13 Facts About Bad Pharma

Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients is a book by the British physician and academic Ben Goldacre about the pharmaceutical industry, its relationship with the medical profession, and the extent to which it controls academic research into its own products.

Bad Pharma writes that these positive results are achieved in a number of ways.

Bad Pharma writes that this publication bias, where negative results remain unpublished, is endemic within medicine and academia.

Bad Pharma argues that regulators do not require that new drugs offer an improvement over what is already available, or even that they be particularly effective.

Bad Pharma cites as examples the statins atorvastatin and simvastatin, which he writes seem to be equally effective, or at least there is no evidence to suggest otherwise.

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Bad Pharma advises doctors, nurses and managers to stop seeing drug reps, to ban them from clinics, hospitals and medical schools, to declare online and in waiting rooms all gifts and hospitality received from the industry, and to remove all drug company promotional material from offices and waiting rooms.

Bad Pharma asks academics to lobby their universities and academic societies to forbid academics from being involved in ghostwriting, and to lobby for "film credit" contributions at the end of every academic paper, listing everyone involved, including who initiated the idea of publishing the paper.

Bad Pharma asks for full disclosure of all past clinical trial results, and a list of academic papers that were, as he puts it, "rigged" by industry, so that they can be retracted or annotated.

Bad Pharma asks drug company employees to become whistleblowers, either by writing an anonymous blog, or by contacting him.

Bad Pharma advises patients to ask their doctors whether they accept drug-company hospitality or sponsorship, and if so to post details in their waiting rooms, and to make clear whether it is acceptable to the patient for the doctor to discuss his or her medical history with drug reps.

Bad Pharma is less strong in explaining the complex background reality, such as the general constraints and individual slips of regulators and pharma companies' employees.

Bad Pharma argued that Goldacre had gone "over the top" in devoting a whole chapter to recommending large clinical trials using electronic patient data from general practitioners, without fully pointing out how problematic these can be; such trials raise issues, for example, about informed consent and regulatory oversight.

Bad Pharma particularly objected to the line, "medicine is broken", calling it a "foolish remark".