Library:Bad Pharma
| Bad Pharma | |
|---|---|
| Author | Ben Goldacre |
| First published | 2012 |
| ISBN | 978-0-00-735074-2 |
| Role | Analysis |
| Domains | Health & Medicine Business, Finance & Scams |
| Tactics | Statistical & Evidentiary Distortion Manipulation |
Bad Pharma is a 2012 book by Ben Goldacre.
Summary
Having taken on quacks in Bad Science, Ben Goldacre turned to a harder target: mainstream medicine and the pharmaceutical industry. His argument is that the evidence doctors rely on to prescribe drugs is systematically distorted, not mainly through outright fraud, but through practices that are legal, routine and largely invisible to patients.
Missing data
The book's central and most important theme is publication bias. Trials with positive results are far more likely to be published than trials with negative results, so the published literature overstates how well drugs work and understates their harms. Goldacre shows how this happens and how even sophisticated doctors cannot correct for evidence they never see. He describes cases where regulators, researchers and independent reviewers struggled for years to obtain unpublished trial data, including a prolonged effort by Cochrane reviewers to obtain full data on the influenza drug Tamiflu.
Where else the system bends
Goldacre then works through the rest of the pipeline. Regulators approve drugs on limited evidence and keep much of what they know confidential. Trials are designed to flatter the product: comparing against a placebo rather than the best existing treatment, using surrogate outcomes instead of what matters to patients, or testing on unrepresentative patients. Marketing shapes what doctors learn, through sponsored education, paid key opinion leaders and ghostwritten academic papers.
What he proposes
Unlike many exposés, the book ends with concrete fixes: register every trial in advance, publish all results, give independent researchers access to the underlying data, and change how doctors are educated about drugs. Goldacre co-founded the AllTrials campaign in 2013 to push for these reforms.
Relevance to Bullshitopedia
This is the key text for deception by omission. Nothing in the published record has to be false for the overall picture to mislead; the distortion comes from what is left out. That pattern appears across many Bullshitopedia entries, well beyond medicine, and the book is a reminder that respectable institutions deserve the same scrutiny as obvious cranks.