Bad Pharma

 

An English doctor, needing to change the anti-depressive drug of one of his patients, consulted the available documentation of an alternative active principle in order to evaluate its effectiveness and safety. Satisfied with the information found in the available literature, together with his patient he decided to use the new drug. But actually his choice turned out to be wrong, because in 2010 a team of researchers re-evaluated the drug taking into consideration all the research done on it (not only that published), highlighting the low effectiveness of the substance and its significant side effects.

How can such a thing happen?

I did everything a doctor is supposed to do. I read all the papers, I critically appraised them, I understood them, I discussed them with the patient and we made a decision together, based on the evidence. In the published data, reboxetine was a safe and effective drug. In reality, it was no better than a sugar pill and, worse, it does more harm than good. As a doctor. I did something that, on the balance of all the evidence, harmed my patient, simply because unflattering data was left unpublished.”

We need to understand the mechanisms underlying the testing of a new molecule: its effectiveness is tested mainly by those who manufacture it! And the pharmaceutical companies are authorised not to publish any negative results! It’s easy to imagine how this mechanism brings about the distortion of information: they (the manufacturers) only tell us (doctors and patients alike) what they want to tell us. It even happens that entire scientific magazines are owned by drug companies!

How many family doctors are aware of this?

Because researchers are free to bury any result they please, patients are exposed to harm on a staggering scale. Doctors often have no idea about the true effects of the treatments they give. Does this drug really work best, or have I simply been deprived of half the data? Nobody can tell. Could this drug kill patients? No one can tell. This is a bizarre situation to arise in medicine, a discipline where everything is supposed to be based on documented evidence. This data is withheld from everyone in medicine, from top to bottom. The National Institute for Health and Clinical Excellence (NICE), for example, has been created by the British government in order to carry out thorough and impartial analysis of all the evidence collected for new treatments. Even so, it does not have access to data regarding the efficiency of a drug if researchers or drug companies don’t wish to reveal it. Even though NICE has to make decisions affecting millions of people, legally it has no more right than a single citizen to view that data.

In the article entitled “The drugs don’t work: a modern medical scandal” by Dr. Ben Goldacre, published in “The Guardian”, 21 September 2012, which is an extract from his book “Bad Pharma” (2012) you will find much more data and many reports of dramatic cases of mismanagement of research and information.

 

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