Who Needs Those Cholesterol Pills, Anyway? ....(not many)

[Guest guest]

Who Needs Those Cholesterol Pills, Anyway? ....(not many)

January 20 2008 at 3:19 PM morse

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Who Needs Those Cholesterol Pills, Anyway?

January 18th, 2008 4:00 pm By Ed Silverman

That's the question pondered in a BusinessWeek piece, and the answer

offered - very few. To illustrate the point, the fine print in a

Lipitor ad is cited - in a large clinical study lasting more than

three years, 3 percent of patients taking a placebo had a heart

attack, compared with 2 percent on the Pfizer pill. This means for

every 100 people, three people on placebos and two people on Lipitor

had heart attacks.

The difference credited to the drug? One fewer heart attack per 100

people. So to spare one person a heart attack, 100 people had to take

Lipitor for more than three years. The other 99 got no measurable

benefit. In other words, the number needed to treat (or NNT) for one

person to benefit is 100. And the mag notes there are reasons to

believe the overall benefit for many patients is even less than what

the NNT score of 100 suggests, because it was determined in an

industry-sponsored trial using carefully selected patients with

multiple risk factors, which include high blood pressure or smoking.

" Anything over an NNT of 50 is worse than a lottery, " Nortin Hadler,

professor of medicine at the University of North Carolina at Chapel

Hill and a longtime drug industry critic, tells the mag. " There may

be no winners. " Drugmakers, however, advertise big percentage drops

in, say, heart attacks, while obscuring the NNT. But when it comes to

side effects, they flip-flop the message, dismissing concerns by

saying only 1 in 100 people suffers a side effect, even if that

represents a 50 percent increase. (Click on the BusinessWeek chart

for a clearer view).

Several recent scientific papers, meanwhile, peg the NNT for statins

at 250 and up for lower-risk patients, even if they take it for five

years or more. " What if you put 250 people in a room and told them

they would each pay $1,000 a year for a drug they would have to take

every day, that many would get diarrhea and muscle pain, and that 249

would have no benefit? And that they could do just as well by

exercising? " asks Jerome Hoffman, professor of clinical medicine at

the University of California at Los Angeles. " How many would take

that? "

Probably not too many. But for those willing to gamble, Mack at

PharmaMarketing, who drew this to our attention, is collecting your

money

[Guest guest]

Who Needs Those Cholesterol Pills, Anyway? ....(not many)

January 20 2008 at 3:19 PM morse

----------------------------------------------------------------------

----------

Who Needs Those Cholesterol Pills, Anyway?

January 18th, 2008 4:00 pm By Ed Silverman

That's the question pondered in a BusinessWeek piece, and the answer

offered - very few. To illustrate the point, the fine print in a

Lipitor ad is cited - in a large clinical study lasting more than

three years, 3 percent of patients taking a placebo had a heart

attack, compared with 2 percent on the Pfizer pill. This means for

every 100 people, three people on placebos and two people on Lipitor

had heart attacks.

The difference credited to the drug? One fewer heart attack per 100

people. So to spare one person a heart attack, 100 people had to take

Lipitor for more than three years. The other 99 got no measurable

benefit. In other words, the number needed to treat (or NNT) for one

person to benefit is 100. And the mag notes there are reasons to

believe the overall benefit for many patients is even less than what

the NNT score of 100 suggests, because it was determined in an

industry-sponsored trial using carefully selected patients with

multiple risk factors, which include high blood pressure or smoking.

" Anything over an NNT of 50 is worse than a lottery, " Nortin Hadler,

professor of medicine at the University of North Carolina at Chapel

Hill and a longtime drug industry critic, tells the mag. " There may

be no winners. " Drugmakers, however, advertise big percentage drops

in, say, heart attacks, while obscuring the NNT. But when it comes to

side effects, they flip-flop the message, dismissing concerns by

saying only 1 in 100 people suffers a side effect, even if that

represents a 50 percent increase. (Click on the BusinessWeek chart

for a clearer view).

Several recent scientific papers, meanwhile, peg the NNT for statins

at 250 and up for lower-risk patients, even if they take it for five

years or more. " What if you put 250 people in a room and told them

they would each pay $1,000 a year for a drug they would have to take

every day, that many would get diarrhea and muscle pain, and that 249

would have no benefit? And that they could do just as well by

exercising? " asks Jerome Hoffman, professor of clinical medicine at

the University of California at Los Angeles. " How many would take

that? "

Probably not too many. But for those willing to gamble, Mack at

PharmaMarketing, who drew this to our attention, is collecting your

money

[Guest guest]

Who Needs Those Cholesterol Pills, Anyway? ....(not many)

January 20 2008 at 3:19 PM morse

----------------------------------------------------------------------

----------

Who Needs Those Cholesterol Pills, Anyway?

January 18th, 2008 4:00 pm By Ed Silverman

That's the question pondered in a BusinessWeek piece, and the answer

offered - very few. To illustrate the point, the fine print in a

Lipitor ad is cited - in a large clinical study lasting more than

three years, 3 percent of patients taking a placebo had a heart

attack, compared with 2 percent on the Pfizer pill. This means for

every 100 people, three people on placebos and two people on Lipitor

had heart attacks.

The difference credited to the drug? One fewer heart attack per 100

people. So to spare one person a heart attack, 100 people had to take

Lipitor for more than three years. The other 99 got no measurable

benefit. In other words, the number needed to treat (or NNT) for one

person to benefit is 100. And the mag notes there are reasons to

believe the overall benefit for many patients is even less than what

the NNT score of 100 suggests, because it was determined in an

industry-sponsored trial using carefully selected patients with

multiple risk factors, which include high blood pressure or smoking.

" Anything over an NNT of 50 is worse than a lottery, " Nortin Hadler,

professor of medicine at the University of North Carolina at Chapel

Hill and a longtime drug industry critic, tells the mag. " There may

be no winners. " Drugmakers, however, advertise big percentage drops

in, say, heart attacks, while obscuring the NNT. But when it comes to

side effects, they flip-flop the message, dismissing concerns by

saying only 1 in 100 people suffers a side effect, even if that

represents a 50 percent increase. (Click on the BusinessWeek chart

for a clearer view).

Several recent scientific papers, meanwhile, peg the NNT for statins

at 250 and up for lower-risk patients, even if they take it for five

years or more. " What if you put 250 people in a room and told them

they would each pay $1,000 a year for a drug they would have to take

every day, that many would get diarrhea and muscle pain, and that 249

would have no benefit? And that they could do just as well by

exercising? " asks Jerome Hoffman, professor of clinical medicine at

the University of California at Los Angeles. " How many would take

that? "

Probably not too many. But for those willing to gamble, Mack at

PharmaMarketing, who drew this to our attention, is collecting your

money

[Guest guest]

Who Needs Those Cholesterol Pills, Anyway? ....(not many)

January 20 2008 at 3:19 PM morse

----------------------------------------------------------------------

----------

Who Needs Those Cholesterol Pills, Anyway?

January 18th, 2008 4:00 pm By Ed Silverman

That's the question pondered in a BusinessWeek piece, and the answer

offered - very few. To illustrate the point, the fine print in a

Lipitor ad is cited - in a large clinical study lasting more than

three years, 3 percent of patients taking a placebo had a heart

attack, compared with 2 percent on the Pfizer pill. This means for

every 100 people, three people on placebos and two people on Lipitor

had heart attacks.

The difference credited to the drug? One fewer heart attack per 100

people. So to spare one person a heart attack, 100 people had to take

Lipitor for more than three years. The other 99 got no measurable

benefit. In other words, the number needed to treat (or NNT) for one

person to benefit is 100. And the mag notes there are reasons to

believe the overall benefit for many patients is even less than what

the NNT score of 100 suggests, because it was determined in an

industry-sponsored trial using carefully selected patients with

multiple risk factors, which include high blood pressure or smoking.

" Anything over an NNT of 50 is worse than a lottery, " Nortin Hadler,

professor of medicine at the University of North Carolina at Chapel

Hill and a longtime drug industry critic, tells the mag. " There may

be no winners. " Drugmakers, however, advertise big percentage drops

in, say, heart attacks, while obscuring the NNT. But when it comes to

side effects, they flip-flop the message, dismissing concerns by

saying only 1 in 100 people suffers a side effect, even if that

represents a 50 percent increase. (Click on the BusinessWeek chart

for a clearer view).

Several recent scientific papers, meanwhile, peg the NNT for statins

at 250 and up for lower-risk patients, even if they take it for five

years or more. " What if you put 250 people in a room and told them

they would each pay $1,000 a year for a drug they would have to take

every day, that many would get diarrhea and muscle pain, and that 249

would have no benefit? And that they could do just as well by

exercising? " asks Jerome Hoffman, professor of clinical medicine at

the University of California at Los Angeles. " How many would take

that? "

Probably not too many. But for those willing to gamble, Mack at

PharmaMarketing, who drew this to our attention, is collecting your

money