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I was a bit pathetic at book logging last year, wasn't I? Doubtless I shall be again this year, but I'm going to try to do slightly better and at least get to the end of January before it all goes horribly wrong...

Ben Goldacre is a very angry man, with good reason. In this book he lays out how the pharmaceutical industry has distorted drug research in pursuit of profit, sometimes intentionally, sometimes entirely without malice but with equally devastating effects for patient welfare. This matters because patients are prescribed less effective drugs, or drugs which are outright harmful, at huge financial expense to those paying for the drugs. This isn't a conspiracy theory book; Goldacre is quite clear that many valuable drugs have come out of the industry, and that most of the people who work in it want to make better drugs. He sets out in detail how and why bias is introduced into both research and prescribing practices, putting it in layman's terms but linking to the research papers and court documents that back up what he's saying. He also addresses the failings of the current regulatory system, and proposes ways to improve things -- pointing out that unless real controls with serious financial penalties are put in place, even those companies which genuinely want to reform will be under commercial pressure to continue with bad practice in a race to the bottom.

It's a dense and at times exhausting read. But Goldacre has done a decent job of making the issue accessible to a wide audience with a direct interest, from patients to practising doctors and academics. You can skim a lot of the book to get the general gist, or you can read it in details without following the links, or you can dig into research material he drew on and has laid out in meticulous footnotes and citations. He concludes the original edition with practical suggestions about what individual people can do to improve things, often simply by asking questions.

I read the second edition, which has a "what happened next" chapter about the reaction to the first edition. As he had predicted, there was a backlash in an attempt to discredit him -- but there was also a lot of covert feedback from industry personnel acknowledging the problems and considering how to improve things. While there's always a "the lurkers support me in email" issue with uncredited sources, he does also offer some examples of companies which have publicly moved to improve transparency.

Bad Pharma is an angry but rational examination of a real problem that affects millions of people, including almost anyone reading this review. It's a worthwhile read, even if it makes for uncomfortable reading for patients, doctors and companies alike.

Kobo
Amazon US
Amazon UK

(no subject)

Date: 2015-01-10 07:29 pm (UTC)
From: [identity profile] hrj.livejournal.com
Pharma is a rather strange industry to work in. Of course it's driven by profit. Developing and manufacturing safe and effective drugs is expensive and public funding of research is under other kinds of attack. But the distortions go beyond that. I'm secretly happy that the specific (very narrow) branch I fell into has few incentives for over- or mis-prescription. (Not a lot of off-label uses for human clotting factor.) My first job in pharma was for a start-up that was working on some rather promising cancer treatments…but didn't have the long-term funding to continue, due to the length of the necessary effectiveness follow-up period.

(And just to cover all relevant bases: I do not in any way speak for my not-even-named-here employer or any of its corporate cousins.)

(no subject)

Date: 2015-01-11 01:26 pm (UTC)
From: [identity profile] lexin.livejournal.com
I read the first edition - I must get the second for the follow up chapter.

(no subject)

Date: 2015-02-07 02:51 pm (UTC)
From: [identity profile] carl-allery.livejournal.com
Bit late catching up, but thanks for this. Very typical of my recent non-fiction reading, so added to my kindle.

(no subject)

Date: 2015-02-12 06:57 pm (UTC)
From: [identity profile] carl-allery.livejournal.com
I've got a few books which cover some of the same ground, but more from the perspective of diet. There's no money or patents for the big food/pharma companies in telling people to go back to basics and eat unprocessed foods. Because there's no money, there's no funding for tests & trials etc to prove the anecdotal evidence emerging about people impacting health conditions with their diet. No results means the medical profession regards it as unscientific and often it goes against what they were taught or what the journals say.

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