---
title: "Bad Pharma"
chunk: 3/4
source: "https://en.wikipedia.org/wiki/Bad_Pharma"
category: "reference"
tags: "science, encyclopedia"
date_saved: "2026-05-05T03:30:59.709251+00:00"
instance: "kb-cron"
---

=== Chapter 6: "Marketing" ===
In the final chapter, Goldacre looks at how doctors are persuaded to prescribe "me-too drugs," brand-name drugs that are no more effective than significantly cheaper off-patent ones. He cites as examples the statins atorvastatin (Lipitor, made by Pfizer) and simvastatin (Zocor), which he writes seem to be equally effective, or at least there is no evidence to suggest otherwise. Simvastatin came off patent several years ago, yet there are still three million prescriptions a year in the UK for atorvastatin, costing the National Health Service (NHS) an annual £165 million extra.
He addresses the issue of medicalization of certain conditions (or, as he argues, of personhood), whereby pharmaceutical companies "widen the boundaries of diagnosis" before offering solutions. Female sexual dysfunction was highlighted in 1999 by a study published in the Journal of the American Medical Association, which alleged that 43 percent of women were suffering from it. After the article appeared, the New York Times wrote that two of its three authors had worked as consultants for Pfizer, which at the time was preparing to launch UK-414,495, known as female Viagra. The journal's editor said that the failure to disclose the relationship with Pfizer was the journal's mistake.
The chapter also examines celebrity endorsement of certain drugs, the extent to which claims in advertisements aimed at doctors are appropriately sourced, and whether direct-to-consumer advertising (currently permitted in the US and New Zealand) ought to be allowed. It discusses how PR firms promote stories from patients who complain in the media that certain drugs are not made available by the funder, which in the UK is the NHS and the National Institute for Health and Clinical Excellence (NICE). Two breast-cancer patients who campaigned in the UK in 2006 for trastuzumab (Herceptin) to be available on the NHS were being handled by a law firm working for Roche, the drug's manufacturer. The historian Lisa Jardine, who was suffering from breast cancer, told the Guardian that she had been approached by a PR firm working for the company.
The chapter also covers the influence of drug reps, how ghostwriters are employed by the drug companies to write papers for academics to publish, how independent the academic journals really are, how the drug companies finance doctors' continuing education, and how patients' groups are often funded by industry.

=== Afterword: "Better Data" ===
In the afterword and throughout the book, Goldacre makes suggestions for action by doctors, medical students, patients, patient groups and the industry. He advises doctors, nurses and managers to stop seeing drug reps, to ban them from clinics, hospitals and medical schools, to declare online and in waiting rooms all gifts and hospitality received from the industry, and to remove all drug company promotional material from offices and waiting rooms. (He praises the website of the American Medical Student Association – www.amsascorecard.org – which ranks institutions according to their conflict-of-interest policies, writing that it makes him "feel weepy.") He also suggests that regulations be introduced to prevent pharmacists from sharing doctors' prescribing records with drug reps.
He asks academics to lobby their universities and academic societies to forbid academics from being involved in ghostwriting, and to lobby for "film credit" contributions at the end of every academic paper, listing everyone involved, including who initiated the idea of publishing the paper. He also asks for full disclosure of all past clinical trial results, and a list of academic papers that were, as he puts it, "rigged" by industry, so that they can be retracted or annotated. He asks drug company employees to become whistleblowers, either by writing an anonymous blog, or by contacting him.
He advises patients to ask their doctors whether they accept drug-company hospitality or sponsorship, and if so to post details in their waiting rooms, and to make clear whether it is acceptable to the patient for the doctor to discuss his or her medical history with drug reps. Patients who are invited to take part in a trial are advised to ask, among other things, for a written guarantee that the trial has been publicly registered, and that the main outcome of the trial will be published within a year of its completion. He advises patient groups to write to drug companies with the following: "We are living with this disease; is there anything at all that you're withholding? If so, tell us today."