Wednesday, March 31, 2010

Who Needs a Working Liver and Pancreas Anyway?

AstraZeneca is now pushing its anti-cholesterol drug Crestor for healthy adults as a preventative measure.  It slightly lowers the risk of heart attacks and strokes.  However, it may increase the risk of diabetes.  Also, statins work by suppressing liver function (your liver naturally produces cholesterol).

If the drug companies had their way, everyone would be on at least three expensive prescription medications.  They've already convinced the American Academy of Pediatrics to push statins for children as young as eight years old.

The Food and Drug Administration is a weak watchdog at best.  Remember Vioxx?  It was approved, since drug companies are allowed to cherry-pick the studies they submit to the FDA with their application.  Merck voluntarily pulled Vioxx off the market before the FDA got around to doing so, after the drug contributed to thousands of fatal heart attacks.  It was fear of wrongful death lawsuits, not FDA regulation, that motivated Merck.

Your doctor is not always a good advocate, either.  Everything your doctor knows about the brand-name pharmaceuticals on the market likely came from the companies that sell those pharmaceuticals.  The drug companies provide educational materials to medical schools, as well as grants to attend continuing-education conferences like Topics in Preventive Cardiology including Psycho-Social Issues Cruise Conference (a seven-night cruise from Hololulu) and Medical Ethics & Legal Medicine Southern Caribbean Cruise (oh, the delicious irony).

People need to realize that they are consumers of medical care just as they are consumers of groceries, electronics, clothing and beer. Take all television advertising with a grain of salt.  The first amendment allows advertisers to make exaggerated claims.  They will also try to circumvent your reason with an appeal to your emotions.  Caveat emptor.

If your doctor prescribes a drug, make sure you understand the risks and benefits.  There is a good chance that your doctor won't know about the studies that are less than favorable, since they were probably not discussed on that cruise conference he or she attended last winter.  Do some research.  Check out the British press, since European regulators often require more disclosure of unfavorable studies.

And if your prescription medication causes some unpleasant side effects, ask yourself if you really need to be on it before you decide to take a second medication to fix the problems caused by the first one.

And for the love of Pete, if you live in Wisconsin, think long and hard before you start taking statins.  You're going to need to keep your liver in good working condition.

1 comment:

Tim Morrissey said...

Oh HELL yes! You are right on. I'm acquainted with two drug reps, both employed by huge pharma, who chuckle about how little the docs actually know about the products they push.

Buyer be VERY aware.