Book recommendation - Bad Pharma

[daemonoid]

I'm 80% of the way through Bad Pharma by Ben Goldacre. He's a doctor and science writer and this book is all about his industry rather than his previous more pop science efforts.

It's got some things that will astound you - the fact that for the majority of medical treatments we don't know what is best, the lack of science in the scientific studies put out by drugs companies, £100s of millions being spent on drugs that doctors don't know whether they work or not and outright fraud within the medical industry.

It's not a simple read, nor is it as fun as his other works. It relies heavily on evidence and so is written in a very dry, almost scientific journal style. The content though is an eye opener.

Recommended to anyone who can put in the time, it has the potential to change society.

<edit> and for people like Kris it'd be a great way to understand the stuff I was talking about in that GM thread - not all 'scientific' studies are worth the paper they're written on.
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[daemonoid]

[angryjonny]

Mrs Angryjonny was at an event last week and Ben Goldacre did a talk. She thought he was really good and has already bought Bad Science. I'll be having a read of that and probably moving onto Bad Pharma afterwards - though I have seen negative reviews based on the fact that it doesn't bang on about bad environmentalism

I bet it also doesn't have much to say about bad cookery, bad taste in interior decor and bad posture either. Must try harder, Goldacre.

[BigJoe78]

I like Ben Goldacre and really enjoyed bad science. His arguments are always well reasoned, and well written. He strives for "good science" and for proper methods and testing, and that can only be comended.
However I have worked in clinical trials and the related industries now for over 12 years, and while i no longer work for a Pharma or CRO i still work in a related industry. While his new book raises some excellent points, its also IMHO one sided and dumbed down to some extent, compared to my own experiences.

The vast majority of trials I have worked on have been randomised double blinded studies.
The vast majority of trials compare current "gold standard" treatments (be that, drug, procedure or device, not all trials are drug related) as they want to better the current treatment.
I have seen very few new products go to market, those that are not more effective than the current gold standard drugs simply dont get released if they dont work.
A large ammount of trials now are done in collaboration with non profit research groups (e.g NCR) and acedemia

That said I have seen patients on the handful of new drugs that do "go to market" have thier lives extended and in some cases totally changed for the better (i spent the majority of my career in oncology so its usually at best a question of extending life expectancy and quality of life).

While "big pharma" does commit some serious wrong doings (what big industry doesn't?) not all clinical trials are corrupt, or inaccurate.
There is a lot of high quality and extremely vital research done because of the pharma industry.

[Rogerborg]

Problem is, anyone who's likely to read these books probably doesn't need to.
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[Walloper]

[daemonoid]

[BigJoe78]

I think a big part of the problem is the link between pharma and the GPs, hopitals, clinics, etc, etc.
Pharma sales staff are just told what the drugs do based on the data they are given, its very low level undergraduate stuff. "its xx% effective!" but not told full details on adverse events, comparison data, etc, etc.

Sales people sell - point blank and the people buying can only make a choice based on knowledge. Yes, Drs can get information other than from the sales reps (pubmed, clinicaltrials.gov, et al)but do they have the time and inclination to do so? Are the drugs within the tight budgets they have been allocated (and increasingly been held accountable for)?

[daemonoid]

[BigJoe78]

agreed they can be tainted but but at least other sources (not just the two examples I gave) CAN give a more objective overview and without the need for your busy GP to wade through a pile of PRJs

[Kris]

[Alpha-9]

Not shocking

Remember when they discovered uranium and put it into toothpastes, make up and all sorts of products before even knowing wtf it was or did?

They just want to sell things, that's all. They don't care whether it works or not, as long as it doesn't make them lose sales.
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[Kris]

[BigJoe78]

cases like that and Thalidomide were what has lead to Pharma being perhaps the most stringently regulated industry.
Thalidomide was what lead to the Declaration of Helsinki, ICH GCP and the begining of more stringent regulations

https://en.wikipedia.org/wiki/Declaration_of_Helsinki

[daemonoid]

[daemonoid]

[daemonoid]

[BigJoe78]

[daemonoid]

[BigJoe78]

yep Big Pharma are shitting themselves at the moment - Less investment, smaller development pipelines , increased competition from small (relatively) innovative biotech companies (who they generally just buy up and put on ice), huge ammounts of their drugs going off patent and being made by generic companies in emerging markets, increased compettition, they are fighting to keep the regulators off their backs AND trying to come up with new products.

IMO and experience they need to be even more regulated and be more transparent with their findings, but balancing the ability to do ground breaking research.

[daemonoid]

[Walloper]