What is the dirty little drug secret for lifestyle diseases?
Pharmaceutical companies go From their way-for example, for example, to “present medicines as a preferred solution for managing cholesterol while deteriorating lifestyle change”. You see that resonated in medical literature, as in this Constitution in Journal of the American Medical Union: “Despite decades to prompt improve, the high prevalence of bad lifestyle behaviors leading to increased risk factors of cardiovascular disease still remain, with myocardial infarction [heart attack] And the stroke remains the main causes of death in the United States. Clearly, many more adults could benefit from … statins for primary prevention. “We really need to put more people in drugs? published to Medical journal: “Once again, doctors will be asked to ‘get real’, hoping that efforts to help patients and their communities adopt healthy lifestyle habits will succeed and start prescribing more statins. This is a self -confidence. [the pro-statin editorial] The disclosure of funding by 11 drug companies, at least four of which produce or develop new categories of cholesterol reduction factors “, which make billions of dollars annually in annual sales.
Each time the cholesterol guidelines dilate The number of people who are eligible for statins are regarded as “big kiss in Big Pharma”. This is understood, as the majority of members of the Guidelines Committee “had industry ties”, financial conflicts of interest. But these days, all the big statins hectare Off-patent, so there are cheap general versions. For example, the safest, most effective statin is Generic Lipitor, sold as atorvastatin for just a few dollars a month. So today, cholesterol instructions hectare Are not necessarily “part of an industry”.
“The lifestyle of the US is the problem, not the guidelines …” The reason so many people are nominated for cholesterol and blood pressure drugs is that so many people get so tremendous care of themselves. The bottom line is that “individuals must take more responsibility for their own health behaviors”. What if you do not want or cannot improve your diet and make lifestyle changes to reduce this risk? If the ten -year risk of having a heart attack is 7.5 percent or more and will remain so, then the benefits of taking a drug statin are likely to exceed the risk. This is really to decide, though. It’s your body, your choice.
‘Either the overall benefit balance justifies The use of a drug for an individual patient cannot be determined by a guideline committee, a health care system or even the treating physician. Instead, it is the individual patient who has a fundamental right to decide whether taking a drug is worth it. “This has been recognized by some of the” historical lighting of medicine such as Hippocrates “, but” only in recent decades has begun to shift the medical profession from a paternalistic “doctor knows the best” attitude towards an explicit adoption of common decisions. One of the problems with the communication of evidence to support this joint decision -making is that most doctors “have A poor understanding of the concepts of risk and probability and … increasing exposure to undergraduate and postgraduate statistics has not made much difference. ” But this understanding is critical to preventive medicine. Not so many doctors such as life insurance sellers, they market deferred benefits in exchange for a small (but certainly not negligible) ongoing suffering and cost. In this new type of drug, non -understanding of the risk is its equivalent by not knowing the bloodstream or basal anatomy. So let’s dive and see exactly what is at stake.
Below at 3:55 in my video Do doctors mislead patients about the dangers and benefits of statin? is an advertisement for lipitor. When drug companies say a statin reduces the risk of heart attack by 36 %, this is the risk.
If you follow the asterisk I have released after “36%” in advertising, you can see how they came With that. I have included it here and at 3:56 in my video. In a large clinical study, 3 % of patients not reception Statin had a heart attack within a certain period of time, compared to 2 % of patients receiving the drug. Thus, the drug reduces the risk of heart attack from 3 % to 2 %. This is a fall of one third, hence 36 % reduced the relative risk statistics. But another way to examine from 3 % to 2 % is that the absolute risk was reduced by only 1 percent. Thus, in fact, “your opportunity avoid A non -fatal heart attack over the next 2 years is about 97% without treatment, but you can increase it to about 98% by taking a Crestor [a statin] every day. ”Another way to say that you have to deal with 100 people with the medicine to prevent a single heart attack.
If you ask patients with what they have driven believeThey do not believe that the possibility of avoiding heart attack in a few years in statins is 1 in 100, but 1 in 2. “On average, it is believed that most patients (53.1%) using statins will avoid a heart attack after statin treatment for 5 years.” Most patients, not only 1 % of patients. And this “inequality between real and expected outcome could be regarded as a dilemma. On the one hand, it is not acceptable for carers to deliberately support and maintain false expectations of treatment by patients”. We can’t mislead people to believe that a medicine works better than it really does, but on the other hand, how else will we make people take their pills?
When asked, people want A total reduction in risk of at least 30 % to get a cholesterol reduction drug every day, while the actual total risk reduction is only about 1 %. So the dirty little secret is that if patients knew the truth about how few actual medicines actually worked, almost no one would agree to get them. Doctors either do not train their patients or do not mislead them. Since the majority of patients expect a much greater benefit than statins than they will take, “there is tension between the patient’s right to know to benefit from a preventive drug and the possible reduction in intake [willingness to take the drugs] If they are so informed “and to learn the truth, this sounds terribly paternalistic, but hundreds of thousands of lives may be at stake.
If patients were Fully up -to -date, people will die. About 20 million Americans are in statins. Even if the drugs saved 1 in 100, it could mean hundreds of thousands of lives lost if everyone stopped taking their statins. “It is ironic that informing patients about statins will increase the effects of themselves designed to prevent.”
