Key Messages
Uncovering How Big Pharma Corrupts Medicine Trials and Harms Consumers
In Bad Pharma, we learn all about the shady business practices that pharmaceutical companies use to harm medicine and make drugs appear better than they really are.
For example, we find out how drug companies conduct flawed trials deliberately in order to make their medicines seem more beneficial than they are, as well as withhold data from the public.
We are also taught how pharmaceutical companies may fail to publish unfavorable trial results, and how drug companies can bribe or manipulate doctors into prescribing their medications over any competitors’.
Moreover, we get an understanding of the long-term effects of this type of manipulative marketing by learning just how much data is stored and remembered by real-life people over time.
It’s chilling just how much power these drug companies throw around with little accountability.
Pharmaceutical Companies Are Unethically Distorting Medical Trial Results
The efficacy and safety of a drug on the market are usually determined by medical trials.
However, not all trials are created equal – especially when they are sponsored by pharmaceutical companies.
When considering results from over 500 medicinal trials, it’s clear that industry-sponsored studies demonstrate a bias in favor of the sponsor’s drug.
In fact, 85% of industry funded research supported positive results while only 50% of government-funded research did.
This discrepancy indicates that most industry-sponsored studies produce positive results that strongly favor the sponsor’s product.
In addition, methodological flaws in these trials often present distorted views that make drugs appear better than they really are.
A good example is Pfizer’s Pregabalin drug trial where participants who experienced negative side effects were excluded from the study and their last measurements of pain were carried over as if nothing had happened – this inflated the reported effectiveness of the drug by 25%.
Publication Bias: How Industry-Sponsored Trials Subvert Medical Evidence and Put Lives at Risk
The pharmaceutical industry has a potent method of creating positive trial results: not publishing the data.
This was revealed in an investigation published in 2010 regarding trials on Pfizer’s antidepressant drug reboxetine.
Out of the seven trials conducted, only one yielded a positive result which corresponded with the one and only trial published in an academic journal.
What about the other six trials and their data? They had almost ten times as many participants, but all showed reboxetine having no effect better than that of a sugar pill.
None of this data ever saw the light of day due to it being held from publication.
By preventing access to half of relevant evidence, it makes it easier to mislead people into false conclusions.
This practice is called publication bias and its effects are incredibly dangerous because medical research exists for the sole purposes of saving lives, curing sickness, and relieving sufferers’ pain.
By withholding this information from researches, we put those goals at risk.
The Commercialization of Medical Research: How It Jeopardizes the Results of Clinical Trials
The commercialization of clinical research trials raises serious ethical concerns that cannot be ignored.
As the pharmaceutical industry turns to CROs (Clinical Research Organizations) in order to cut costs, they are testing drugs on a population that may not benefit from the results at all.
According to the Declaration of Helsinki, the people being tested should come from a population who could reasonably benefit from the results of their tests.
However, this ethic is not always upheld as CROs often turn to poorer countries for their trial participants – even if those countries can’t afford the drugs that are being studied.
Moreover, there is also the issue of reputability of data when it comes to conducting clinical research trials on a global scale.
For instance, if a high blood pressure drug were tested in India by a particular CRO and then tested again in Europe or America using different variables or patient characteristics, this could lead to disparate results that wouldn’t always be applicable across regions or populations.
In many cases, clinical trials conducted in developing countries have yielded positive results that did not necessarily match those obtained elsewhere despite identical trial procedures and protocols – meaning we can’t necessarily rely on economic solutions for research over ethical ones if accurate data is our goal.
Conflict of Interest Within Drug Regulation Makes Approval Process Ineffective
The regulation mechanisms that are supposed to guarantee drug safety are largely ineffective.
This is due to a conflict of interest amongst the regulatory bodies, who often take jobs in the pharmaceutical industry for better pay than what is offered by governmental regulators.
This change in employers does not just affect the individuals involved but presents an overall risk of lack of precautions and oversight for medications.
Regulators are further hampered by low standards, setting the bar so low that pharmaceutical companies only need to show their drugs are better than nothing – not necessarily better than other treatments available on the market.
Of all 197 newly approved drugs between 2000-2010 by the American Federal Drug Administration (FDA), only 70 percent provided data suggesting they were superior to competitor treatments.
In Europe’s top medicinal regulator, only half of the drugs approved between 1995-2005 had been studied in comparison with other treatment options before being cleared for sale.
This effectively creates a situation wherein medication doses and risks may be untested or even hazardous when released into the market, endangering public health without thorough research or proper review.
While regulations exist for drug safety, it’s apparent that these frameworks currently do not enough to protect consumers from dangerous pharmaceuticals masquerading as viable treatments
The Risk of Medical Research Fraud and Unrepresentative Trials in Pharmaceutical Companies
When it comes to medical research, there are many ways that the trials can fail or be conducted “badly”.
This can range from outright fraud like in the case of Dr.
Scott Reuben, who made up data for clinical trials he had published, to using unrepresentative and “ideal” patients.
These patients might be young and only have one singular diagnosis; free from real-life complications which could affect results.
In addition, pharmaceutical research often includes tests of a drug against an inferior competitor just to make the new treatment look promising — a sure way to misrepresent the results.
In conclusion, it is important to understand how various factors can lead to faulty or otherwise bad medical trials.
Awareness of these issues is essential for ensuring that future studies are conducted with accuracy and integrity both in terms of methodology, results and patient representation.
How the pharmaceutical industry influences doctors’ prescribing habits through manipulative marketing techniques and what can be done to create change
It’s estimated that pharmaceutical companies spend around $60 billion in the US alone every year to influence treatment decisions, and it’s easy to see why.
After all, doctors don’t have time to read every single peer-reviewed article relevant to their work, so this presents a perfect opportunity for drug companies to market their products.
The majority of the promotional budget is spent on marketing directly aimed at doctors.
About half of this money goes toward paying for drug reps – young and attractive people who visit doctors in person and try to convince them that one product is better than its competitors.
Drugs are also advertised in academic journals, where nearly 50% of ads reference high-quality trials that support their claims.
However, many patient groups are funded by drug companies as this gives them the chance to create a positive image while still avoiding direct advertising towards patients (which isn’t allowed).
Randomized Trials in Routine Medical Practice Can Help The Pharmaceutical Industry Better Evaluate Drug Effectiveness
Randomized trials in routine medical practice could be a game changer when it comes to tackling many of the major problems with drug trials today.
For instance, these types of trials could help doctors get an accurate picture of how drugs are actually performing in the real world.
Normally, when a general practitioner prescribes a statin, she clicks the “prescribe” button and moves on to the next patient, but with randomized trials such as this extra step can be implemented, whereby instead the doctor has to decide whether or not to select one particular ‘statin’ or have the software randomly assign one or the other to their patient.
This means that real-world data can be collected – eliminating any risk of unrepresentative “ideal patients” – and could even bring down trial costs since they now don’t need additional equipment/staff to conduct them.
Plus, ongoing monitoring and studying of drug effectiveness can also be done over time rather than having limited results from brief trials which overall gives more credibility to its outcomes.
Wrap Up
Bad Pharma, written by Ben Goldacre, is an eye-opening look into the world of pharmaceutical companies.
The main takeaway from this book is that pharma companies put little effort into developing effective drugs, but instead invest billions of dollars in marketing strategies.
This means that a lot of times we are prescribed not the right medicine for our ailments as companies have a vested interest in pointing us towards medicines they wish to sell.
To end up having better published treatments, Goldacre recommends major overhauls to clinical trial regulations and recommendations.
In conclusion, Bad Pharma paints a picture of the industry that needs serious work to ensure everyone has access to the best medicine available.
