Interview with Dr. Peter Gotzsche, author of Deadly Medicines and Organised Crime
Dr. Gøtzsche is co-founder of the Cochrane Collaboration and head of the Nordic Cochrane Centre. His new book is entitled: Deadly Medicines and Organised Crime: How big pharma has corrupted healthcare.
Apr 8, 2014
ANH-Intl: Towards the end of your book you state that “What we should do is … identify overdiagnosed and overtreated patients, take patients off most or all of their drugs, and teach them that a life without drugs is possible for most of us.” Can you please explain this a little further?
PG: Removal of drugs should usually not be accompanied by the introduction of other types of treatment. Many patients would gain a better quality of life if their drugs were taken away from them. What we need is to remember Brian McFerrin’s song: “Don’t worry, be happy”. We shall all die, but we should remember to live while we are here without worrying that some day in the future we might get ill. It is daunting how many healthy people are put on drugs that lower blood pressure or cholesterol, and it changes people from healthy citizens to patients who may start worrying about their good health. This can have profound psychological consequences apart from the side effects of the drugs that the patients don’t always realise are side effects, e.g. if they get more tired or depressed after starting antihypertensive therapy or experience problems in their sex life.
ANH-Intl: What can the public and patients do to help redress the situation? Are they effectively disempowered or are there things they can do to help build a more functional healthcare system?
PG: First of all, the public needs to know the extent to which they are being deceived in the current system, e.g. few people know that prescription drugs are the third major killer. If drug testing and drug regulation were effective, this wouldn’t happen.
ANH-Intl: Numerous problems with the medical literature are cited in your book, among them unpublished trials, fiddled statistics, unsuitable comparators and other methodological weaknesses and the preponderance of academic ‘flak’ in the form of weak, industry-sourced publications designed to muddy the waters. Bearing this in mind, what advice would you have for anyone wishing to locate high-quality published data?
PG: There are very little high-quality published data. Neither the drug industry nor publicly employed researchers are particularly willing to share their data with others, which essentially means that science ceases to exist. Scrutiny of data by others is a fundamental aspect of science that moves science forward, but that’s not how it works in healthcare. Most doctors are willing to add their names to articles produced by drug companies, although they are being denied access to the data they and their patients have produced and without which the articles cannot be written. This is corruption of academic integrity and betrayal of the trust patients have in the research enterprise. No self-respecting scientists should publish findings based on data to which they do not have free and full access.
ANH-Intl: Are there any classes of drug, as opposed to individual products, for which, in your opinion, there is no valid scientific or medical justification for their use in healthcare?
PG: There are several classes of drugs, e.g. cough medicines and anticholinergic drugs for urinary incontinence, where the effect is doubtful but there is no doubt about their harms, which in my opinion means they should be withdrawn from the market. There are many other types of drugs that likely have no effect. All drugs have side effects, and it is therefore difficult to blind placebo-controlled trials effectively. We know that lack of blinding leads to exaggerated views on the effect for subjective outcomes, such as dementia, depression and pain, and it is for this reason that many drugs, which are believed to have minor effects, likely aren’t effective at all.
There are also classes of drugs where, although an effect has been demonstrated, their availability likely does more harm than good. I write in my book that, although some psychiatric drugs can be helpful sometimes for some patients, our citizens would be far better off if we removed all the psychotropic drugs from the market, as doctors are unable to handle them. Patients get dependent on them, and if used for more than a few weeks, several drugs will cause even worse disorders than the one that led to starting the drugs. As far as I can see, it is inescapable that their availability does more harm than good.
ANH-Intl: The chapter in your book entitled “Intimidation, violence and threats to protect sales” begins as follows: “It takes great courage to become a whistle-blower. Healthcare is so corrupt that those who expose drug companies’ criminal acts become pariahs.” Have you experienced any blowback since publishing the book?
PG: No, quite the contrary, as people have praised the book. I don’t hear from the drug industry of course, but I have seen blunt lies about the book being propagated by drug industry associations and their paid allies among doctors.