I try not to be as angry and cynical as my daughter's rant about pharmaceutical companies (caution: not work safe, especially if you work for Big Pharma). I don't regard Big Pharma as evil. America's pharmaceutical companies have been busily developing a lot of new and often quite effective drugs. Because of severe price controls in much of the rest of the world, American consumers have been paying for this development--creating a lot of really astonishing drugs, and subsidizing the rest of the world. Some day, I hope, the rest of the world will thank us for this.
That's why I get very upset when I see this report:
CHICAGO (AP) -- Full results of a failed trial on Vytorin, a medicine taken by millions of Americans to lower cholesterol, left doctors stunned that the drug did not improve heart disease even though it worked as intended to lower three key risk factors.Gee, could it have something to do with the really, really clever ads that they have been running for Vytorin, selling a drug that apparently doesn't work [UPDATE: doesn't work any better than statins alone]? They were very clever ads--about how cholesterol can come from the food that you eat, and from genetics--and they would have "your Aunt Madge" dressed in a way that parallels some cholesterol-rich food.
Use of Vytorin and a related drug, Zetia, seemed sure to continue to fall after the findings reported Sunday and fresh questions about why drugmakers took nearly two years after the study ended to give results. [emphasis added]
"A lot of us thought that there would be some glimmer of benefit," said Dr. Roger Blumenthal, a Johns Hopkins University cardiologist and spokesman for the American Heart Association.This really bothers me. Was there some financial incentive behind this?
Many doctors were prescribing Vytorin without trying older, proven medications first, as guidelines advise. The key message from the study is "don't do that," Blumenthal said. [emphasis added]
UPDATE: A reader reports:
I think there was money somewhere.
I'm covered by Blue Cross. I took a different statin for cholesterol - Lipitor, for a few years, and had good control of my levels.
A couple of years back, my doctor switched me to Vytorin; my cholesterol levels are even better.
But the prescription formulary for Blue Cross eliminated Lipitor. I could still buy it, if I wanted to pay full price, about $112 for 30 tablets. Hmm; that price vs a $15 co-pay for 90 tablets. I guess I'll go with my doctor and the covered medication.
I don't know if Lipitor is back in the formulary for Blue Cross.
Vytorin works; here's just no evidence that adding ezetimbe to the statin works any better. I haven't spoken to my doctor about this yet.