About four years ago, I lectured to a group of conventional cardiologists about statin drugs. In that presentation, I presented data that cholesterol-lowering medications including statins and Zetia were poor choices to treat heart disease.
Needless to say, the lecture was not well received. When I presented data about Zetia, the audience voiced their displeasure. I stated at the time that there were no studies that show that Zetia or Vytorin (which contains Zetia and the statin drug Zocor) were effective at treating or preventing heart disease. At that time, I stated that Zetia should be pulled from the market.
Perhaps I was wrong. You can decide.
The headline at Forbes.com today stated, “IMPROVE-IT Meets Endpoint and Demonstrates Real But Modest Clinical Benefit for Ezetimibe.” (1)
Let’s look at the “real but modest” benefit that is touted in the headline. IMPROVE-IT randomized 18,144 high-risk patients (those who already had a cardiac event) to either Vytorin or placebo. Patients were followed for an average of six years. The endpoints included cardiovascular death, heart attack, hospital admission for unstable angina, coronary bypass surgery, or stroke.
The “real but modest benefits” were this: 34.7% of the placebo group versus 32.7% of the Vytorin group suffered a cardiac event. The article stated that represents a 6.4% reduction(32.7/34.7) in cardiac risk in those that took Vytorin versus placebo. However, the 6.4% reduction is the relative risk reduction.
Relative risk reduction provides little useful information on whether a drug therapy is beneficial or not. A more meaningful number is the absolute risk reduction. The absolute risk reduction from taking Vytorin (when compared to placebo) for six years was 2% (34.7-32.7).
So, how many people need to take Vytorin for six years to prevent one cardiac event? This number is called the number needed to treat. In this study, 50 patients would have to take Vytorin for six years to prevent one cardiac event. That comes out to a cost of $900,000.00 as a quick call to CVS informed me that it costs $250.00/month for Vytorin.
That is not the whole story. This study found no difference in the most important endpoints: overall deaths, cardiovascular deaths, or coronary deaths.
Why should a 2% cardiovascular risk reduction in a drug that has shown nothing before this be considered a success? And, keep in mind, that this risk reduction did not include the most meaningful risk reduction–death. In this article, a senior author of the paper stated, “These results are a home-run for patients.”
A “home-run”? Yougottabekiddingme! Another way to look at the study is that this study found that Vytorin failed 98% of those that took it since 49 out of 50 treated subjects receive no benefit. And, the 49 who did not receive a benefit were exposed to adverse effects and pad $250 per month for naught. The only home-run here is for Big Pharma who gets to promote another mediocre drug.
Why does my profession accept this mediocrity? Not only do they accept it, they embrace it. It is pathetic.
Folks, we spend too much money on drugs that provide little, if any, benefit. In fact, we spend more on drugs than any country on the face of the earth and we lag behind every major Western country on every important health and disease indicator.
This study should be the last nail in the coffin for Vytorin. It is a failed drug that has little usefulness. We would be better served to remove it from the marketplace.
More information about cholesterol-lowering drugs can be found in my book, Drugs That Don’t Work and Natural Therapies That Do.
Touché Dr. Brownstein!
For the past several years I’ve thought of my own primary care physician as a sort of overpaid Professional Prescription Writer. Some of the blame can be placed on insurance companies. Their policy constraints compromise patient care oftentimes forcing both doctors and patients to gravitate towards the quickest response, i.e. prescriptions.
I believe moving the medical community away from routinely treating with ineffective prescriptions will be difficult. Until we’re able to change the mentality of patients (and insurance companies), so that the goal become searching for the root cause of an illness, I don’t see much changing with our “mediocre” healthcare system.
In my opinion about half of Americans would rather pop a pill and hope for the best. Don’t get me wrong, I do believe there is a time and place for prescriptions. But if that’s the case, why not create a universal database that tracks all patient prescriptions. Medical offices could utilize their data entry workers (at a much lower cost per hour) to input patient prescriptions based on symptoms and/or complaints, which could then get cross checked with current medications within the universal system and viola….a prescription sheet is printed and everyone’s happy.
This would free up the doctor’s schedule, so he or she is able to spend more time with patients interested in finding the root cause of their symptoms. It might also weed out the physicians who are only interested in writing prescriptions, which is not necessarily a bad thing.
Catherine,
I agree with some of your comments. I agree that we need to change the mentality of the patient to take ownership of their health care decisions. This can only occur with educating the patient. Since most doctors don’t do a good job of that, it is up to the patient to become knowledgeable about their health care issues. That is why I began writing my books! The education should start with the basics: Eating better and exercising. As for the insurance companies–no way will they listen. They are the problem. We have a mediocre health care system–in part–because of the insurance companies.
All prescriptions are tracked now. We don’t need a new monitoring system for prescriptions. Rather, we need less prescriptions! Too many ineffective, toxic drugs are currently prescribed. In many cases, there is no reason to prescribe a medication that blocks a receptor and/or poisons an enzyme–all the while when it is not treating the underlying cause of the problem.
DrB
Because of you Dr. David Brownstein, I have started my own mini revolution against Big Pharmacy and their lies to the American Public! How can I as a physician, knowingly prescribe a statin drug such as Crestor, Lipitor, Vytorin, atorvastatin etc when I know that these drugs can eat up muscle ( rhabdomyolysis), cause heart attacks, deplete the body of ubiquitous (Coq10) and worst of all CAUSE DEMENTIA! Thank you for defying mainstream pharmaceuticals and uncovering the truth about the money making machine known as BIG PHARMA!
I am glad to hear from you Dr. Solomon. When I lecture to health care providers, I encourage them to look at the biochemical pathways. If the treatment enhances the pathways, then it is probably a good thing. If the treatment poisons the pathways, it is probably not helpful. Statins poison the HMG CoA Reductase enzyme which causes all the problems you mention above. The idea of taking a statin for a health benefit is ludicrous.
DrB
It is so wonderful to find a doctor that understands the “situation”.
Your are one of those doctors. My wife has found another here in northern Cincinnati, after going through several other doctors before this doctor.
I just don’t get how any doctor who understands human physiology can prescribe drugs (statins) that block the activity of coQ10, most heart-protective nutrient there is. And don’t statins contribute to Alzheimer’s, since the brain is mostly cholesterol?
Meanwhile, drug companies run junk science studies to discredit Vitamin E, which actually does help the heart, because it competes with Wafarin and Xarelto. Now that’s insane!
Dr. Brownstein,
Thankyou for standing up and saying something to your peers! My husband is a pilot where mediocrity is rarely accepted. You have a better chance of getting killed walking across the street, than dying in a plane crash. Certainly, there are more drug related deaths than there are plane crash victims! The difference between a pilot and a physician (nurse, MD, ND, etc.) is the pilot has his own life in the game! Pilots go through checklists, calculations and procedures that can mean the difference between life and death. The pilot doesnt want to die! By the way, a professional pilot (military, major airlines) goes through as much training as the average doc. I can’t argue which profession is most revered!
My Dad was a master chemist. I grew up around hospitals, doctors and laboratories. I have to be careful what I say publicly, but I took a chance on you, I happen to believe you! The only thing I could do for you was to make the decision to share your article on Facebook. I ASK OTHERS TO DO THE SAME! I wish you the best.
Valda,
I love the pilot analogy.
Thank you,
DrB
I am surprised by your amazement about the mediocrity in medical profession.Of all people you should know that it is by design, Medical Powers to be want mediocrity, in fact they encourage it and reward it.It is good that you are speaking up. But the establishment is very powerful. All I can say is, Keep it up!
Thank you for your use of sense in a nonsensical world
$$$$$$$$ speak very loudly where drugs are concerned.
Thank-you Dr. B for so eloquently translating what the statistics from these studies really say. I wish that more people understood the true meaning of the numbers derived from these studies.
Matthew 18:20 has the gist of collaborating holistic efforts !! The medical world needs an intervention. Your efforts are recognized Dr. Brownstein.
Dr. Brownstein,
Thank you for continuing to sort out the real numbers and publish results of these studies. Medicine has become rarely more than a band-aid, and a poor one at that. I spend my days working to educate patients and doctors about the need for essential nutrients and repletion of those nutrients that are often depleted by the drugs that are prescribed. “Mediicine” in our country is generally nothing more than reactive. Real prevention, i.e. lifestyle changes, is virtually ignored.
If you sometimes feel like a “lone voice in the wilderness”, know you are not, and people all over the country are working to try to steer the “ship” into saner waters.
Blessings to you and your family, and may your courageous work continue to be spread.
Thank you Dr. Brownstein! ABC’s Good Morning America had Dr. Richard Besser on this morning raving about the results of this study. So sad what is happening to our country…. Thank goodness for doctors like you and your tribe! Bravo!
Dr W,
Raving about these results? Unbelievable!
DrB
It is sad to see that this kind of thing is rampant across the board. Get your flu shot?
I was driving by CVS yesterday and there was a sign with a designated time for children
to get it and it broke my heart.
MD’s seem to lump like sheep. Anybody want to step out of the herd and cure someone?
Dr. Brownstein; We your readers get it but the rest of the medical establishment is lost and dead. Just keep doing what you are doing and let the sleeping dogs lie.
I am grateful to have discovered you thru BreastCancerChoices.org where I learned about IODORAL & got linked to your website & got your book “Iodine, Why You Need It, Why You Can’t Live Without It” & completely turned my life around & solved issues I’ve had my whole life. Instead of Capitol Hill arguing about what they don’t understand regarding Health Insurance Coverage costs for all, they need a big team like you & Joseph Mercola & Mark Hyman & Andrew Wakefield & John Gray etc. educating on prevention thru good food & exercise & supplements & getting rid of toxins in air, water, food. We could reduce health care suffering & costs so much & quit having the stupid arguing for nothing by politicians. They are so ignorant! Actually they are so greedy!
Thank you Dr. Brownstein for all you do and all you´re willing to say even to the disgruntlement of the establishment. I agree completely, it IS insane. I´ve been using natural remedies to treat problems that traditional doctors have not been able to help me with, including thyroid and candida issues. It was you and your books that started to help me see the light of how I was going to truly get better. Thank you!
You are the voice of sanity and reason Dr. Brownstein! Thank your for your work and information!!
Pam,
Thank you. I feel like I live in an insane medical world.
DrB
“This study should be the last nail in the coffin for Vytorin. It is a failed drug that has little usefulness. We would be better served to remove it from the marketplace.” AMEN!