We have all seen the Lipitor commercials with Dr. Robert Jarvik (he is not licensed to practice medicine in any state, but went to medical school) touting the cholesterol lowering benefits of that drug.
In fact, the company claims it will lower bad cholesterol by 39-60%:
The average consumer reading this rightfully thinks this is a good thing for your health. The question, though, is what is the real significance of lowering bad cholesterol.
Another Lipitor ad helps explain this too:
So, for people at risk, taking Lipitor lowers your chances of having a heart attack by 36%. This certainly sounds like a big benefit for most people considering taking this drug, until you look at the fine print:
*MOUSE PRINT:
The company apparently conducted a test whereby high risk people were divided into two groups, one of which got Lipitor, and the other got a placebo. Out of every 100 subjects tested, only three people who in essence took nothing to lower their cholesterol suffered heart attacks. On the other hand, two out of 100 Lipitor takers had a heart attack. The difference, according to the study, is that for every 100 people who take Lipitor, only one additional person will be spared a heart attack compared to those who do nothing.
So despite the big percentage claims made in advertising — 39% to 60% reduction in bad cholesterol, and 36% reduction in risk of heart attacks — if the risk the pill is reducing is very small to start with, very few people will actually be spared that heart attack by taking Lipitor (but the company will make a lot of money in the process).
Of course, for the one person in a hundred who is spared, the pill is priceless.
For more information on the math used in drug advertising, read this Business Week story.
Another way of interpreting the statistics is that the placebo protected 97/100 and Lipitor protected 98/100 of the subjects. I would run the study again and double the dose of the placebo.
I’ve been on Lipitor for over two years (40mg daily). My doctor says I should be “the poster child” for the product because my cholesterol went from 240 to 110 and all the other numbers were just as remarkable. I did learn via the internet that there could be muscle pain problems associated with this product and I am VERY concerned that it could be affecting me now. Having said that, is it a question of “do I want” to die early from heart a heart attack or live longer in pain? Not sure if there is an answer. In any event, this product worked for me and I’m going to continue using it.
Still would seem that going from 3 to 2% is a reduction of 33%, not 36%.
Or, to put it in even better advertisement terms: Not taking Lipiro increases your chance of a heart attack by 50%!
Again with you questioning the validity of very true numbers. It’s nice you spell uit out for people, but the reality is that if one of three is helped then the at risk population has benefited by 1/. The fact that it is one third of a very small number does not change the fact that it is one third of those who might have had a heart attack did not. True it might be more impressive for the number prevented to be higher, but when you can stop 1/3 of subsequent heart attacks, it should not matter if you prevent 1 or 100. Just my 2 cents.
Another excellent source of information regarding direct to consumer drug marketing is the Prescription Access Litigation Project website. I like that consumers are getting additional information that may be useful to them. I just want to make sure that is what is happening. I have less and less confidence in the FDA since several drugs approved by them were recalled and I have no confidence in drug companies whose primary goal is to make a profit.
Robert: If you are having muscle pain now, tell your doc and ask to be the poster child for another drug — been there and done that myself. Even though some others may warn of the same pains that doesn’t mean those pains will occur. I changed from Lipitor a long time ago and have not had muscle pains since. It does not have to be a choice of heart attack or muscle pain. First, statins are only indirectly, and somewhat tenuously, related to prevention of heart attacks, and second, there are options via other brands AND, more importantly, other mechanisms.
And a rhetorical question for you. Are you taking Lipitor so you can eat what you want and exercise little, or are you eating and exercising smartly and taking Lipitor only as an adjunct? Some docs observe >90% of their patients are in the latter category and the other <10% are the only ones who really *need* the drugs.
Regarding the Lipitor claims, until I know the answer to those rhetorical questions, their entire study result is meaningless to me, fine print or no fine print, never mind the fact that the geniuses in government use the coop’s daily egg and chicken count as provided by the fox.
OK, brain fart in my post above. Swap “former” and “latter.”
Obviously my numbers/docs’ observations are swapped. The contention is that most folks eat and exercise unwisely and take statins purely so they can do so. Mmmm. Time for another pork rind…good for the thought process…not.
Lipitor nearly killed my uncle a few years ago. He had a horrible and very fast reaction — the whites of his eyes yellowed and his urine turned brown. He was supposed to see his cardiologist the next day, but ended up in the ER and then ICU. His liver function has still not fully returned to normal. The sad thing is that his cholesterol wasn’t that bad to begin with, but because he had had a heart attack, Lipitor was prescribed.
The real question is, does it actually do any good at all? 2/100 vs. 3/100 is statistically almost negligible difference at all. With expected attack rates of 2-3% we’d need a whole lot more people in the study to get any kind of useful information. Lipitor could double your chances of having a heart attack and it wouldn’t be all that unlikely that you could still get these exact same study results. Now if they had 10,000 people each taking placebo or Lipitor, then it would nearly be a statistical impossibility to get 2% for Lipitor and 3% for placebo if Lipitor was not actually helping. Unfortunately, that study would also be really, really expensive.
Perhaps the overall question should be, “Why are drug companies allowed to advertise prescription medications to the general public?” These drugs are not meant for everyone, yet there are those who will “doctor shop” until they find one willing to write a prescription for them based on what is said in the ads. How much does all this advertising add to the cost of medications?
I sort of agree with Doug. There is something really wrong with advertising directly to the consumer. It would be wonderful if there were alternatives to drugs. Red Yeast Rice shows promise, but seems inconsistent (at least the companies that make it are inconsistent). NutritionalTree.com actually rates several of these products as being effective though.
I’m surprised no one on here has made a comment on how the media only reports what they want to. If you look at other Lipitor studies, the numbers are vastly improved. This study mentioned above is from a study that was supposed to go over 5 years in duration and was stopped after 3 1/2 years because the safety board said it was unethical to keep patients on placebo. If the study went the duration, the numbers would have improved. Other studies show 1 out of 25, 1 out of 27 and 1 out of 34 were saved from a cardiovascular event by taking Lipitor. Lipitor is a great drug and has saved many, so please make sure you look at the 400+ studies that have been done, including multiple cardiac trials that show great improvement (there are about ten of them). For those with muscle aches, that will happen. If you look, statins will different in how many muscle aches patients will get. Lipitor should only cause about 3-5% of patients taking it. Remember, as we get older, we tend to pull things and get sore more easily than when we were younger. It might not always be the statin!
PS – one other point. I’ve had homeowner’s insurance to help in case of fire damage, trees falling on my roof, etc. and have yet to use it. If the chances of having one of those events happen is only about 3%, does that mean I take my chances and get rid of the insurance? Same thing with drugs. If spending $10-20 on my copays a month for each drug I take can prevent stuff from happening (from what my doctor showed me), I’d rather take his word for it that having something happen to me. Don’t get me wrong, some of the stuff we are taking shouldn’t be necessary, but like someone posted above, we rather take a pill than eat healthy, work out, etc. I think we all need to change, thus making the drug industry change. They’re just giving us what we want. If they got rid of commercials, I would love it, but until we all change, it will only get worse. I
Well put Fred, than you for a well thought out, intelligent response to this posting. This site mostly serves a great purpose, but at other times (like this) it skews the numbers and points out facts that are true as “mouseprint”. In this case, the facts as presented still make a case for prescribing the drug to those who need it, that and the fact that you doctor should be able to help you decide if this is the correct therapy for you should be enough.
I only ask that those who chose to make this a “mouseprint†ad and think that these numbers are not worthwhile, please tell your doctor NO! if he or she ever indicates that you might benefit from this medication. Put your health where your mouth is and refuse the treatment.
From the Wall Street Journal, Jan. 7, 2008:
“Now Congress has seen enough of Jarvik to ask Pfizer some questions about his qualifications to be recommending the cholesterol buster.
The House Committee on Energy and Commerce said today that it is investigating the use of celebrity endorsements in marketing prescription drugs directly to consumers. And Jarvik is Celebrity No. 1 on the list.”
I know several people who were told to get on to cholesterol lowering drugs for the rest of their lives and never given any nutrition advice. The vast majority of high cholesterol can be brought down with diet. Look at Dr. Dean Ornish and how he has reversed heart disease. But, that takes time and knowledge that the doctors don’t have. They only know what the drug reps tell them. And people want a magic pill and a McBurger for lunch. (I know there are some few folks who really, really need this medication. But, not the numbers it’s prescribed for today.)
This is where damn statistics come into play. The low percentages of 2 and 3 made well be within the error bounds. A “large” clinical study may only as large as a 200 hundred persons, so that 1 less heart attack has really no significance.
I take all of these drug ads with a grain of salt. They seem to be designed to be deceptive because otherwise they wasted a lot of money developing a drug that nobody would want.
50 years ago it seemed that drugs were about healing people; now they are often about hiding people’s problems. If you have cholesterol problems, it’s probably because of your diet, which is usually directly influenced by TV ads and the lifestyle thrust upon us by society.
I figure that if the average person has to take daily/weekly drugs to stay healthy, then we have other problems…last I knew, biology dictated how survival works but these drug companies are pushing that only science can keep us healthy and without that you’re a sad specimen of a human being.
If a drug helps you get to a healthier life so you can stay there, that’s one thing, but then the drug is not needed afterwards. But the way these are marketed as lifetime drugs, I see it as the equivalent of what bulimics do to keep their weight problems down.
I was on Lipitor for years after my insurance company told the Doctor Zocor was too expensive. After I experienced muscle pain and weakness, the Doc switched me to Zetia, which blocks absorbtion in the digestive tract.. It is much more effective for someone whose liver is not over-producing cholesterol and only needs it for dietary reasons.
Lipitor almost killed me in 5 days. My doctor put me on Lipitor on Thursday. I began aching all over on Friday night. I could barely get around on Saturday. All I wanted to do was stay in bed. I began going into a depressed state. My glucose level soared. By Sunday I was hurting so badly and so depressed I was sobbing uncontrollably and had horrible unmentionable thoughts. I am not the type person that gets depressed ever! At work on Monday, I would tear up anytime someone spoke to me. I had enough! I looked on the internet to see the side effects. All the symptoms were there–aching, glucose change, and in mouse print, oh-by-the-way style, was depression. After stopping the Lipitor on Monday, by Wednesday I was back to normal. EVERYONE should know that Lipitor can cause very bad depression.
I did fine on the lower doses of Lipitor for the first several years than begin having serious problems. I didn’t think it was the Lipitor at first but stopped taking it for a while on 2 different occasions and all my symptoms disappeared. I’ve been taking Lipitor for about 10 years and now for the 3rd time have quit taking this poison pill permanently after talking to my new doctor. He told me to quit taking it and not let anyone else make me take it after telling him some of the problems I was having saying some of them were life threatening.
I have been aware of me having high cholesterol since about 16 years old, but back than there were absolutely no treatments for many years. I’ll be 62 in about 2 weeks and have lived without statins all this time. My heart has always been healthy and had low blood pressure. And such a high level of HDL that the doctor’s can’t figure it out. But, after I started taking Lipitor, my blood pressure went up to dangerously high readings and was even taken out to the hospital a few times because I though I was having a heart attack. Started having swallowing problems because of phlegm would fill my stomach keeping my food from going down. The longest it took to get this phlegm up was about 2 hours-scary indeed. Also had a lot of diarrhea, Was in so much in pain that I had to hold on to everything just to get to the bathroom and back. And Ibuprofen had no affect on this pain caused by the lipitor.
I also worry about my brother who is the same age since he is taking 80 mg of Lipitor, which is the maximun amount. He has to take prescription pain killers now because his body is so full of pain. I’ve talked to him about it and he says it’s arthritis. But I will never believe it since he didn’t have this terrible pain before. I could have easily blamed my pain on arthritis as well since I have arthritis-but the pain went away when I quit taking Lipitor.
So Lipitor’s side affects rears it’s ugly head in many ways.
If lipitor causes the above problems, (and I believe it does) when are the American people going to rise up and say no to the doctors and drug companies. I believe this time is long overdue.