I just finished reading the excellent, yet disturbing book Bad Pharma. If find yourself taking antibiotics on an sort of regular basis, or if you have faith in the US Healthcare / Pharmaceutical industry, I suggestion you go out and get a copy as soon as possible.

Here are some notes I took while reading the book:

Missing Data

Clinical trials undertaken by drug companies routinely reach conclusions favourable to the company, and this is achieved in a number of different ways such as

  • the industry-sponsored studies are flawed by design
  • patients are selected in a way that will make a positive result more likely
  • if the trial seems to be producing negative data it is stopped prematurely and results are not published
  • if the trail is producing positive data it may be stopped early so that longer-term effects are not examined
  • publication bias (negative results not being unpublished) is endemic within medicine and academia

Where Do New Drugs Come From

  • Phase 1 trail participants are usually paid to take the trail and come from the poorest areas of society (and the world) - their earning potential becomes the main reason for participation
  • Participants are usually taken from the poorest groups in society (India, China, South America, etc.)
  • Because most P1 testing happens in other countries, can that drug be applied to other countries with the same success?
  • How does corruption affect the results of the tests from third world countries

The Regulators

  • The governments (UK+US) end up advancing the interests of the drug companies rather than the interests of the public
  • There is a revolving door between the FDA/MHRA and the private sector
  • friendships develop between regulator and company employees simply because they have knowledge and interests in common
  • It is very difficult for the regulators to remove ineffective drugs from the market because of surrogate outcomes (durgs that are on the market but actual are being prescribed for their original intended use)
  • regulators do not require that new drugs offer an improvement over what is already available, or even that they be particularly effective