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Bad Pharma
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Bad Pharma (2012)

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7502422,437 (4.14)59
We like to imagine that medicine is based on evidence and the results of fair tests. In reality, those tests are often profoundly flawed. We like to imagine that doctors are familiar with the research literature about a drug, when in reality much of the research is hidden from them by drug companies. We like to imagine that doctors are impartially educated, when in reality much of their education is funded by the pharmaceutical industry. We like to imagine that regulators let only effective drugs onto the market, when in reality they approve useless drugs, with data on side effects casually withheld from doctors and patients. All these problems have been shielded from public scrutiny because they're too complex to capture in a sound bite. But Ben Goldacre shows that the true scale of this murderous disaster fully reveals itself only when the details are untangled. He believes we should all be able to understand precisely how data manipulation works and how research misconduct on a global scale affects us. This book reveals a shockingly broken system and calls for something to be done.--From publisher description.… (mais)
Membro:eulensteak
Título:Bad Pharma
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Informação:Harpercollins, Paperback
Coleções:Sua biblioteca
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Detalhes da Obra

Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients de Ben Goldacre (2012)

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» Veja também 59 menções

Mostrando 1-5 de 24 (seguinte | mostrar todas)
Iedereen weet dat de farmaceutische industrie, zoals vele andere industrieën, geplaagd wordt door corruptie, omkoping, enz... Money makes the world go around, ook en zeker in deze sector. Dit boek, althans de flaptekst, sprak me aan, omdat ik eens wou weten wat Ben Goldacre te vertellen heeft over die medische industrie. Veel, zo blijkt uit deze klomp die ik met gemengde gevoelens "uitgelezen" heb.

Er passeert veel de revue: van proeven/testen (trials) over hoe nieuwe medicijnen uitgevonden worden tot het marketingaspect. De inhoud verteer je niet op enkele dagen, tenzij je er echt voor gaat. Het is zwaar; ik heb het boek eigenlijk niet van A tot Z gelezen, vooral veel diagonaal gelezen na enkele hoofdstukken, want Goldacre wijdt soms te veel uit, waardoor ie in herhaling valt of zaken vertelt waar jij (als niet-Brit of niet-Amerikaan) niet zoveel aan hebt.

Bij proeven gaat het dan o.a. over ontbrekende gegevens, over het feit dat niet alles verteld wordt of waarbij bepaalde elementen (bijv. bijwerkingen) geminimaliseerd worden. Proeven worden verdergezet zelfs als er x-aantal personen afhaken of bepaalde resultaten worden niet openbaar gemaakt, omdat het bedrijf in kwestie een slechte naam zou geven of schadeclaims creëren.

Ook heeft Goldacre het over nieuwe versies van bepaalde medicijnen die dan worden gepromoot, terwijl de oudere veel beter werkten. Maar toch moet dat nieuwe product zo veel en goed mogelijk gepromoot worden, want er moet geld verdiend worden. Soms worden voor die nieuwe versies zelfs geen testen gedaan.

Er volgt ook een heel groot stuk over trials (proeven) zelf, niet hoe er data (al dan niet opzettelijk) weggelaten worden in de resultaten en publicaties.

In het Marketinggedeelte gaat het dan o.a. over reclame voor medicatie, verkooppraktijken naar dokters/ziekenhuizen/... toe, met de nodige "voordelen" en "cadeaus", en hoe die reclame en promotie ten dele ervoor zorgt dat die specifieke producten toch voorgeschreven worden, zelfs al heeft de patiënt in kwestie er geen baat bij en zou hij/zij beter een ander medicament voorgeschreven krijgen.

Na het lezen van enkele hoofdstukken ben ik beginnen letten op reclame op TV voor medicatie. Normaal gezien sta je daar niet bij stil, al krijg je die reclamespots keer op keer te zien. Maar waarom wordt voor bepaalde producten zoveel reclame gemaakt? Bijv. Gaviscon (voorheen Rennie) voor maagzuur, Rhinospray (neusspray), Nurofen, en ga zo maar door. Men zet de mensen op die manier aan, na voldoende "indoctrinatie", om die producten te gebruiken als ze ook maar iets van de symptomen hebben.

En dat kaart Goldacre ook aan: Dat men op de duur, via allerlei manieren (waaronder vragenlijstjes op websites), ziektebeelden gaat creëren en mensen doet geloven dat men dan ook aan een dergelijk ziektebeeld lijdt, ook al hebben ze eerder 'neen' dan 'ja' geantwoord op de vragen. En natuurlijk bestaat er dan de nodige medicatie om dat probleem aan te pakken. Of wat had je gedacht?

Goldacre heeft het verder, naar het einde toe, ook over de misstappen en veroordelingen van farmaceutische reuzen als Eli Lilly, Pfizer, GlaxoSmithKline (GSK), ...

Andere partijen die aangevallen worden zijn, vanzelfsprekend, de politiek en daaraan gerelateerde organisaties, scholen, de pers, en meer.

Geld blijft een kernelement doorheen het boek, omdat het gebruikt wordt om nieuwe medicijnen op de markt te brengen, de nodige promo te voeren, de nodige goedkeuringen/licenties/... te bekomen, en ga zo maar door. Of wat met, bijvoorbeeld, de dreigende Mexicaanse griep van enkele jaren geleden, waarvoor een hoop vaccins werd gemaakt, maar veel daarvan niet werd gebruikt (althans in België), omdat ze eigenlijk niet nodig waren? Ofte: De bevolking werd opgejut, bang gemaakt voor wat? Tenzij uiteraard in die landen waar het virus wél had toegeslagen.

Hij geeft ook voorstellen over wat de patiënt of de dokter zelf kan doen om steeds correct te handelen en ingelicht te worden. Een logisch voorbeeld is: uitwisseling van informatie tussen patiënt en dokter, zodat de dokter een gerichtere diagnose kan stellen en gepaste(re) medicatie voorschrijven. En dat is nodig, dat je als patiënt niet steeds alles aan de dokter overlaat: het moet een win-winsituatie zijn. Jij weet beter dan de dokter hoe je je voelt, welke impact de voorgeschreven medicatie (niet) heeft, ... waardoor je beter gewapend bent om geen meuk voorgeschreven te krijgen. Maar het betekent niet dat je je dan slimmer dan de dokter moet wanen, zeker niet. Het gaat erom dat jouw gezondheid op punt blijft en daarvoor heb je een zekere mondigheid voor nodig.

Goldacre schetst een donker beeld van de farmaceutische industrie, da's waar. In het nawoord, waarin hij een update geeft over wat er gebeurd is sinds de eerste publicatie van het boek, probeert hij de criticasters van woord te dienen door (nogmaals) aan te geven dat zijn onderzoek gebaseerd is op wat hij zelf meegemaakt heeft en slechts voorbeelden van medicatie gaf om zijn voorbeelden beter te onderbouwen, vulling te geven, zodat je als lezer niet zelf moest proberen uit te vissen waar het over ging.

Zoals met alles dien je Goldacres betoog niet voor de volle 100% te slikken, zeker niet. Corruptie en de macht van het geld zijn zeker aanwezig in de farmaceutische industrie en nog geen klein beetje. Maar die industrie heeft de voorbije jaren ook veel goede geneesmiddelen uitgevonden. Het is dus geen zwart-witverhaal. Maar 'Bad Pharma' zet je wel aan het denken, zou je aan het denken moeten zetten, want de pers zal het niet voor jou doen. Jezelf inlichten, je lichaam laten vertellen wat er scheelt, ... het kan allemaal helpen om, als je dan ziek bent en medicatie nodig hebt, dit gerichter te laten gebeuren. ( )
  TechThing | Jan 22, 2021 |
Fascinating insight into the corruption that is rife in pharma and how it permeates medicine. ( )
  Conor.Murphy | May 27, 2020 |
Goldacre has a way of making complex science subjects accessible to the wider public. His first book, Bad Science, highlighted the way that the media dealt with reporting science, and in this book he concentrates his ire onto the $600 billion global pharmacy industry, now dominated by a handful of behemoths.

And what he reveals is frankly terrifying. He details the way that the industry hides a large majority of the trial data, the way that the legislation requiring data to be published is ignored by companies, and in the EU it is still secret in some cases. There is loads of detail on the way that the data is cherry picked to demonstrate that a particular drug is so much better than the competition. There is lots of detail on the appalling way that the industry is regulated, even though it is very heavily regulated, most of it is ineffective and not enforced, and where the regulation could be improved to help patients and save lives these are not enforced or are not enacted on after lobbying from the industry.

The biggest chapter though is on the marketing that these companies employ. Their budgets for marketing are normally twice the R&D budgets, which gives you some idea of where their priorities lie. He explains how they sponsor various ‘conferences’ and provided sweeteners to medical professionals at all levels, from lunches to flights to what most people would consider bribes. The nefarious dealings of the drugs rep are dealt with too, from the pressure that they put onto doctors to use their medicines and the way that they collect data directly from surgeries and pharmacies. A lot of academic papers are ghost written, and a leading figure puts their name to it, shocking really.

There is some details on NICE, but not a huge amount. He looks at the way that they select the drugs for use in treatment, noting that even they do not have access to all the trail data for each medicine that they consider.

He also writes about how a lot of the drug companies fund patient groups either overtly with cash donations or covertly by funding particular conferences and so on. They have been proven to use them to exert pressure on national agencies (FDA and NICE) to supply the latest drugs regardless of the cost; i.e. £50K spent with a group means that they get their £21k per patient drug treatment approved, even though the trial evidence is not there or is at best not proven to be any more effective than the current items on the market. A real scandal.

Throughout the book he does give suggestions on how the situation can be improved but he does realise that they is an endemic problem and powerful vested interests do hold sway. Even just enforcing the current rules would make a difference, but it seems unlikely at the moment.

The phrase for illegal drugs used to be: Just Say No. Perhaps it should apply to legal drugs too... ( )
  PDCRead | Apr 6, 2020 |
This is a shocking read in many ways, even for those who have a latent mistrust of large corporations and institutions. The author's passion for the topic is as plain as day and he makes it very clear that this is as much a long-form campaigning pamphlet as it is a non-fiction book.

While the content was illuminating, the style was a little grating in places. Frequent repetition was the biggest peeve and one which could have been edited out quite easily to chop a hundred pages from the book.

I read the ebook version from Google Play in 2018 and there were useful footnotes and hyperlinks embedded, with a significant postscript written a year after initial publication. ( )
  Sam.Prince | May 7, 2019 |
You will look at your pills in a different way ( )
  lucaconti | Jan 24, 2019 |
Mostrando 1-5 de 24 (seguinte | mostrar todas)
Goldacre is not a conspiracy minded nutcase who sees bad guys behind every garbage can. No, he sees a system that has, despite some really perverse incentives, produced some blindingly good products. But those incentives also allow life-threateningly poor decisions to be rewarded, and that needs to change.

Goldacre's encouraging outlook is why each chapter ends with a list of what you, personally, can do to help. Questions you can ask your doctor if you are a patient. Things you can do as a doctor. What academics can do, what pharmaceutical companies can do.

Read this book. It will make you mad, it will make you scared. And, hopefully, it will bring about some change.
adicionado por jimroberts | editarArs Technica, Chris Lee (Jan 5, 2013)
 

» Adicionar outros autores

Nome do autorFunçãoTipo de autorObra?Status
Ben Goldacreautor principaltodas as ediçõescalculado
Corral, RodrigoDesigner da capaautor secundárioalgumas ediçõesconfirmado
Cowley, JonathanNarradorautor secundárioalgumas ediçõesconfirmado
Lacey, RobertCopy editorautor secundárioalgumas ediçõesconfirmado
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We like to imagine that medicine is based on evidence and the results of fair tests. In reality, those tests are often profoundly flawed. We like to imagine that doctors are familiar with the research literature about a drug, when in reality much of the research is hidden from them by drug companies. We like to imagine that doctors are impartially educated, when in reality much of their education is funded by the pharmaceutical industry. We like to imagine that regulators let only effective drugs onto the market, when in reality they approve useless drugs, with data on side effects casually withheld from doctors and patients. All these problems have been shielded from public scrutiny because they're too complex to capture in a sound bite. But Ben Goldacre shows that the true scale of this murderous disaster fully reveals itself only when the details are untangled. He believes we should all be able to understand precisely how data manipulation works and how research misconduct on a global scale affects us. This book reveals a shockingly broken system and calls for something to be done.--From publisher description.

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