Review of Bad Pharma by Ben Goldacre

He goes on to clarify that “this whole book is about meticulously defending every assertion” in that paragraph – and meticulously defend them he does.

The paragraph is over 300 words long; here are just 50 of them:

“Drugs are tested by the people who manufacture them, in poorly designed trials, on hopelessly small numbers of patients, and analysed using techniques which are flawed by design, in such a way that they exaggerate the benefits of treatments. Unsurprisingly, these trials tend to produce results that favour the manufacturer.”

The first 100 of the book’s 400 pages are devoted to the disturbing issue of missing – or more specifically hidden – data.

Before a drug can go on the market to be prescribed by doctors and make money for the company that developed it, it must be approved by regulators.

In order to achieve this a company generally has to provide at least two or three clinical trials showing that its drug works.

If a company were to conduct seven trials into a drug, five of which showed it to be either ineffective or dangerous, it would obviously give a very distorted picture of reality if only the two other trials, the positive ones, were published and publicised.

But, reveals Goldacre, companies are not only perfectly entitled to conduct as many trials as they wish and then cherry pick which ones to publish; the practice is endemic throughout the whole of orthodox medicine.

The result? “We have no idea which treatments are best and by extension we have no idea which are harmful.”

Indeed, because companies are free to bury any result they please, “patients are exposed to harm on a staggering scale throughout the whole of medicine. Doctors can have no idea about the true effects of the treatments they give. Does this drug really work best, or have I simply been deprived of half the data? Nobody can tell. Is there any evidence that this drug is dangerous? No one can tell.”

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