Bad Pharma读后感100字

《Bad Pharma》是一本由Ben Goldacre著作，Fourth Estate出版的Paperback图书，本书定价：GBP 13.99，页数：448，特精心收集的读后感，希望对大家能有帮助。

《Bad Pharma》读后感(一)：Comments from Quora

https://www.quora.com/What-do-medics-researchers-drug-company-employees-or-drug-regulators-think-about-Bad-Pharma

先放链接在这里，如果我以后有空了就来翻译_(:з」∠)_

《Bad Pharma》读后感(二)：Informative

该书的第一句话就是Medicine is broken. 这不是什么新问题. 基本上大家都知道, 其根源都在于制药公司. 制药公司不公开很多实验数据, 他们公开的实验结果大多都是对药品有利的; 而发表的这些结果很多并没有详细的实验过程的描述, 而仔细考察其原始数据可以发现很多实验设计都存在问题, 数据的处理方法也做了手脚, 使得其药品的功效被夸大. 监管机构也不见得有足够的数据, 所以他们也不知道实情, 医生就更不知道实情了. 制药公司派出医药代表向医生推销他们的产品, 办培训班向医生推销新药, 通过广告宣传误导患者. 制药公司还给发表对他们药品有利的杂志给予奖励. 他们也打压发现问题的人, 施压让他们闭嘴. 他们发明新的疾病, 使得一些正常的个体差异看起来是disorder一样, 好让自己的药卖出去. 他们也雇佣商业写手写好称赞自己产品的文章, 然后找学术界的人来挂名, 将文章发表在学术杂志上.

这本书对所有这些问题都做了讨论并且列举了很多实例, 比如抗抑郁药paroxetine, 减肥药sibutramine, 抗神经分裂药olanzapine. 我个人对最后那条ghostwriting还是挺吃惊的, 因为以前不知道有这回事. 比如Lilly在其开发的抗精神分裂症药olanzapine获批之前就定下基调说怎么写一篇赞扬该产品的文章. 基调之一是"create a need for intramuscular olanzapine through the promotion of awareness of safety issues surrounding current typical IM treatments for acute agitation associated with schizophrenia".

该书也批评了监管机构的不透明. 虽然这个情况各国都有, 但是书中看下来貌似美国的FDA严一点, 英国的MHRA其次, 欧洲的EMA最为糟糕. 监管机构甚至拒绝学术界获得实验数据.

该书总结说, 所有问题的核心就是数据不公开. 该书1/4的篇幅讲missing data (还有1/4讲marketing). 所以在提出的解决办法中, 被认为是最重要的就是严格执行严厉的报告制度. 但是制药界和监管机构都认为现在已实行的规则已经够用, 虽然事实上并非如此, 书中也就此举了不少例子. 因此透明和公众监督是解决问题的关键, 但是由于大量的资金都来自制药业 (他们的资金远比国家机构的多), 透明就成为了一个很大的问题.

倒数第二条, 英国有着独特的NHS系统, 就是英国的所有医院都属于这个系统. 这个使得收集患者的数据变得比在其他国家容易, 因此统计, 例如药物的不良反应, 也更为容易.

最后一条, 这个书的封面设计就很cute, 就如同一个药品的外包装一样.

《Bad Pharma》读后感(三)：Book review/Note-taking on “Bad Pharma”

The major concern raised from BP was on missing reliable data on academic papers. Pharmaceutical industry play a tremendous influence on data integrity and transparency, they normally refuse to disclose. Apart from it, doctors, drug reps, ghost writers, and regulatory bodies all have involved to worsen the situation and make the evidence-based clinical search more miserable. Problems it mentioned and disused: 1. Biased trails. Industry funded trails were more likely to produce positive outcomes. For those negatively resulted papers, they tend to be withhold by investigators and drug companies, or refused to be published by major journals. (i.e.TGN1412) o Author recommends to use systemic review for better evaluate clinical trial results, which enhance further decision making. (i.e. Chocrane review) o All trails should be registered, and publish its results no matter of positive or negative. o Regulatory bodies and drug companies are encouraged to share their clinical data to the public, for not only surveillance but also better decision-making for doctors. o Study design with multiple primary goals. 2. Ethical disturbance. Trail participants (normally from developing countries/undeveloped countries) may not benefit from trail results. CRO companies seems make profit from carrying out trails in those “Poor regulated, and poor social-economic status” countries. 3. Drug approval for useless drugs. For novel drug to be approved, it only need to show that the treatment is better than placebo. o Comparison study to its competitor to achieve better results was either by overdose “c” to induce increased side-effects, or under-dose “c” to diminish the efficacy. Those data manipulations when conducting trails enables better performance of own drug. o Surrogate outcomes. o Preference of regulatory authority also affect the drug approval (i.e. Tyressa). o Failed to remove already on-market drugs. EMA and FDA has poorly update its information of on-market medicines. o Monitored publicly campaign accelerate drug approval process. 4. Majority of money spent on drug marketing. o Drug representatives trained to influence the prescribing behavior of doctors. o Sponsored conferences and meetings, patient groups, and campaigns. 5. Ghostwriters. Writing up literatures for the interest of industry, or for individual academics.