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Book Review Deadly Medicines and Organised Crime by Gøtzsche

The Danish medical researcher Dr. Peter C. Gøtzsche uses examples and scientific studies to show how the pharma industry has corrupted our health care system.

Collage book "Deadly Medicine" by Prof. Gøtzsche with text statement on the right.© CC-by-sa 2.0, Catalina Sparleanu, PhD, Foundation Diet and Health Switzerland


From a world company we received the demand for not using 4864 different names. They are mainly prescription drugs, etc. Including "I" for the active ingredient in the body that inhibits diabetes. We now use "shortcuts" and have deleted some passages and numerous helpful links. The original contribution can only be viewed by members (membership is possible at the top left of our pages, EE June 2019).


In a precise and in-depth manner, professor Peter Christian Gøtzsche describes the many manipulations (also intrigue) of the pharmaceutical industry. It is a story of deception, concealment of negative studies, bribery, intimidation, and threats directed at critics (criticism).

The goal of the major players in this industry is to make their already huge profits even larger.

The book does not contain a critique of capitalism. It is easy to read and comes across a bit like a crime thriller. However, in our book review, we only have room to present the facts, which are somewhat drier to read. We were only able to include a few of the many examples from the book.

The author suggests a number of solutions, which he summarizes in Chapter 21. Keywords here are independent medical testing bodies and regulatory authorities, rejection of money and benefits the industry provides to those who play a role in the healthcare industry including physicians, hospitals, universities, institutes, self-help groups, newspapers, journalists, and politics, and preventing conflicts of interests where experts are involved.

The book is definitely a must-read for all medical professionals who still believe that the pharmaceutical industry acts in the best interest of patients and not simply for their own benefit. It is a question whether or not this book should also be recommended to laypeople without prior knowledge.

After reading this book or our book review, no one should simply stop taking their medications. Instead, they should consult their physician and give him or her this book review to read. You can just send them the link. There are many essential medications.

In contrast to the information in this book, you should know that we owe the successes we have had with achieving a higher life expectancy to the pharmaceutical industry. This scathing but objective critique doesn’t have the task of conveying this fact. This book review includes confirmation that Gøtzsche is right on the mark.

Video image: "A pharmaceutical insider unpacks - ZDF".© CC-by-sa 2.0, Uwe Dolata, ZDF
Video: Ein Pharma-Insider packt aus (A pharma-insider reveals the shocking truth), 3:28 min. YouTube channel DieAndereWahrheit (The other truth).

ZDF, a German public-service television broadcaster in Germany, is known for its reliable and unbiased reports. This is further evidence that the book discussed here depicts the situation as it is — without exaggerating.

1. Summary

What is the subject of this book? It deals with the methods employed by pharmaceutical companies and their managers. Their goal is usually to increase their profits, no matter what the price. Using the tricks provided by the author, they could offer good, effective medications that have very few side effects and are reasonably priced. But if a company wants to be successful today, this can’t be their goal. Society would have to first change.

The author dedicated the book to the many honest people who work in the pharmaceutical industry who are as outraged as he is about the criminal dealings of their superiors and the consequences that these have on patients and the economy.

To some extent, the companies in the food industry act similarly, as we saw in the book review of Salt Sugar Fat (book written by Michael Moss). Moss received a Pulitzer Prize for his book.

How people act when money and/or prestige are at stake
Clip on YouTube about ZDF heute show. Interview with a lobbyist of ProGenerika.© CC-by-sa 2.0, Martin Sonneborn, ZDF
Video: Martin Sonneborn interviews a spokesperson for the lobby association ProGenerika. (German only, 3:42 min, uploaded by QVCinsider, ZDF’s heute-show (satirical television program) on May 14, 2010)

You can hear more about how cheap medications from China or India really have the same quality as medications produced in Europe.

It’s quite funny, the point being that the pharmaceutical industry wants us to buy their more expensive medications, but it doesn’t add anything that isn’t already included in this book.

Forewords and statements

2. Book review

Professor Peter C. Gøtzsche writes that the major epidemics are under control in the majority of the countries in the world — and he criticizes the fact that many poor people still die of AIDS or malaria because they can’t afford the expensive medications. Instead we have two new epidemics: tobacco and medications.

In the United States and Europe drugs are the third leading cause of death after heart disease and cancer (p. 1).

He compares the tobacco industry with the pharmaceutical industry. Although there have long been studies about the addictive nature and the harm that both active and passive smoking cause, these were not published and their existence was kept confidential. The tobacco firm Philip Morris even conducted some of the studies itself.

This is corruption

In the United States, TV commercials urge viewers to take pills, tablets, or capsules as a way to get their life back under control. The characters in Aldous Huxley’s novel from 1932 Brave New World can take somadrugs as tablets every day ... (p. 2).

According to the author, the people in Denmark take so many drugs that it equals an average of 1.4 daily adult doses per person.

Why do people do this? The author believes that the main reason is that the pharmaceutical companies aren’t selling drugs to people, but instead lies about drugs.

This book is not about the successes the pharmaceutical industry has had against infections, some types of cancer, and hormone deficiencies such as Type 1 diabetes; instead it is about the failures of the system and the reasons for this. The author writes:

The research literature on drugs is systematically distorted through trials with flawed designs and analyses, selective publication of trials and data, suppression of unwelcome results, and ghostwritten papers.

Ghostwriters are paid to remain anonymous, and the articles are then published under the names of well-known professors even though they often contribute nothing to the text (p. 3).

2.1. Confessions from an insider

The author begins by reporting on his first experiences with preventative medicines.

Some types of vitamins increases overall mortality
Enterovioform (Clioquinol) for diarrhea leads to nerve damage, paralysis, and eye disorders.

Upon completing a degree in chemistry and biology, the author applied for a position as a drug representative at Astra (today AstraZeneca). There he learned how to persuade physicians to use the company’s product rather than the products of its competitors.

"Miracle drugs"

After eight months, he became a product manager. In this position, he was responsible for the sales of the asthma spray "Brican.." ("terbutali.." and inhalers). The goal was to get doctors to prescribe their patients constant treatment with the spray. And asthma death rates increased accordingly.

Picture of a YouTube video, titled: "10 Lies That Advertising Sold You".© CC-by-sa 2.0, Alltime10s
YouTube video about marketing persuasion techniques: Top 10 Lies That Advertising Has Sold You (7:13 min.).

During his time at Astra-Syntex, where he was responsible for clinical studies and registration applications for new drugs and indications, the author studied medicine.


In his doctoral thesis Bias in Double-Blind Trials, Peter C. Gøtzsche showed that many studies are designed to come out in favor of the sponsoring company’s drug and against the control drug (sponsors).

2.2. Organised Crime, the Business Model of Big Pharma

The pharmaceutical industry doesn’t speak about the advantages and disadvantages of its drugs, but instead of their efficacy and safety. When doctors prescribe medications and patients take them, both parties are convinced that the pharmaceutical industry has done thorough testing and the drug regulatory authorities have carefully scrutinised them (p. 53).

Pharmaceutical companies try to create the impression that they do so, but not even the majority of the employees believe their bosses are honest.

Examples of settlements
Image of a YouTube video, title: "The Pharma-Kartell - How to Betray Patients - ZDF".© CC-by-sa 2.0, Christian Esser, ZDF
Video: Das Pharma-Kartell - Wie Patienten betrogen werden (The pharma cartel—how patients are deceived), 44:17 min, from the program ZDF Frontal 21 - political show on the German television channel ZDF, clearly explains how the pharmaceutical industry uses certain steps and strategies to achieve its goals. Uploaded by DieAndereWahrheit.

The Hall of Shame for Big Pharma

Although the British Medical Journal (BMJ) and the New York Times publish articles almost weekly about the misconduct of drug companies, the companies dismiss these by stating that they are isolated cases.

In order to determine if this was indeed the case, in 2012 the author searched the Web (Google search combining the names of the top 10 drug companies with the word “fraud”). He then chose the most prominent case to describe in more detail:

Pfizer, Novartis, and Sanofi-Aventis
GlaxoSmithKline, AstraZeneca and Roche
Johnson & Johnson, Merk, Eli Lilly and Abbott
More cases

In 2004–05, the Health Committee in the British House of Commons examined the drug industry in detail and found that its influence was enormous and out of control. They found an industry that buys influence over doctors, charities, patient groups, journalists and politicians, and whose regulation is sometimes weak or ambiguous (p. 37).

In the United States, the pharmaceutical companies violate the law three times more than other industries.

The report showed that it would be good to limit the industry’s influence, also good for the industry because then they could again concentrate on developing new drugs instead of spending money on corrupt deals. But the British government did nothing; after all, the pharmaceutical industry is the third most profitable industry in the country (p. 37).

Pharma industry falls into the category of “organised crime"

2.3. Very few patients benefit from the drugs they take

In this chapter, the authors explains the importance of double-blind trials. With this type of study, neither the patients nor the doctors know who receives the medication and who receives the placebo. The assessment of the effectiveness changes depending on who and what percent of the investigators and test subjects aren’t “blind.”

Active placebos

The Number Needed to Treat (NNT) is a practical method used to determine how many people will be helped by a certain treatment. Using the example of statins, the author explains that an NNT is not provided for healthy patients with high cholesterol because they do not benefit from the treatment. However, they do experience a diminished quality of life because of muscle pain and weakness.

2.4. Clinical trials, a broken social contract with patients

As the pharmaceutical industry has had a monopoly on clinical trials conducted on its own products and only published the information that is to its benefit, this social contract has been broken over and over again.

The industry doesn’t only hide negative studies, it also intimidates people who have discovered harmful effects of its medications.

It covers up study aims if the desired result is not achieved and it designs studies so that the results can hardly be refuted.

Our governments have not succeeded in regulating the powerful pharmaceutical companies or in protecting scientific objectivity and academic curiousity (p. 52) against commercial interests.

Misleading results, data massage and fishing expeditions

Another interesting link: Why we can’t trust clinical guidelines.

2.5. Conflicts of interest at medical journals

Medical journals are finding it increasingly difficult to find authors who are independent from the pharmaceutical industry. They also have difficulties rejecting “pro-industry” articles because they then lose out on the profits for lucrative reprints and advertisements paid for by the industry.

This fact was also confirmed by the former editor of the British Medical Journal.

New England Journal of Medicine (NEJM)

According to the author, the British Medical Journal (BMJ) is a journal that is very dependent on pharmaceutical companies.

2.6. The corruptive influence of easy money

Speaking from his own experience, the author explains how corruption can begin. About 20 years ago, he took part in a planning meeting with clinical investigators and a certain company. In the evening, the head of the division for clinical trials gave him an envelope that contained cash.

If you don’t send the money back, you have signalled that you might be willing to think you are even more valuable for the company the next time (p. 70).

At the beginning, the amount of money you receive could be considered commensurate to the service you provide. But with time the amount increases and at some point the person receiving the money doesn’t even notice how disproportionately high the payments have become. They are, of course, beholden to the company and have to sometimes recommend drugs that are more expensive or less effective or use these in their practice even if a cheaper generic version becomes available.

Influential friends in politics and law

2.7. What do thousands of doctors on industry payroll do?

A small percentage of doctors serve in valuable research positions, for example, as investigators in relevant trials. However, most doctors work to help companies market their products. This is necessary because there are only rarely truly new and better drugs.

In 2009, Prescribe (journal in France) analyzed 109 new drugs or indications: 3 were considered a minor therapeutic breakthrough, 76 added nothing new, while 19 were deemed to represent a possible public health risk (p. 74).

Seeding trials

Opinion leaders can be bought for a price. They receive a lot of money, and in return companies occasionally use their name for recommendations and these individuals refrain from writing negative articles about poor or overpriced medications.

Hormone replacement therapy
YouTube from the, David Healy: Bad Medicine 13 Min. from 21.March 2012.© CC-by-sa 2.0, David Healy, MD, The Agenda

YouTube video, 13 min, with Dr. David Healy called “Bad Medicine.”

Wikipedia (German version): In Great Britain, the use of HRT drugs in women between the ages of 50 and 64 led to an estimated 20,000 cases of breast cancer.

2.8. Hard sell

Clinical trials conducted by pharmaceutical companies are often marketing in disguise. The author gives the example of trials conducted for new nonsteroidal anti-inflammatory drugs that were much too small to be statistically significant.

A Cochrane review also concluded that in the majority of statin trials they analyzed, the sponsor’s drug had much better results as compared to the competitor’s product.

If A is higher than B, and B is higher than C, then C cannot be higher than A

However, literature is not necessarily needed for marketing to be successful. An aggressive advertising campaign can also do the trick as the author shows with the example of the gastric acid inhibitor Zantac (ranitidine).

The gastric acid inhibitor Zantac (ranitidine)

It is much more lucrative for pharmaceutical companies to put their money into advertising, drug samples, sponsored meetings and training, and paid experts and pharmaceutical representatives than into serious research and trials.

Promotional trip to the Caribbean
Books about the mostly undesirable interactions between the pharmaceutical industry and physicians
YouTube video: "The Truth About the Drug Companies" - Dr. Marcia Angell.© CC-by-sa 2.0, Marcia Angell, MD, YouTube
Video: On the left is an image from this informative video, which is however quite long at 1 hour 17 minutes. If you search the name Dr. Marcia Angell, you will find other shorter viedeos, but these naturally include less information.

With the example of biologic agents (biopharmaceutical) used to treat rheumatoid arthritis, Peter C. Gøtzsche shows how an expert panel recommended these expensive medications even though two cheap medications had been shown to achieve the same results. After such recommendations are issued, it is very difficult to change them.

The author describes examples of expensive cancer drugs that, for example, only prolong life by 10 days and reduce the quality of life. In many cases, a cheap pain treatment would be better for patients.

Pfizer, "doxazos.." and the ALLHAT trial

As an example of an expert paid by the industry, Peter C. Gøtzsche refers to the chairman of the Danish Society for Hypertension, an individual who always recommends the newest and most expensive drugs of his sponsor company.

Many patient organizations, for example, support groups, funded by the pharmaceutical industry play quite the inglorious role. And the members often don’t know that they are being used by the company to introduce and pay for expensive and often ineffective drugs.

2.9. Impotent drug regulation

There are federal drug agencies, but since the companies conduct trials themselves or have them conducted on their behalf or at least monitor them and then only have to submit reports about them, a number of tricks are possible to cover up harmful effects. Drug agencies can, for example, hide information about serious side effects in their “mountains of documentation” (p. 107).

Some officials virtually work part-time as advisors for companies that they should actually be monitoring or they might even own shares in these companies. If they have to leave a regulatory agency after a particularly large scandal, lucrative positions in the pharmaceutical industry are waiting for them.


The unbearable lightness of politicians (p. 114)

In the United States, the pharmaceutical industry is a very generous donor to election and political campaigns. And there is more than one lobbyist from the pharmaceutical industry for every member of Congress. The Republicans receive the majority of the money. And in return they take measures to help the industry.

Measures to help the industry in USA and Europe

Drug Regulation Builds on Trust

In this section, the author begins with a quote from Dr. Alan Maynard, a well-known British health economist: Economic theory predicts that firms will invest in corruption of the evidence base wherever its benefits exceeds its costs. If detection is costly for regulators, corruption of the evidence base can be expected to be extensive (p. 119).

GlaxoSmithKline, the SMART study and treatment of asthma


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