By Ben Goldacre
“Medicine is broken”
Before I assess the many merits of this book which make it worth reading, it has to be said that this is a hugely important work, and its unassuming cover (along with the rather cheeky photo of Dr Goldacre included near the start) may not do justice to the seriousness of the topics it addresses. Just like the author’s debut Bad Science, it focuses on issues in the world of modern medicine and academia, but while the majority of Bad Science is given over to the dangers of pseudo-sciences such as homeopathy, Bad Pharma has far bigger, far more terrifying fish to fry. With Bad Pharma, Goldacre drops Jaws into the pan.
As the title suggests, the book’s subject is the big, possibly bad pharmaceutical industry, and its relationship with national health organisations, researchers, doctors and patients. That last one is why this book’s importance must not be overlooked: it calls itself a “pop-science” book, and therefore it’s for everyone, because everyone is affected by the issues it deals with. Yes, even you, immortal youths in the prime of life. Just because this book is about science, do not dismiss it as irrelevant if you flunked biology in High School. It’s so important because it’s about our lives, and how they are shockingly and needlessly threatened by the very people whose job it is to protect them.
Bad Pharma discusses in great depth how patients are put at risk because doctors are kept in the dark about the drugs they prescribe. In many cases, getting this vital information (like whether a drug actually works or not, or if it comes with the risk of severe side-effects) can be like getting blood from a stone, to use Goldacre’s own words – or simply important. This is bad. Think about it: doctors need to know if what they are prescribing is going to help or harm their patients. But often, the commercial interests of the drug companies often come first, and they, and the supposedly impartial drugs regulators, do everything in their power to keep unhelpful information (for the industry) under wraps.
In a similarly unbelievable vein, Goldacre talks about the unreliability of academic journals, which provide most of what doctors know about certain treatments, because studies showing negative results are very often never published. He elaborates on how trials can be designed to be biased, and how the end results can be manipulated to show a positive outcome. If all this seems arbitrary, think about the fact that the abstract data in trials has been put to use in real patients, and has most definitely caused great harm in numerous cases. I wish I could say I was exaggerating for sensational effect, but Goldacre provides some pretty damning evidence; there are no conspiracy theories, and it’s not simply 400 pages of mouthing off. It’s genuinely shocking and professionally written, and hopefully it won’t go unnoticed.
As a reading experience, it’s written well, and it’s easy to follow Goldacre’s arguments even if, like me, you struggle with the more technical bits. If its size is off-putting, its message won’t be lost if it’s read out of order, and reading Bad Science wouldn’t be a bad place to start if its heavy subject is daunting – it’s certainly a funnier, more accessible book, and there are about twenty copies in the library. But Bad Pharma’s implications are much wider-reaching, and though at times it may feel like a slow read, it’s one you couldn’t possibly regret.