I Wanna Be Medicated

Since my heart surgery three and a half years ago (!), my bedside table looks like a Walgreen’s. I take two medications for my blood pressure, two for diabetes, one for cholesterol, an anti-depressant, aspirin, and a thrice-daily fish oil supplement. At the moment, I am also taking ibuprofen three times a day because that little snowstorm the other day caused me to injure something in my left leg while I was snowblowing. So altogether that’s 10 pills this morning, 5 at lunchtime, and 9 more at bedtime.

Other than that, I feel great!

I started taking the fish oil supplements a few months ago on the recommendation from the nurse practitioner who prescribes my anti-depressant. According to the research she’s read, she says the three Omega fatty acids (Omega-3, -6, and -9) have therapeutic value for everything from hypertension to depression to metabolism. Considering that I needed help with all of that, it seemed worth a try. She said it would take about six months of taking supplements to see any results, but I have definitely lost a few pounds since I started (it’s been about five months for me now). I just came across this article in Discover last week that says studies of people taking fish oil supplements do show benefits in controlling diabetes as well. Another recent popular dietary supplement for glucose control, cinnamon, may not be as effective as originally thought. That’s okay with me, because I don’t particularly like cinnamon and don’t really want to add yet another pill to my daily regimen (you can take it as a pill or by adding ground cinnamon to food).

The cholesterol med I take is the near-ubiquitous Lipitor, and, as it happens, this week’s cover story at BusinessWeek magazine is about this particular “wonder drug”. I’m using scare quotes there because the thrust of the article is that there is a growing body of research that says statin drugs are not very effective. Oh, they lower your LDL cholestrol, but studies are showing that reduced LDL cholesterol is not particularly effective at reducing the risk of heart attacks, which is the primary motivation for prescribing the medication. In fact, there was news just last week about a new study of the statin drug Zetia (and an offshoot drug, Vytorin) that shows that it doesn’t produce any medical benefit at all.

The BW story is especially telling because it reveals a dirty little secret that Pfizer, the maker of Lipitor, doesn’t want you to be aware of — a statistic called “NNT” (Number Needed to Treat). In clinical studies, Lipitor has an NNT of 100, which is to say that 100 patients need to take the drug to see 1 patient have a positive result. By comparison, the article says, the antibiotic used to treat stomach ulcers has an NNT of 1.1; give the drug to 11 patients and 10 of them will get better. One doctor quoted in the article says that any NNT above 50 is “worse than a lottery ticket”.

That’s quite a reversal given the very positive news that has been released about statin drugs in the last couple of years. In the U.K., for example, doctors recommend that ALL diabetics take statins to address cardiac risks. And in the last year or two, recommendations have been made in this country to give statin drugs proactively to EVERYONE over the age of 35, whether they have high cholesterol or not.

The BW article openly wonders if Pfizer and the other Big Pharmas have overstated the research to serve their marketing aims. Pfizer generated almost $3 billion in revenue from Lipitor in one quarter last year, and the drug accounts for 19% of Pfizer’s total revenue. Here’s a telling pull quote:

“What the shrewd marketing people at Pfizer and the other companies did was spin it to make everyone with high cholesterol think they really need to reduce it,” says Dr. Bryan A. Liang, director of the Institute of Health Law Studies at the California Western School of Law and co-director of the San Diego Center for Patient Safety. “It was pseudo-science, never telling you the bottom-line truth, [which is] that the drugs don’t help unless you have pre-existing cardiovascular disease.”

Remember what I said the other day? Capitalism destroys EVERYTHING in the name of profit. BW says here’s a clear case of a drug that was only useful to a small group of patients (people who already had cardiovascular disease) and created demand for the drug among people it would not directly benefit (anyone with high cholesterol) to boost sales, even though there are serious side effects that can stem from taking statins. Of those 100 people in the “NNT” number, 99 of them are putting themselves at an increased risk of liver problems and other physical damage for NO CLINICAL VALUE, just Pfizer’s profit.

As someone who’s already had quadruple bypass surgery, I’m not likely to stop taking Lipitor. I AM that 1 person in 100. You probably are not and should read the BusinessWeek article and consider talking to your physician about it.