really a way of introducing new diagnoses that can then be monetized. An example is given of grief, where for DSM III the "acceptable" period for grief was one year before it was considered a clinical depression. In DSM IV this changed to two months, and in DSM V this became two weeks. You learn about how wholly unreliable and unscientific psychiatry is, and how dangerous happy pills really are, causing more harm than good. Actually, I started reading this book because of an article Peter Gøtzsche had in the Danish newspaper Politiken where he strongly recommended banning Psychopharma to kids, and generally criticized the extreme over use of Psychopharma. That got me interested and made me purchase and read the book.
Throughout the book it is clear that the author knows his area extremely well. The book is easy to read and in general whenever something new is introduced it comes with a good description. So the role of EMA and FDA is clearly explained, what an NSAID is (Vioxx is from that class of drugs), how evidence based medicine works, what the DSM is, ghost writing, how you can cheat with results, etc.
The book can be read by people without a medical background like me, but it might help reading for example Ben Goldacre's two books first, since this book is pretty fast moving covering loads of areas, so Ben's book would be good primers, but by no means necessary!
For me as a layperson some of the numbers that the author quotes seem a bit high, for example the estimate of 130,000 dead due to Vioxx, but in the book the author does go through the calculations that leads him to the conclusions, and they seem sound, so it could well be just me not used to seeing those kind of numbers attributed to a single medicine, that is downright scary!
As stated before the book is full of examples, and the author names the individual people involved and responsible by name in general. Frankly, to me that is gutsy, and I like that approach, it shows he is certain of his facts. Great read, I cannot recommend it enough, but it does paint a depressing picture. I guess the good news is that after reading the book you stand a better chance of becoming an informed consumer in this space, the last chapter has several recommendations, and that can only be a good thing.
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