Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients
Bad Pharma: om hvordan medicinalindustrien vildleder lægestanden og skader patienter

Paperback: 448 pages
Publisher: Fourth Estate (25 Sep 2012)
Language: English
ISBN-10: 0007350740
ISBN-13: 978-0007350742
Amazon.co.uk
Amazon.com Release date: February 5, 2013 | ISBN-10: 0865478007 | ISBN-13: 978-0865478008 | Edition: Reprint
Saxo.com

Contents

Intro

- What's comming
- How to read this book

1. Missing Data

Sponsors get the answer yhey want
- Why missing data matters
- Why we summaraise data
- How much data is missing?
- Why do negative trials disappear?
- How ethics committees and universities have failed us
- What can be done?

How regulators and journals have failed us
- Registers
- What can be done?
- Blood from a stone: trying to get data from regulators
- Wher are we so far?
- What to do about this?
- Trying to get trial data from drug compagnies: the story of Tamiflu
- What can be done?

2. Where Do New Drugs Come From?

- Where do drugs come from?
- From laboratory to pill
- Early trials
- Phase 2 and 3
- 'CROs' and trials around the world

3. Bad Regulators

- Getting your drug approved
- Pressures on regulators
- Approving a drug
- 'Better than nothing'
- Surrogate outcomes
- Accelerated approval
- Midodrine
- The impact on innovation
- Comparative effectiveness research
- Monitoring side effects
- Solutions

4. Bad Trials

- Outright fraud
- Test your treatment in freakishly perfect 'ideal' patients
- Test your drug against something rubbish
- Trials that are too short
- Trials that stop early
- Trials that stpo late
- Trials that are to small
- Trials that measure uinformative outcomes
- Trials that bundle their outcomes together in odd ways
- Trials that ignore drop-uots
- Trials that change their main outcome after they've finished
- Dodgy subgroup analyses
- Dodgy subgroups of trials, rather than patients
- 'Seeding Trials'
- Pretend it's all positive regardless

5. Bigger, Simpler Trials

6. Marketing

- Adverts to patients
- Celebrity endorsement
- More than molecules
- Medicalisation
- Patient groups
- Adversing to doctors
- 'Drug reps'
- Ghostwriters
- Academic journals

Pharma's medical shool

- What does it mean to take money?

Afterword: Better Data

- Clearing the decks
- Things you can do

- Everyone
- Patients
- Patient groups
- Doctors
- Medical schools
- Ghostwriters
- Lawyers
- Journal editors
- The pharmaceutical industry
- Professional bodies
- Funders
- Academics and nerds

Glossary
Acknowledgements, Further Reading and a Note of Errors
Notes
Index



Stark medicin för läkemedelsmyndigheter "Den evidensbaserade medicinen är sjuk, enligt Ben Goldacre. I »Bad Pharma« beskriver han detaljerat problemen och presenterar radikala förslag för en sundare läkemedelsanvändning. (...) Den viktiga, kontroversiella förs~ta delen handlar om försvunna data. Goldacre menar att evidensbaserad medicin inte är möjlig i dag eftersom högst hälften av resultaten från läkemedelsstudier redovisas. Resten saknas. Forskningsdata från läkemedelsprövningar förvrängs genom publikationsbias. Läkemedelsmyndigheterna undanhåller rådata från extern granskning." Les bokanmeldelsen i Läkartidningen.se