February 25, 2013
JUST SAY, NO, TO DRUGS:
The Pill Pushers (CHRIS WILSON, Feb/March 2013, Book Forum)
Posted by Orrin Judd at February 25, 2013 9:58 PMMost of us would like to believe that our doctors spend every free moment buried in medical journals, impervious to the long tentacles of drug companies--no matter what their inexhaustible supplies of AstraZeneca pens and Eli Lilly clipboards may suggest to the contrary. But physician and journalist Ben Goldacre takes firm and decisive aim at that comforting myth in Bad Pharma, a sequel of sorts to his 2009 title, Bad Science.Thanks to the moral ineptitude of oil and tobacco companies, we're all familiar with tales of soulless corporations skewing data, buying off critics, and silencing dissidents. Pharmaceutical companies are especially practiced in these dark arts because the regulatory process is long, bureaucratic, and deeply entangled with many different stakeholders--ensuring, in other words, that the drugmakers have ample room to induce all sorts of players into making new markets for them. Most accounts of how the industry games the regulatory process concern themselves with the new breed of shady marketing and advertising come-ons that sends patients flocking to their doctors demanding worthless, expensive medications. Goldacre covers this ground thoroughly, but he is more concerned with the phony ways that companies get their drugs past the phalanx of would-be regulators to begin with. It is surely the most comprehensive account of the subject to date.Documents exposed by litigation and the diligent work of various watchdog concerns have provided an extensive public record of just how drug manufacturers can manipulate each stage of a drug's lifetime. Occasionally, some of these practices, such as false advertising and the suppression of harmful side effects, result in lawsuits like the one that GlaxoSmithKline settled last summer for $3 billion. Most of the time, though, the abuses take place in the expansive gray area where industry and academia intersect. Goldacre contends that every person and entity responsible for policing this relationship has failed us: companies themselves, regulators, researchers, journal editors, and doctors. The result is a glut of ineffective medications with poorly understood side effects that often continue to be prescribed years after they're shown to be useless.