Laura Ahmad
Royal North Shore Hospital

The stated aims of this openly polemic book are to explain how the relationship between the pharmaceutical industry and the field of medicine has distorted the practice of medicine.  

The author strongly emphasises the important issue of missing data. He describes how negative clinical trial data, that are not published due to strong industry bias and some academic journal bias, distort the evidence regarding the benefits and adverse effects of drugs. 

This book has chapters covering the flaws in the drug development process, in the design and reporting of drug trials, and in the ability of regulators to carry out their roles. There is also an extensive discussion of drug marketing practices. He goes on to describe the role prescribing doctors and key opinion leaders play in the practice of medicine, which is now strongly influenced by pharmaceutical companies. The author, Dr Ben Goldacre, who has also published a book called Bad Science, has referenced his points well and illustrated them using examples. 

The author accurately introduces this book as pop science. I found the writing style colloquial and repetitive. The examples and explanations are too simplistic for healthcare practitioners. This is a shame because the book provides important evidence of the ongoing problems in the relationship between medical practitioners, healthcare systems and the pharmaceutical industry, and offers concrete actions that could be taken. However, given the redundancy, digressions and patronising exposition, it is likely that this book will mainly be of interest to a motivated lay audience.

Dr Ahmad is a member of the Editorial Executive Committee of Australian Prescriber.

Laura Ahmad

Geriatrician, Royal North Shore Hospital, Sydney