What Dr. Google lacks in bedside manner, she more than makes up for in convenience. I never have to wait for an appointment; just type some symptoms into the search bar and go. Those of us outside the healing professions can access—and consequently must weigh—more health information than ever. Discussions about “big pharma” are in the popular media frequently, as many people are concerned about greed within the industry and a tendency toward overmedicalization. I’m fascinated by the science and sociology behind medicine (not to mention the owner of my very own, very fallible body), but how can I hope to sort through even a fraction of what’s out there?
Enter Ben Goldacre, practicing physician and science writer.
Bad Pharma takes us through various stages of a drug’s life, from testing and regulatory approval to marketing and use. Statistics are used by researchers and regulators to separate effective medicines from duds, and a combination of professional experience and complicated science is involved in developing drugs and putting together treatment plans. But like most people, I don’t have the background or even the time to get into the nitty gritty of pharmacology, especially when research is published—and publicized—daily. What Bad Pharma provides is insight into the process and where it breaks down, a sort of meta-knowledge necessary to being a savvy and skeptical consumer.
Just one of the topics Goldacre covers is the organization of drug trials. Appropriately blinded, randomized, and controlled studies have vastly improved medical practice. Yet for a variety of reasons they are often short, focus on “ideal” subjects without other health problems or complicating life factors, and rely on proxy measures as a stand-in for other outcomes (for instance, a trial might measure blood pressure instead of counting heart attacks). To make up for this, Goldacre proposes creating a unified database of medical histories and records, allowing researchers to cross-reference data from real patients and analyze treatments across large and diverse groups. People would be asked to opt in to the system by their healthcare providers, and databases could be structured to preserve individual privacy. Said ongoing “trials” would help assess long-term effects, as companies frequently fail to complete the follow-up studies they have promised.
If there’s one thing I took away from Bad Pharma, it’s the importance of greater transparency at every point in the process, from research labs to medical offices. Goldacre’s book is serious and scientifically rigorous, but it’s also remarkably accessible and fascinating from cover to cover. (The cover is pretty cool, too.)