Posted by Colin Rose on March 13, 2009
Here is a classic example of drug marketing a disguised as a “research study” funded by two drug dealers, Pfizer and Astra-Zeneca, with $1.2 million to give $100 to any doctor who starts a statin in ANY patient for no reason in particular. The goal is to find out why the patients STOP taking their expensive drugs, not why they really NEED them in the first place. With 4500 enrolled “patients” $450,000 will be spent by drug dealers on direct bribes to doctors. If each statin pill conservatively costs $2 per day, in just one year, they will have sold $3.3 million worth of drugs, an almost 400% yearly return on the investment including payments to the doctors. Over three years of the “study” the drug dealers will have sold about $10 million worth of drugs to people, the vast majority of whom will never have had a heart attack or stroke and in whom, “statins have not been shown to provide an overall health benefit.” And the cost of this study will likely be classified as “research” by the drug dealers, not a marketing expense. All perfectly legal. Isn’t the drug business wonderful?
Needless to say, the lead “investigator” in OBSTAT, Jacques LeLorier, has a long history of personal payments from multiple manufacturers of statins. Here is a list from a publication in 2004. “Dr. LeLorier reports having served as a paid speaker or consultant for the following manufacturers of statins: Merck Frosst Canada, Pfizer Canada, AstraZeneca, and Bristol-Myers Squibb.” Is it any wonder he wants to keep any- and everyone on a statin for life?
All you unemployed Canadians will be thrilled to learn that this drug marketing is being supported by $584,250 from your income taxes via the Canadian Institutes of Health Research, if and when you get a job.
If you think it is unethical and unacceptable for doctors in Quebec or anywhere to accept money from drug dealers contact the Collège des Médecins du Québec. The licensing bodies will only take action if the public complains.
Here is the justification of OBSTAT for which Lelorier et al have received $584,000 of taxpayer money at a time of large cutbacks in funding to basic research. I will translate the most interesting part of the description.
” The premature cessation of this medication [statins] that most of patients must take for life can have disastrous consequences.”
There is no reason anyone has to take a statin for life. Atherosclerosis is NOT caused by a deficiency of a statin. A non-atherogenic lifestyle is much more efficacious that statins in preventing and treating atherosclerosis. The only disastrous consequence of stopping statins is to the profits of the drug dealers.
Posted in ethics, professionalism, statins | Tagged: Daniel Gaudet, Dominique Dion, Elisabeth Martin, Jacques LeLorier, Jean Bergeron, Jean-Claude Tardif, Manon Choiniere, professionalism, statins | 2 Comments »
Posted by Colin Rose on March 31, 2007
Intravascular ultrasound is a sensitive method for measuring the size of atherosclerotic plaques in the arterial wall. When testing a drug to see if it will have an effect on plaque volume, this technique is the gold standard.
ILLUSTRATE set out to show that adding torcetrapib, a drug that increases HDL, the “good” cholesterol, to Lipitor, that decreases, LDL, “bad” cholesterol would reverse plaque or at least stop its progression.
Here are the baseline characteristics of the subjects. Note that the average BMI was 30. Overweight is defined as a BMI over 25 and obesity over 30. So, all of them were overweight or obese. 20% were diabetic, most likely Type 2, related to obesity, and 75% were hypertensive. 18% smoked. All of those factors are risk factors for atherosclerosis related to lifestyle. Therefore, unless one intends to first completely eliminate these lifestyle risk factors, it was unethical to even conceive such a trial particularly since it is proven that atherosclerosis can be reversed by lifestyle change alone. The trialists probably rationalized that atherosclerosis, like pneumonia, must be treatable by drugs and Pfizer, who funded the trial, has a slogan, “Working for a Healthier World” it is ethical to do such a trial. Besides the money helps to keep one’s IVUS lab going and one is promoting the notion that the technique will some day lead to the cure for atherosclerosis.
The typical ILLUSTRATE patient
Here are the reported results. What was not mentioned in the abstract above is that plaque actually INCREASED in both the the Lipitor only group and the Lipitor plus torcetrapib group. Now, before actually starting the trial, the subjects were given enough Lipitor to adhere to the guidelines written by doctors paid by Pfizer and other statin dealers. So, following the guidelines for blood cholesterol lowering with Lipitor does not slow progression of plaque. The obsession with blood cholesterol is completely futile.
The conclusions of the authors shows their blinkered view of atherosclerosis. While Dr. Nissen donates his personal drug money to charity (how much is paid to run his IVUS lab, if any, is not stated), all the other authors have major financial connections to drug dealers. Revkin, Shear and Duggan are employees of Pfizer and own stock. Naturally this group would ignore non-drug methods for reversing atherosclerosis
We have known how to reverse the atherosclerotic process very easily since the revolutionary work of Dean Ornish the final report of which was published in 1998. No drugs are necessary, only a change in lifestyle which was not seriously attempted in this study. There is even no reference to Ornish’s work in the paper, a major oversight of the reviewers. So, why don’t the IVUS groups do a study of plaque volume after significant lifestyle change? Who would fund it? If Pfizer is really “Working for a Healthier World” and not just making a profit, Pfizer should be funding an IVUS lifestyle trial.
Posted in atherosclerosis, cholesterol, coronary artery disease, professionalism, statins | Tagged: atheroma volume, atherosclerosis, atorvastatin, CAD, cholesterol, cigarette, dean ornish, E. Murat Tuzcu, HDL, intravascular ultrasound, Jean-Claude Tardif, LDL, lifestyle, lifestyle diseases, lipids, Lipitor, obesity, Pfizer, plaque, Stephen Nicholls, tobacco, torcetrapib | Leave a Comment »