“The intention of the pharmaceutical industry in my view is simply to delay the public becoming aware of the problem and professionals and policymakers addressing the problem and they will defend what they believe is their right to withhold unflattering clinical trial data. They will defend that harder than they defend anything else. You watch.

“Marketing, payments to doctors, all of that stuff, they’ll fight on it but to hide the unflattering results in clinical trials, they will fight viciously, tooth and nail, because that is more important to them than anything else. If you can poison the well of medical evidence, then you are made.”

http://healthland.time.com/2013/02/28/how-drug-companies-distort-science-qa-with-ben-goldacre/

via Pharmagossip (who has been giving Goldacre and the book a lot of coverage. 1boringoldman – cannot recommend that site enough – has also been covering alltrials a fair amount).

Some other relevant links worth the time to read:

http://www2.macleans.ca/2013/02/05/talking-with-ben-goldacre-about-his-new-book-bad-pharma/

http://theconversation.edu.au/peer-review-bad-pharma-by-ben-goldacre-9940

http://www.economist.com/blogs/babbage/2012/11/qa-ben-goldacre

Especially:
http://www.csicop.org/specialarticles/show/bad_pharma_interview_with_ben_goldacre
Because it lays out just how sophisticated an argument he is making.

I actually think he is altogether too optimistic about the overall impact of medications. I also think that broader access to patient level data is very important, and not included in the main thrust of alltrials. I also think he oversells the promise of data mining through electronic health (health care renewal, which you might want to think about adding to your blog roll – I’m full of suggestions today – speaks eloquently to the challenges inherent in that).

So, I’m not a fan of everything he is saying.

But, Goldacre seems to speak clearly about just how savage a fight this is going to be. And, he’s actually fighting it. And, fighting it damn well.

We really need him to win, at least on some real levels.

Because, there is simply NO way for patients and clinicians to compensate on an individual level for this absence of data.

“because that is more important to them than anything else”

Is it to the rest of us?

There is an enormous amount of potential loss of money at stake for a handful of companies.
vs
There is some benefit spread across an enormous number of people. But, it’s hard to know for any one person when the trickle down impact of that information (well, lack of information) is going to come into play.

So maybe not.

People might need a reminder about ethics. Ethics of the highly highly practical kind.

Perhaps need to be nagged about it.

Oh ….

You could do worse than convince every reader of your blog to read the book and sign on to the campaign.

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http://www.alltrials.net/supporters/the-alltrials-web-button/

You can see what that link on a website looks like here:

And, pick up a copy of Ben Goldacre’s new book “Bad Pharma” if you haven’t already done so.

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Although the Cochrane reviewers described the overall quality of the trials as “good”, there remains the known credibility issue of studies that are bought and paid for by industry. Heard an interesting analogy the other day: if Big Tobacco paid physicians (as they certainly have in the past) to cite “research” that claims to show cigarette smoking is harmless, how credible would you consider those claims?

The other red flag for me is the fact (caught by the second report) that in 14 of the 19 trials studied, participants included those with “cardiovascular risk factors such as raised cholesterol, diabetes and high blood pressure.” These are not and never would be considered low risk adults even though they have not had a cardiac event – YET!

Finally, an independent Health Canada-funded report called Evidence For Caution: Women and Statin Use in 2008 found: “The evidence base for prescribing statins for women, especially for primary prevention, is weak yet Canadian data suggest that half of all prescriptions are for women. Safety meta-analyses do not disaggregate for women; do not consider female vulnerability to statin-induced muscle problems, and women-centred concerns such as breast-cancer, miscarriage or birth defects are under-researched. Many trials have not published their non-cardiac serious adverse event data. These factors suggest that the standards of full-disclosure, informed consent, evidence-based prescribing and gender-based analysis are not being met and women should proceed with caution.”

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