December 10, 2008

The Statin Scam

The television ad featuring artificial heart inventor Dr. Robert Jarvik, who by the way can’t row a skull, and never practiced medicine, claims that Lipitor will lower heart attack risk by 36%. Now, who wouldn’t want to do that?

However, the fine print required says, “in a large clinical study 3% of people taking placebo had a heart attack and 2% of those taking Lipitor had a heart attack.” Let’s do the math.

For every 100 people in the trial that lasted for 3 1/2 years, three people on placebo, and two people on Lipitor had heart attacks-that is one less heart attack for every 100 people. In other words, 100 people had to take the drug for 3 1/2 years to prevent one heart attack. What this really means is 99 out of 100 people taking the drug had no benefit.

This is explained in a little known statistic called Number Needed to Treat (NNT). In the case of Lipitor, 100 patients would have to be treated for 3 1/2 years to possibly eliminate one heart attack. Let’s compare that to today’s antibiotic treatment to eradicate ulcer causing H. pylori stomach bacteria.

The NNT is 1.1, which means, give the antibody to 11 people and 10 will be cured. Several recent scientific papers peg the NNT for statins at 250. Dr. Jerome R. Hoffman, Professor of Clinical Medicine at UCLA asks:

“What if you put 250 people in a room and told them that they each would have to pay over $1000 per year for a medicine they must take every day, that may give them diarrhea and muscle pain, and that 249 would get no benefit, how many would take that?”

Marketing over Medicine!

Drug companies have a responsibility to their shareholders to make a profit, and we need them to develop new medicines. However, when they grossly overstate the benefits and spend huge amounts of money influencing physicians it turns bad and leads to potential corruption.

The National Cholesterol Education Program, (NCEP) 2004 guidelines that lowered the targets for cholesterol treatment and recommended many more Americans take statins was issued by a panel on which 8 of 9 experts at financial ties to the drug industry.

“The guideline and process went awry” says Dr. Henry C. Barry of the Michigan State University College of Medicine. Dr. Barry and 34 other experts sent a petition of protest to the National Institutes of Health, saying the evidence was weak and the panel biased because of its ties to the drug industry.

I and all other physicians whose speak out take great risks-medicine and government agencies do not like criticism. At a recent meeting, a prominent statin boosting physician who advises the NCEP says that Dr. Rodney A. Hayward, Professor of Internal Medicine at the University of Michigan Medical School “should be held accountable in a court of law for doing things to kill people” because Dr. Hayward had the audacity to suggest that “current evidence supports ignoring LDL cholesterol altogether.”

We would expect this kind of vitriol from zealots and extremists not from government agencies or scientists. If we spent a fraction of the money that we do on cholesterol testing, cholesterol lowering drugs, and doctor visits on educating people about proper diet, exercise and weight loss we would be far healthier.

–Dr. Dwight Lundell

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