The Pharmaceutical Market’s Adverse Effects

In this review of Ben Goldacre’s Bad Pharma, Kesselheim discusses Goldacre’s account of systemic flaws in how drugs are developed, studied, approved, and prescribed—framing the problems not as individual fraud but as “institutional corruption” in which actors across the pharmaceutical ecosystem behave rationally within a poorly designed system. He notes that while Goldacre’s emphasis on transparency as a remedy is essential, transparency alone carries risks of complacency and more biased recommendations, and that fundamental cultural and regulatory changes are needed to address institutional corruption head-on.