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All Thumbs Book Reviews

Deadly Medicines and Organized Crime: The biggest difficulty with discussing drug
How Big Pharma Has Corrupted Healthcare trials is knowing where to begin. Other book
by Peter C Gøtzsche reviews have talked about this so I will try not
Radcliffe Publishing to be redundant. One of the key problems with
placebo controlled trials is that often the placebo
The author, Peter Gøtzsche, graduated with doesn't fool anybody. Most people know drugs
a Master of Science degree in biology and chem- have side effects so if you are not experiencing
istry in 1974 and as a physician in 1984. He is a any, you got the placebo. This book recommends
specialist in internal medicine; he worked with correcting that with active placebos, meaning
clinical trials and regulatory affairs in the drug placebos that generate side effects similar to the
industry and is a co-founder of the Cochrane actual drug.
Collaboration. While poor methodology is epidemic, there
I mention this just to point out that the infor- is a much larger, more central problem. Pharma-
mation in this book comes from someone who ceutical trials are not motivated by any dedica-
has been inside the industry for a long time. He tion to science or safety. They are marketing. It
is not just another troll regurgitating nonsense should be obvious to the FDA and everybody
made up by some other troll. else that the testing of a product by the producer
A few numbers begin to paint the picture. will never be anything but marketing, but the
In 2009, Pfizer paid over two billion dollars in farce continues.
a healthcare fraud settlement. GlaxoSmithKline Scientific journals helpfully provide support
paid three billion in 2011. Johnson & Johnson for this marketing. Lancet editor Richard Horton
was fined over one billion dollars in 2012, and he said “Journals have devolved into information
lists several others. Even for large corporations laundering operations for the pharmaceutical in-
these numbers sound huge to me. dustry.” The pharmaceutical industry is clearly
His evaluation of the pharmaceutical in- about money and not health. If you make it half
dustry may seem excessively harsh if you are way through this book without getting that point
new to this subject, but the numbers above are you either work for the industry or perhaps you
just a few early details in an account of many are availing yourself of a few too many of their
documented offenses. When asked to comment products.
on what he thinks of the industry's ethics, he But. . . but the FDA will protect us, right?
jokes that it is difficult to describe what doesn’t FDA scientist Len Lutwalk said that if the
exist. American people knew some of the things that
I worked in the defense industry for many go on in the FDA, they'd never take anything
years and I find the approach of industry in but Bayer aspirin. Pharmaceutical
general to ethics would be funny if the conse- Companies like to claim that the efficacy of trials are not
quences were not so often dangerous or deadly. their product is backed up by the data, but does motivated by
We had to attend mandatory ethics training anyone ever see the data? Russell Katz, director
which typically occupied about one hour of our of the neuropharmacology division of the FDA any dedication
time each year. The effectiveness of this is dubi- said companies don't like to publish negative to science or
ous at best. If I just intentionally sold a “health” studies. He finds it amusing how so many sci- safety.
product that kills people, is a little training going entists and physicians make pronouncements on
to reform me? Oops, that happened because I the data without seeing the data. If you really They are
missed my ethics training. Sorry. My bad. want to see data you usually have to pay. Even marketing.

Wise Traditions SUMMER 2016 Wise Traditions 85