Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Bad Pharma – Can we trust drug companies to provide accurate information about their products? Part III

 

 

We have a problem with the way drug companies do business. Dr. Ben Goldacre regularly criticizes the misbehavior and nonsensical claims of alternative medicine and other bad science at his blog Bad Science and in his book Bad Science. He included some criticism of the misbehavior of drug companies, as well. Now he has written a book that is more specifically critical of the drug companies – Bad Pharma.

The whining by the representatives of the drug companies is just as ludicrous as that of the placebo pushers of alternative medicine. In Forbes, John LaMattina writes that a two page section of a 449 page book misrepresents the pharmaceutical industry.
 

I agree that one of the big challenges that the industry faces is the need to be more transparent about its work and I have written about this both on this blog and in Devalued & Distrusted. However, Goldacre’s cherry-picking of data to fit his arguments is inappropriate and infuriating to those who know something about the pharmaceutical industry.[1]

 

If Goldacre’s cherry-picking of data to fit his arguments is inappropriate, is LaMattina’s cherry-picking of only a portion of two pages of a 449 page book appropriate?

The pharmaceutical industry has been getting better at reporting trials, but the improvements are in things that they should have been doing all along.

A sensationalistic way of presenting this might be to ask if a serial killer cutting back on killing is a good person, because he is working at getting better.

Yes, the drug companies do make drugs that sometimes kill, but they are not the same as serial killers, since they make drugs that do a lot of good, too.

One of the reasons people are harmed by medications is that they do not have full information about the effects of the medications. An important part of this is selective publishing. Dr. Goldacre does not need to use this example to make a case that drug companies engage in selective publishing. There is plenty of evidence that drug companies .
 

The authors have been unable to obtain the full set of clinical study reports or obtain verification of data from the manufacturer of oseltamivir (Roche) despite five requests between June 2010 and February 2011. No substantial comments were made by Roche on the protocol of our Cochrane Review which has been publicly available since December 2010.[2]

 

Is this a surprise?

No.

Is Dr. Goldacre misrepresenting the misbehavior of drug companies?

No.
 

We expect full clinical study reports containing study protocol, reporting analysis plan, statistical analysis plan and individual patient data to clarify outstanding issues. These full clinical study reports are at present unavailable to us.[2]

 

Listen to Dr. Goldacre discussing the book and the ways it is misrepresented by the media and the drug companies.[3]

Maybe Dr. Goldacre’s next book should have a specific focus on alternative medicine – Bad Placebo.

It is disappointing that we are so interested in taking something – anything new, but not interested in knowing if any of these new drugs are safe or if the drugs do what they are supposed to do – help people heal.
 

The desire to take medicine is perhaps the greatest feature which distinguishes man from animals. – William Osler.
 

If we point out the imperfections in medicine, in order to try to improve medicine, we end up being criticized as being opposed to medicine . This is idiotic.

There is a lot of room for medicine to improve, but ignoring the problems is very bad medicine.
 


 
http://www.alltrials.net/
An initiative of Bad Science, Sense About Science, BMJ, James Lind Initiative and Centre for Evidence-based Medicine.

There is still a long way to go.

Footnotes:

[1] Bad Pharma? Maybe. But Goldacre’s Selective Use of Data Is Wrong
2/14/2013 @ 8:20AM
John LaMattina
Forbes
Article

[2] Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children.
Jefferson T, Jones MA, Doshi P, Del Mar CB, Heneghan CJ, Hama R, Thompson MJ.
Cochrane Database Syst Rev. 2012 Jan 18;1:CD008965. doi: 10.1002/14651858.CD008965.pub3. Review.
PMID: 22258996 [PubMed – indexed for MEDLINE]

[3] #201 Bad Pharma
February 22, 2013
Skeptically Speaking
Podcast page.

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