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“Bad Science: Quacks, Hacks, and Big Pharma Flacks,” by Ben Goldacre, Faber and Faber, Inc, NY, 2010. This 288-page paperback presents the many ways those promoting health programs and drugs distort the data. Goldacre is especially intense in his criticism of the media which tends to hype the most emotional stories to sell newspapers or attract eyeballs. His presentation emphasizes the misuse of statistics. The result can be distortion of the facts and even concealment of unfavorable data.

The author begins with a discussion of clear frauds such as electrolytic treatments claimed to detoxify your body. He shows that the treatment is even effective when a doll is treated. All the claims are due to simple chemistry which has nothing to do with toxins.

We are given a thorough discussion of the many aspects of the placebo effect. Patients often respond psychologically to a treatment. Even the color of the tablets can affect results. Double blind studies are preferred where patients may receive a placebo or the medicine under test and even the staff does not know which is which.

He is critical of skin creams which often contain magical ingredients with fancy names but mostly exaggerated claims. Ditto additives like antioxidants and much hyped nutrition claims.

Goldacre tells the AZT story in the treatment of AIDS passionately. A vitamin pill entrepreneur named Mathias Rath of the Linus Pauling Institute in California claimed that chemotherapy for the treatment of cancer was killing patients. In South Africa where AIDS was an epidemic he claimed that antiviral drugs were poisonous and a conspiracy to kill patients. Multivitamins were more effective. South Africa also had AIDS deniers, who claimed AIDS does not exist. By blocking treatment it is estimated that 343,000 deaths occurred that could have been prevented.

Goldacre is critical of the pharmaceutical industry. The need for profits and the high cost of drug development result in some negatives. He describes eclampsia, a condition in pregnancy that kills 50,000 per year globally. Inexpensive magnesium sulfate has been an effective treatment since 1906, but drug companies promote expensive anticonvulsants because they are more profitable. The World Heath Organization established that magnesium sulfate is best only in 2002.

Similarly the high cost of drug trials causes the industry to de-emphasize unfavorable results. Perhaps a drug with minor defects can still go to market. Tricks are used to make a me-too drug look better than the competition. Testing vs an inadequate dose of the industry leader is one way. Most readers won’t notice. Or high doses can be used to emphasize the side effects of the competitor. And if results are unfavorable, simply don’t publish them.

The Vioxx story is told. Merck found the drug similar to naproxen in treatment of rheumatoid arthritis, but with reduced risk of gastrointestinal events. Vioxx was taken off the market in 2004 due to increased risk of heart attacks. Merck knew of the risk, but thought it insignificant. The problem was revealed in FDA data.

A chapter describes the opposition to vaccines and especially MMR, the measles, mumps and rubella vaccine. The information is especially timely given the recent outbreak of measles attributed to parents who decided not to vaccinate their children. The suspicion that MMR causes autism is attributed to a study published by Andrew Wakefield in 1998. His work has been thoroughly discredited, but yet is cited by the media and antivaccine activists repeatedly.

Wakefield’s study was not from a random population but instead was based on a group being studied for autism and bowel issues. Plus Wakefield was paid $75,000 by lawyers preparing a case against MMR. Eleven of the twelve patients studied sued.

Nevertheless, media picked up the story and played it big. This became a major issue in UK where middle class Brits decided not to vaccinate their children. Tony Blair’s son may or may not have been vaccinated. MMR vaccination became a highly politicized subject. Anti-business bias also seems part of the story. Are too many vaccinations being promoted? Are pharmaceutical companies trustworthy or merely in it for the profits?

Goldberg presents extensive data showing that MMR vaccinations are effective. US measles cases peaked at nearly 800K in 1958. After the vaccine was introduced in the early ‘60s, cases fell sharply. He disputes those who say childhood diseases are not serious. Outbreaks do produce deaths.

Anti-vaccination advocates are not new. The author cites opposition to smallpox vaccinations in Zurich, Switzerland. After no cases were reported in 1882, opponents questioned the need for required vaccinations. Thereafter the number of cases increased each year reaching 85 in 1886.

The World Health Organization has a program to eliminate polio by vaccination. A province in northern Nigeria resisted claiming the vaccine was part of the US program to spread AIDS and infertility in the Islamic World. Outbreaks followed.

Mercury amalgam fillings are discussed. Most of us had silver amalgam fillings until at least 1990. They became a concern given the known toxicity of mercury. A study of 1000 children found no toxic effects. Nevertheless, BBC ran a chilling documentary on the subject.

The story of thalidomide is told in a few paragraphs. It was marketed as an anti-nausea drug in Europe from 1958-1962. When given in pregnancy, it was found to cause birth defects. The problem was noted by physicians in Australia and Germany in 1961. Goldberg does not tell of the personnel at FDA in the US that kept thalidomide off the market here. Nor does he mention its recent use as a treatment for cancer.

This book is a useful introduction to many health treatments, some effective, some over promoted. The book is British but includes much US data. Many will find it a fascinating read. References, bibliography, index.
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