Bad Pharma Quotes

“The American Academy of Nutrition and Dietetics is sponsored by Coca-Cola.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“It is clear from the evidence presented in this book that the pharmaceutical industry does a biased job of disseminating evidence - to be surprised by this would be absurd - whether it is through advertising, drug reps, ghostwriting, hiding data, bribing people, or running educational programmes for doctors.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“So what steps can a regulator take when it has established that there is a problem? In very extreme cases it can remove a drug from the market (although in the US, technically drugs usually stay on the market, with the FDA advising against their use). More commonly it will issue a warning to doctors through one of its drug safety updates, a ‘Dear Doctor’ letter, or by changing the ‘label’ (confusingly, in reality, a leaflet) that comes with the drug. Drug-safety updates are sent to most doctors, though it’s not entirely clear whether they are widely read. But, amazingly, when a regulator decides to notify doctors about a side effect, the drug company can contest this, and delay the notice being sent out for months, or even years.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“Problems in medicine do not mean that homeopathic sugar pills work; just because there are problems with aircraft design, that doesn't mean that magic carpets really fly.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“At this time we should take a brife moment to mention quacks: alternative therapists who sell vitamins and homeopathy sugar pills [the latter of which, by definition, contain no active ingredients], which perform no better than placebo in fair tests, and who use even cruder marketing tricks than the ones described in this book. In these people profit at all from the justified anger that people feel towards the pharmaceutical industry, then it comes at the expense of genuinely constructive activity. Selling ineffective sugar pills is not a meaningful policy response to the regulatory failure we have seen in this book”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“The current regulations -- for companies, doctors and researchers -- create perverse incentives; and we'll have better luck fixing those broken systems than we will ever have trying to rid the world of avarice”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“So, if we're to make any sense of the mess that the pharmaceutical industry - and my profession - has made of the academic literature, then we need an amnesty: we need a full and clear declaration of all the distortions, on missing data, ghostwriting, and all the other activity described in this book, to prevent the ongoing harm that they still cause.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“The American Academy of Pediatrics officially supports breastfeeding, but receives about half a million dollars from Ross, manufacturers of Similac infant formula.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“If your drug didn’t win overall in your trial, you can chop up the data in lots of different ways, to try and see if it won in a subgroup: maybe it works brilliantly in Chinese men between fifty-six and seventy-one. This is as stupid as playing ‘Best of three … Best of five…’ And yet it is commonplace.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“Some have estimated that the pharmaceutical industry overall spends about twice as much on marketing and promotion as it does on research and development.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“The idea that depression is caused by low serotonin levels in the brain is now deeply embedded in popular folklore, and people with no neuroscience background at all will routinely incorporate phrases about it into everyday discussion of their mood, just to keep their serotonin levels up. Many people also don't know that this is how antidepressant drugs work: depression is caused by low serotonin, so you need drugs which raise the serotonin levels in your brain, like SSRI antidepressants, which are 'selective serotonin reuptake inhibitors'. But this theory is wrong. The 'serotonin hypothesis' for depression, as it is known, was always shaky, and the evidence now is hugely contradictory ... But in popular culture the depression-serotonin theory is proven and absolute, because it has been marketed so effectively.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“Doctors are generally nice people, and eager to please. They will get bounced into giving people what they want, and a lot of patients have been persuaded, through whatever social processes are at play in the world, that pills fix things. I'll rephrase that for something that's coming later in this chapter: a lot of people have been convinced that they're patients.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“Here we will see that pharmaceutical companies spend tens of billions of pounds every year trying to change the treatment decisions of doctors: in fact, they spend twice as much on marketing and advertising as they do on the research and development of new drugs. Since we all want doctors to prescribe medicine based on evidence, and evidence is universal, there is only one possible reason for such huge spends: to distort evidence-based practice.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“different subject. The story of the serotonin hypothesis for depression, and its enthusiastic promotion by drug companies, is part of a wider process that has been called ‘disease-mongering’ or ‘medicalisation’, where diagnostic categories are widened, whole new diagnoses are invented, and normal variants of human experience are pathologised, so they can be treated with pills. One simple illustration of this is the recent spread of ‘checklists’ enabling the public to diagnose, or help diagnose, various medical conditions. In 2010, for example, the popular website WebMD launched a new test: ‘Rate your risk for depression: could you be depressed?’ It was funded by Eli Lilly, manufacturers of the antidepressant duloxetine, and this was duly declared on the page, though that doesn’t reduce the absurdity of what followed. The test consisted of ten questions, such as: ‘I feel sad or down most of the time’; ‘I feel tired almost every day’; ‘I have trouble concentrating’; ‘I feel worthless or hopeless’; ‘I find myself thinking a lot about dying’; and so on. If you answered ‘no’ to every single one of these questions – every single one – and then pressed ‘Submit’, the response was clear: ‘You may be at risk for major depression’.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“Some have estimated that the pharmaceutical industry overall spends about twice as much on marketing and promotion as it does on research and development. Regardless of how those two figures compare to each other, the fact that they are in the same ballpark gives one pause, and this is worth mulling over in various contexts. For example, when a drug company refuses to let a developing country have affordable access to a new AIDS drug it’s because – the company says – it needs the money from sales to fund research and development on other new AIDS drugs for the future. If R&D is a fraction of the company’s outgoings, and it spends a similar amount on promotion, then this moral and practical argument doesn’t hold water quite so well. The scale of this spend is fascinating in itself, when you put it in the context of what we all expect from evidence-based medicine, which is that people will simply use the best treatment for the patient. Because when you pull away from the industry’s carefully fostered belief that this marketing activity is all completely normal, and stop thinking of drugs as being a consumer product like clothes or cosmetics, you suddenly realise that medicines marketing only exists for one reason. In medicine, brand identities are irrelevant, and there’s a factual, objective answer to whether one drug is the most likely to improve a patient’s pain, suffering and longevity. Marketing, therefore, one might argue, exists for no reason other than to pervert evidence-based decision-making in medicine.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“So should patients born under Libra and Gemini be deprived of treatment? You would say no, of course, and that would make you wiser than many in the medical profession: the CCSG trial found that aspirin was effective at preventing stroke and death in men, but not in women;30 as a result, women were undertreated for a decade, until further trials and overviews showed a benefit. That is just one of many subgroup analyses that have misled us in medicine, often incorrectly identifying subgroups of people who wouldn’t benefit from a treatment that was usually effective. So, for example, we thought the hormone-blocking drug tamoxifen was no good for treating breast cancer in women if they were younger than fifty (we were wrong). We thought clotbusting drugs were ineffective, or even harmful, when treating heart attacks in people who’d already had a heart attack (we were wrong). We thought drugs called ‘ACE inhibitors’ stopped reducing the death rate in heart failure patients if they were also on aspirin (we were wrong). Unusually, none of these findings was driven by financial avarice: they were driven by ambition, perhaps; excitement at new findings, certainly; ignorance of the risks of subgroup analysis; and, of course, chance.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“The most notorious story is the Trovan antibiotic study conducted by Pfizer in Kano, Nigeria, during a meningitis epidemic. An experimental new antibiotic was compared, in a randomised trial, with a low dose of a competing antibiotic that was known to be effective. Eleven children died, roughly the same number from each group. Crucially, the participants were apparently not informed about the experimental nature of the treatments, and moreover, they were not informed that a treatment known to be effective was available, immediately, from Médecins sans Frontières next door at the very same facility. Pfizer argued in court – successfully – that there was no international norm requiring it to get informed consent for a trial involving experimental drugs in Africa, so the cases relating to the trial should be heard in Nigeria only. That’s a chilling thing to hear a company claim about experimental drug trials, and it was knocked back in 2006 when the Nigerian Ministry of Health released its report on the trial. This stated that Pfizer had violated Nigerian law, the UN Convention on the Rights of the Child and the Declaration of Helsinki.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“in 2008, shortly after being elected President, Barack Obama demonstrated to many academics and doctors that he had a clear understanding of the deep problems in health care, by committing to spend $1 billion on head-to-head trials of commonly used treatments, in order to find out which is best. In return he was derided by right-wing critics as ‘anti-industry’.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“In medicine, brand identities are irrelevant, and there’s a factual, objective answer to whether one drug is the most likely to improve a patient’s pain, suffering and longevity. Marketing, therefore, one might argue, exists for no reason other than to pervert evidence-based decision-making in medicine.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“I hope that you will be asked to participate in a trial at some stage in your disease”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“Aside from all this, for several of the most important and enduring problems in medicine, we have no idea what the best treatment is, because it’s not in anyone’s financial interest to conduct any trials at all.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“Like many doctors, I was frankly traumatized by some of the experiences I had early on in my career. When you lean over a patient in an emergency room, trying to bring a dead body back to life, you are entirely focused on the job at hand. On the other side of a thin curtain, you can hear that person’s husband or wife howling and wailing, knowing that the person they loved and lived with for fifty years is dying, begging the staff to do all they can, phoning their children, struggling to speak through tears to form the words and communicate the horror, telling them to come, quickly. I have memories from cubicles that I will never be able to deal with, and they upset me even now.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“The most widely cited figure for the number of women suffering from Female Sexual Dysfunction comes from 1999: according to this, some 43 per cent of all women have a medical problem around their sex drive.27 This survey was published in the Journal of the American Medical Association (JAMA), one of the most influential journals in the world. It looked at questionnaire data asking about things like lack of desire for sex, poor lubrication, anxiety over sexual performance, and so on. If you answered ‘yes’ to any one of these questions, you were labelled as having Female Sexual Dysfunction. For the avoidance of any doubt about the influence of this paper, it has – as of a sunny evening in March 2012 – been cited 1,691 times. That is a spectacular number of citations. At the time, no financial interest was declared by the study’s authors. Six months later, after criticism in the New York Times, two of the three authors declared consulting and advisory work for Pfizer.28 The company was gearing up to launch Viagra for the female market at this time, and had lots to gain from more women being labelled as having a medical sexual problem.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“It would be a mistake to imagine that drug companies are the only people applying pressure for fast approvals. Patients can also feel they are being deprived of access to drugs, especially if they are desperate. In fact, in the 1980s and 1990s the key public drive for faster approvals came from an alliance forged between drug companies and AIDS activists such as ACT UP. At the time, HIV and AIDS had suddenly appeared out of nowhere, and young, previously healthy gay men were falling ill and dying in terrifying numbers, with no treatment available. We don’t care, they explained, if the drugs that are currently being researched for effectiveness might kill us: we want them, because we’re dying anyway. Losing a couple of months of life because a currently unapproved drug turned out to be dangerous was nothing, compared to a shot at a normal lifespan. In an extreme form, the HIV-positive community was exemplifying the very best motivations that drive people to participate in clinical trials: they were prepared to take a risk, in the hope of finding better treatments for themselves or others like them in the future. To achieve this goal they blocked traffic on Wall Street, marched on the FDA headquarters in Rockville, Maryland, and campaigned tirelessly for faster approvals.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“Amateur critics often like to dismiss anecdotes as ‘unscientific’, but this is wrong: anecdotes are weaker evidence than trials, but they are not without value, and are often the first sign of a problem (or an unexpected benefit).”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“Some have estimated that the pharmaceutical industry overall spends about twice as much on marketing and promotion as it does on research and development. Regardless of how those two figures compare to each other, the fact that they are in the same ballpark gives one pause, and this is worth mulling over in various contexts. For example, when a drug company refuses to let a developing country have affordable access to a new AIDS drug it’s because – the company says – it needs the money from sales to fund research and development on other new AIDS drugs for the future. If R&D is a fraction of the company’s outgoings, and it spends a similar amount on promotion, then this moral and practical argument doesn’t hold water quite so well.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“we hope that this will help reduce the chances of real-world outcomes, like heart attack and death, both of which occur at a higher rate in people with”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“Around half of the authors had a financial conflict of interest, and analysing the findings by who said what gave a dismal but predictable result: people who thought rosiglitazone was safe (or, to be absolutely clear, who had a favourable view on the risk of heart attack after taking it) were 3.38 times more likely to have a financial conflict of interest with manufacturers of diabetes drugs generally, and with GSK in particular, when compared with people who took a dim view of the drug’s safety. Authors who made favourable recommendations about using the drug were similarly three and a half times more likely to have a financial interest. When the analysis was restricted to opinion articles, the link was even stronger: people recommending the drug were six times more likely to have a financial interest.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“So there you have it. Doctors around the world – except in Norway – are taught which drugs are best by the drug companies themselves. The content is biased, and that’s why companies pay for it. For decades”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients

“Merck explicitly carried out an internal study to establish the ‘return on investment’ from discussion groups led by doctors, which was leaked in a court case.110 It estimated that for every dollar it spent on teaching, it got back almost $2 in revenue from doctors prescribing more of its drugs.”
― Ben Goldacre, Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients