Ben Goldacre on Bad Pharma

Is it a problem that many prescription drugs are deemed effective based on research studies funded by their own makers?

As TEDMED 2012 speaker Ben Goldacre charges in his new book, Bad Pharma, the ramifications of this practice could be very bad indeed. Many drug studies are poorly designed or weighted toward producing specific results, he says. Plus, thanks to positive bias in reporting research results, few studies that show little benefit or harmful side effects see the light of publishing — if the drug companies even release these results.

As Goldacre says in his book, “When trials throw up results that companies don’t like, they are perfectly entitled to hide them from doctors and patients, so we only ever see a distorted picture of any drug’s true effects.”

Bad Pharma lists five drugs in particular in which published data doesn’t show the full picture of efficacy and side effects, Goldacre says: Reboxetine, lorcainide, rosiglitazone, oseltamvir (Tamiflu), and paroxetine. Read more about them, and about Goldacre’s book, on the TED Blog, and watch his alarming — yet amusing — talk at TEDMED 2012, below.

Perspectives: The upside of early innovation

What kind of corporate culture makes innovation inevitable?

Thomas Graham, M.D., Chief of Cleveland Clinic Innovations, and Vinay Gidwaney, co-founder and Chief Product Officer of DailyFeats — two who should know — talked with Lisa Witter as part of Perspectives, a series of conversations with thought leaders  co-produced by TEDMED and Fenton Studios and filmed at TEDMED 2012.

Achieving more medical innovation, more affordably is also one of TEDMED’s Great Challenges in health and medicine. The Challenges are persistent issues that demand collective understanding and discussion for management. Join this effort and help shape the future by sharing your thoughts now.

Fake food and the obesity crisis

How much of our nation’s obesity crisis is driven by an overabundance of processed food — and a lack of access to the real stuff?

In a new video series co-produced by TEDMED and Fenton Studios, and filmed at TEDMED 2012, Tracie McMillan, author of “The American Way of Eating” and David Ludwig of Boston Children’s Hospital sat down with Lisa Witter to discuss the issue.

What do you think contributes most to the obesity crisis? Share your thoughts and ask our team of thought leaders on the TEDMED Great Challenges website.

Coming surprisingly soon: Bioengineered leather

Would you rather eat bioengineered flesh – or wear it?

Tissue engineering has been much in the news over the past 18 months, yet the technology is in use now mainly for transplants. But engineered consumer products like meat and skin could be widely available much sooner than you’d think. Question is: Which would be more popular?

Gabor Forgacs, scientific founder of the company Modern Meadow, gave the TEDMED 2011 community a close-up demo of a 3D bioprinting process, including cooking and eating a small portion of bioengineered meat onstage. The company received significant financial backing from Paypal co-founder Peter Thiel in August.

But Modern Meadow’s first projects could be wearable rather than edible. In an interview with Scientific American, Meadow CEO Andras Forgacs (yes, son of Gabor), revealed that the company plans to produce skin rather than meat right now, in part because of potential resistance to eating manufactured flesh:

“Anecdotally, we’ve found that around 40 percent of people would be willing to try cultured meat,” he says. “There’s much less controversy around using leather that doesn’t involve killing animals.”

A full production line could be up and running in as soon as five years, he says; it’s just a matter of putting know-how into practice:

There’s no science we’re using that we’re not confident with. This isn’t about scientific risks, it’s about engineering challenges.”

Watch the senior Forgac’s TEDMED 2011 talk to see how it all began.

How can we better support caregivers?

An estimated 44 million people provide full-time or part-time care for the elderly,disabled veterans, new mothers, the injured, the sick — a problem that eventually impacts everyone in the nation.

Caregivers have few tools, few support systems and receive minimal, if any, training for these responsibilities. What innovations can we develop specifically to support the caregiver community?

Ask a collected team of leaders on the issue — from a caregiver to a psychologist — about how we can better manage the crisis, at

Patient as consumer: What does it mean for healthcare?

Patient empowerment can be a double-edged sword. From hospitals and insurance companies to doctors and patients themselves, much of the medical system increasingly treats patients as “customers” or “consumers,” terms that some people love and others hate. If patients are customers, does that mean “the customer is king” or does it mean “buyer beware” — or both?

If patients retain their traditional role, does that mean doctors are in charge? Are both in charge somehow? How is “power” shared among all stakeholders and how should it be shared?

The changing role of the patient was voted the number one Great Challenge in health and medicine by the TEDMED community in 2011, one of 20 complex issues with broad impact that needs cross-disciplinary understanding and discussion to manage.  Join the online interactive Challenges community now to share your thoughts on patient engagement and to ask questions of thought leaders in the field.

The challenge: More affordable medical innovation

New medical tests, treatments and devices are often very expensive when first introduced. Eventually, market forces bring the prices down. However, since most patients don’t pay for healthcare out of their own pockets, they don’t want to wait.

How can we achieve more innovation, more affordably?

Patients disproportionately demand the latest, best medical products and services immediately — often, even if the demanded good is of marginal relevance to their condition. Leaving out questions of universal access and rationing, how can we make more medical innovations more affordable, more quickly, for more people?

Which proven strategies from Silicon Valley, the Moon landings, the Manhattan Project or other successful models could be applied effectively to achieving faster, yet less costly innovation in health and medicine?  Join the boards on the TEDMED Great Challenges web site to share strategies and ask questions directly of leaders in the field.

Great Challenge #2: Managing chronic diseases

Chronic disease is America’s leading cause of premature death and disability. Heart disease, cancer, respiratory illness and certain others are among the most costly and common health problems, yet they are often among the most easily prevented and controlled.

How can we innovate better approaches to help patients prevent, manage and treat their chronic diseases and achieve better outcomes?

Stop by the boards on TEDMED’s Great Challenges interactive community to share your ideas and ask questions of thought leaders in the field.

Can we eliminate medical errors?

All humans make mistakes. Doctors and nurses are human; they make mistakes. All systems are imperfect. Medical professionals use systems.

Errors by medical professionals and systems are inevitable (unfortunately, they send 2.4 million patients to hospitals yearly and are directly linked to 200,000 annual fatalities). Regardless of methods used to detect, prove and compensate for medical errors, how much better can we do in reducing or eliminating medical errors and what areas should we focus on to get the best improvements?

TEDMED’s Great Challenges program is a forum to discuss pervasive, broad-based issues like these that demand collective understanding and action to manage. Join the online community to share your thoughts and to ask questions directly of experts on the issue.

Great Challenge #3: Can we manage the obesity crisis? Discuss.

In 40 years, the U.S. population has gone from 40% overweight to 68% overweight. Half of American adults are dangerously obese, leading to many chronic conditions and deadly (and expensive) diseases.

The key drivers are our choices of food and activity, but multiple additional factors also play a role — from family dynamics to cultural roots, stress, economics, lifestyle and many more. Unlike smoking or drinking, eating is not optional. How can Americans move to healthier lifestyles — or, if we can’t change these trends, how can the healthcare system cope with the results?

What’s your take? Multidisciplinary discussions and broad-based action are essential to coping with the Great Challenges of health and medicine. A Challenge Team of experts on the adult obesity crisis is standing by at this week to take your questions and comments. They’ll share their perspectives on the site.  Visit now and share your thoughts.