Panaceia or Hygeia

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Posts Tagged ‘statins’

OBSTAT: Doctors bribed to prescribe statins in Quebec

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.

obstatletter

obstat1

obstat2

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.

obstat-publicmoney

Posted in ethics, professionalism, statins | Tagged: , , , , , , , , | 3 Comments »

Harvard Medical School in Ethics Quandary

Posted by Colin Rose on March 3, 2009

March 3, 2009

BOSTON — In a first-year pharmacology class at Harvard Medical School, Matt Zerden grew wary as the professor promoted the benefits of cholesterol drugs and seemed to belittle a student who asked about side effects.

Mr. Zerden later discovered something by searching online that he began sharing with his classmates. The professor was not only a full-time member of the Harvard Medical faculty, but a paid consultant to 10 drug companies, including five makers of cholesterol treatments.

“I felt really violated,” Mr. Zerden, now a fourth-year student, recently recalled. “Here we have 160 open minds trying to learn the basics in a protected space, and the information he was giving wasn’t as pure as I think it should be.”

Mr. Zerden’s minor stir four years ago has lately grown into a full-blown movement by more than 200 Harvard Medical School students and sympathetic faculty, intent on exposing and curtailing the industry influence in their classrooms and laboratories, as well as in Harvard’s 17 affiliated teaching hospitals and institutes.

They say they are concerned that the same money that helped build the school’s world-class status may in fact be hurting its reputation and affecting its teaching.

The students argue, for example, that Harvard should be embarrassed by the F grade it recently received from the American Medical Student Association, a national group that rates how well medical schools monitor and control drug industry money.

Harvard Medical School’s peers received much higher grades, ranging from the A for the University of Pennsylvania, to B’s received by Stanford, Columbia and New York University, to the C for Yale.

Harvard has fallen behind, some faculty and administrators say, because its teaching hospitals are not owned by the university, complicating reform; because the dean is fairly new and his predecessor was such an industry booster that he served on a pharmaceutical company board; and because a crackdown, simply put, could cost it money or faculty.

Further, the potential embarrassments — a Senate investigation of several medical professors, the F grade, a new state law effective July 1 requiring Massachusetts doctors to disclose corporate gifts over $50 — are only now adding to pressure for change.

The dean, Dr. Jeffrey S. Flier, who says he wants Harvard to catch up with the best practices at other leading medical schools, recently announced a 19-member committee to re-examine his school’s conflict-of-interest policies. The group, which includes three students, is to meet in private on Thursday.

Advising the group will be Dr. David Korn, a former dean of the Stanford Medical School who started work at Harvard about four months ago as vice provost for research. Last year he helped the Association of American Medical Colleges draft a model conflict-of-interest policy for medical schools.

The Harvard students have already secured a requirement that all professors and lecturers disclose their industry ties in class — a blanket policy that has been adopted by no other leading medical school. (One Harvard professor’s disclosure in class listed 47 company affiliations.)

“Harvard needs to live up to its name,” said Kirsten Austad, 24, a first-year Harvard Medical student who is one of the movement’s leaders. “We are really being indoctrinated into a field of medicine that is becoming more and more commercialized.”

David Tian, 24, a first-year Harvard Medical student, said: “Before coming here, I had no idea how much influence companies had on medical education. And it’s something that’s purposely meant to be under the table, providing information under the guise of education when that information is also presented for marketing purposes.”

The students say they worry that pharmaceutical industry scandals in recent years — including some criminal convictions, billions of dollars in fines, proof of bias in research and publishing and false marketing claims — have cast a bad light on the medical profession. And they criticize Harvard as being less vigilant than other leading medical schools in monitoring potential financial conflicts by faculty members.

Dr. Flier says that the Harvard Medical faculty may lead the nation in receiving money from industry, as well as government and charities, and he does not want to tighten the spigot. “One entirely appropriate source, if done properly, is industrial funds,” Dr. Flier said in an interview.

And school officials see corporate support for their faculty as all the more crucial, as the university endowment has lost 22 percent of its value since last July and the recession has caused philanthropic contributors to retrench. The school said it was unable to provide annual measures of the money flow to its faculty, beyond the $8.6 million that pharmaceutical companies contributed last year for basic science research and the $3 million for continuing education classes on campus. Most of the money goes to professors at the Harvard-affiliated teaching hospitals, and the dean’s office does not keep track of the total.

But no one disputes that many individual Harvard Medical faculty members receive tens or even hundreds of thousands of dollars a year through industry consulting and speaking fees. Under the school’s disclosure rules, about 1,600 of 8,900 professors and lecturers have reported to the dean that they or a family member had a financial interest in a business related to their teaching, research or clinical care. The reports show 149 with financial ties to Pfizer and 130 with Merck.

The rules, though, do not require them to report specific amounts received for speaking or consulting, other than broad indications like “more than $30,000.” Some faculty who conduct research have limits of $30,000 in stock and $20,000 a year in fees. But there are no limits on companies’ making outright gifts to faculty — free meals, tickets, trips or the like.

Other blandishments include industry-endowed chairs like the three Harvard created with $8 million from sleep research companies; faculty prizes like the $50,000 award named after Bristol-Myers Squibb, and sponsorships like Pfizer’s $1 million annual subsidy for 20 new M.D.’s in a two-year program to learn clinical investigation and pursue Harvard Master of Medical Science degrees, including classes taught by Pfizer scientists.

Dr. Flier, who became dean 17 months ago, previously received a $500,000 research grant from Bristol-Myers Squibb. He also consulted for three Cambridge biotechnology companies, but says that those relationships have ended and that he has accepted no new industry affiliations.

That is in contrast to his predecessor as dean, Dr. Joseph B. Martin. Harvard’s rules allowed Dr. Martin to sit on the board of the medical products company Baxter International for 5 of the 10 years he led the medical school, supplementing his university salary with up to $197,000 a year from Baxter, according to company filings.

Dr. Martin is still on the medical faculty and is founder and co-chairman of the Harvard NeuroDiscovery Center, which researches degenerative diseases, and actively solicits industry money to do so. Dr. Martin declined any comment.

A smaller rival faction among Harvard’s 750 medical students has circulated a petition signed by about 100 people that calls for “continued interaction between medicine and industry at Harvard Medical School.”

A leader of the group, Vijay Yanamadala, 22, said, “To say that because these industry sources are inherently biased, physicians should never listen to them, is wrong.”

Encouraging them is Dr. Thomas P. Stossel, a Harvard Medical professor who has served on advisory boards for Merck, Biogen Idec and Dyax, and has written widely on academic-industry ties. “I think if you look at it with intellectual honesty, you see industry interaction has produced far more good than harm,” Dr. Stossel said. “Harvard absolutely could get more from industry but I think they’re very skittish. There’s a huge opportunity we ought to mine.”

Brian Fuchs, 26, a second-year student from Queens, credited drug companies with great medical discoveries. “It’s not a problem,” he said, pointing out a classroom window to a 12-story building nearby. “In fact, Merck is right there.”

Merck built a corporate research center in 2004 across the street from Harvard’s own big new medical research and class building. And Merck underwrites plenty of work on the Harvard campus, including the immunology lab run by Dr. Laurie H. Glimcher — a professor who also sits on the board of the drug maker Bristol-Myers Squibb, which paid her nearly $270,000 in 2007.

Dr. Glimcher says industry money is not only appropriate but necessary. “Without the support of the private sector, we would not have been able to develop what I call our ‘bone team’ in our lab,” she said at a recent student and faculty forum to discuss industry relationships. Merck is counting on her team to help come up with a successor to Fosamax, the formerly $3 billion-a-year bone drug that went generic last year. But Dr. Marcia Angell, a faculty member and former editor in chief of The New England Journal of Medicine, is among the professors who argue that industry profit motives do not correspond to the scientific aims of academic medicine and that much of the financing needs to be not only disclosed, but banned. Too many medical schools, she says, have struck a “Faustian bargain” with pharmaceutical companies.

“If a school like Harvard can’t behave itself,” Dr. Angell said, “who can?”

Posted in cholesterol, drugs, professionalism, statins | Tagged: , , , , , | 1 Comment »

JUPITER is a gas giant

Posted by Colin Rose on November 21, 2008

An excellent article by André Picard in today’s Globe and Mail, the only story on JUPITER I have seen in the lay press that reveals the massive fraud behind the reporting of this “study”.

JUPITER is aptly named. It’s gigantic. Probably the largest, most expensive drug trial in history. When one looks below the surface of the publication in the NEJM, the results are about as exciting as the Jovian composition. A lot of gas. I would conservatively estimate that this “study” cost at least $500 million. But if you are AstraZeneca and stand to sell $many billions worth of Crestor because of this paper that’s small change. And junk food addicts, who comprise most of the subjects of JUPITER have one more excuse, however deceptive, to continue their self-destructive habits.

Here is my opinion posted in the NEJM blog on the paper.

nyt-jupiter-unethical

A more detailed analysis of the marketing driven deception and lack of professionalism in the paper by Sandy Szwarc.

Another perspective by John McDougall similar to mine on the big lie behind the claim that many “healthy” people need Crestor..

When all of these criticisms are considered it turns out that JUPITER is nothing more than a thinly disguised  infomercial for Crestor and should never have been published in a presumably high quality journal like the NEJM. But in being able to make this paper freely available on the web (and not wait 6 months like other papers) the NEJM must have received a large payment from AstraZeneca.

Non-blinded statin trials like JUPITER, have the potential for bias in subjective outcomes like the decision to do an angioplasty or coronary bypass, outcomes that constitute the vast majority of the combined endpoint. Also, it is quite likely that when the JUPITER subjects knew that their blood LDL was low because they were taking Crestor they had less incentive to change self-destructive lifestyles. That is probably why the group treated with Crestor had significantly more diabetes. In light of the JUPITER trial the Therapeutics Initiatives group at the University of British Columbia has updated their recommendations for use of statins in primary prevention, which would include people like those entered into the JUPITER trial, and concluded that “statins do not have a proven net health benefit in primary prevention populations and thus when used in that setting do not represent good use of scarce health care resources.

See a slide show on JUPITER and “dyslipidemia”.

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Lead “investigators” of JUPITER

Paul M Ridker, M.D., Eleanor Danielson, M.I.A., Francisco A.H. Fonseca, M.D., Jacques Genest, M.D., Antonio M. Gotto, Jr., M.D., John J.P. Kastelein, M.D., Wolfgang Koenig, M.D., Peter Libby, M.D., Alberto J. Lorenzatti, M.D., Jean G. MacFadyen, B.A., Børge G. Nordestgaard, M.D., James Shepherd, M.D., James T. Willerson, M.D., Robert J. Glynn, Sc.D., for the JUPITER Study Group

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Dominican Republic

What typical JUPITER subjects would look like. These are "apparently healthy" people? Is it not unethical to prescribe drugs to these people to "treat" the symptoms of their self-destructive lifestyles?

Nowhere in the JUPITER paper will you see it mentioned that CRP can be markedly reduced with cost-free lifestyle change alone, no statins, as shown in this paper in the Journal of Applied Physiology in 2006, results of which are summarized below. The subjects in the JAP paper were just the same as in the JUPITER study, obese people, many with metabolic syndrome but the authors did not call them “apparently healthy”. They had nothing to sell.

jap-diet-crp

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When it comes to statins, don’t believe the hype

November 20, 2008
The Globe and Mail
André Picard”Cholesterol drug causes risk of heart attack to plummet” – Fox News.

“Cholesterol-fighting drugs show wider benefit” – The New York Times.

“Cholesterol drug cuts heart risk in healthy patients” – The Wall Street Journal.

The New York Times article summarized the exciting news in a front-page story saying that “millions more people could benefit from taking the cholesterol-lowering drugs known as statins.”

That’s big medical/business news, because statins are already the bestselling drugs in the world, with sales in excess of $20-billion (U.S.).

Quoting some of the world’s top heart researchers, media reports touted the importance of a blood test for C-reactive protein. That’s because those benefiting from statins had high levels of CRP (a marker for inflammation) rather than high levels of LDL cholesterol, which is usually the criterion for statin prescription.

The news stories were based on research published last week in the prestigious New England Journal of Medicine and presented, with much fanfare, at the annual convention of the American Heart Association.

Like much reporting on medical research (and drug research in particular), however, there is more (or, more accurately, less) to these stories than meets the eye.

The principal finding in this study was that participants who took a statin pill recorded a 50-per-cent reduction in the risk of heart attack, stroke, surgery and death compared with those who took a placebo (a sugar pill).

Who wouldn’t be wowed by those numbers? Who wouldn’t want that miracle drug?

But the benefits are relative risk reductions.

When you look at the raw data in the study, they reveal that 0.9 per cent of statin users had cardiovascular problems. By comparison, 1.8 per cent of those taking a placebo had heart problems.

There were 17,802 participants in the study, yet there were only 83 cardiac events among statin users, compared with 157 in the placebo group. That’s 50 per cent fewer.

Are those really “dramatic” findings? Do statins really make heart attack risk “plummet”?

According to a cautionary editorial in the New England Journal of Medicine (which received virtually no mention in news reports), 120 people in this study needed to be treated with a statin for two years to see a benefit in one person.

That’s a lot of people taking a pricey drug ($3 Canadian a day) for no benefit – not to mention that there are risks.

While researchers (and journalists who report on studies) love to highlight benefits of drugs, they too often gloss over risks.

Like all drugs, statins have side effects. The drug used in the study, rosuvastatin (brand name Crestor), has been associated with muscle deterioration and kidney problems.

In the study, those taking statins had a higher risk of developing Type 2 diabetes – 3 per cent compared with 2.4 per cent of those taking a placebo. That’s a 25 per cent higher relative risk among people with very little heart disease to begin with.

As noted earlier, researchers (and news stories) suggested that, based on the findings, the number of patients taking statins could and should expand dramatically.

But is that really what the research tells us, even in its most optimistic interpretation?

The study involved exclusively men older than 50 and women older than 60 who did not have high cholesterol or histories of heart disease or inflammatory illness. All the people in the study needed to have low cholesterol and high CRP.

Initially, researchers recruited 90,000 people in those age groups, but more than 80 per cent of them were deemed ineligible. This is a very select population.

To say, by extrapolation, that these “dramatic” (read: modest) benefits apply to the general population is erroneous.

Similarly, while it is true that about half of all heart attacks and strokes occur in people whose cholesterol is not considered high, does that mean everyone should get a blood test to measure levels of C-reactive protein? Hardly.

Yes, there is more heart disease among people with high levels of CRP, but the jury is still out on what this means.

Some scientists believe that because CRP – secreted in response to inflammation – is present in plaque, it increases the risk that the plaque will burst, leading to blood clots that cause heart attacks. But other researchers think that CRP levels are, at best, a telltale sign of heart disease, a bit like grey hairs are a sign of aging – not its cause.

The CRP test is expensive at almost $50. And it’s worth noting that one of the principal authors of the new research holds the patent on the test and makes money every time it is used.

When you cut through all the hype and the self-interest, what we know is this: Statins reduce levels of [LDL] cholesterol. This is beneficial to people who have had a heart attack or other serious heart problems.

But for otherwise healthy people, high CRP levels or not, the potential benefits of taking statins are marginal, and the risks are not insignificant.

Hardly the stuff of dramatic newspaper headlines.

Posted in atherosclerosis, cardiology, cholesterol, coronary artery disease, death, diabetes, diabetes, Type 2, drugs, junk food, obesity, professionalism, statins, waist circumference | Tagged: , , , , , , , , , , , , , , , , , , | 2 Comments »

Rate of increase in Type 2 Diabetes in UK doubles in one year

Posted by Colin Rose on October 24, 2008

Has anyone considered the possibility that this disaster might be because the UK is the only developed country to have made statins non-prescription drugs? This is truly a revenge of unintended consequences. Just take your statin and eat anything. Result? An epidemic of obesity whose consequences are as bad or worse than the disease the statins were supposed to prevent.

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From The Independent

Diabetes may cause first fall in life expectancy for 200 years

By Jeremy Laurance, health editor
Monday, 20 October 2008

Britain is in the grip of a diabetes epidemic that threatens to overwhelm the NHS and could lead to the first fall in life expectancy in 200 years. The number of cases diagnosed has doubled in a year, figures out today will show. Family doctors recorded an extra 167,000 sufferers last year, compared with a rise of 83,000 in 2006-7.

The increase brings to almost 2.5 million the number of British diabetics. A further 500,000 people are thought to be affected but unaware of their condition. The condition shortens lives by 10 years and is a leading cause of circulatory problems and blindness.

The soaring rate of diabetes is driven by rising obesity. Today’s figures from Diabetes UK show five million people are registered as obese by their GPs, up from 4.8 million in 2006-07. At least a million more Britons are predicted to succumb to diabetes by 2010.

Professor Sir George Alberti, a Government adviser and former head of the International Diabetes Federation, said the accelerating increase was partly due to improved screening but also to a genuine rise in cases.

“It is a clarion call for society to take this seriously,” he added. “The catastrophe has started to happen. The Government has begun to tackle obesity and inactivity but converting good words into action is very difficult. It will take ages to have an effect.”

The World Health Organisation has predicted that deaths from diabetes in Britain would rise from 33,000 a year in 2005 to 41,000 by 2015 but Professor Alberti said that figure underestimated its true impact. More than 80 per cent of sufferers die from heart attacks or strokes and more than 1,000 a year suffer kidney failure requiring dialysis.

“The WHO figure [for deaths] was very conservative,” he said. “Large numbers die from heart disease and strokes [linked with diabetes] and they do not include those.”

Diabetes is spreading around the world, fuelled by increasing urbanisation and the spread of Western lifestyles. It is estimated to have killed 2.9 million people in 2000, equivalent to the number of Aids deaths, although it has received a fraction of the attention. From 170 million people affected in 2000, doctors predict the total will rise to 370 million by 2025, leading to an epidemic of blindness and amputations.

Researchers have warned that the increase in diabetes and other chronic diseases driven by rising obesity could lead to a fall in general life expectancy. Writing in the New England Journal Of Medicine in 2004, Jay Olshansky and colleagues at the University of Illinois said life expectancy could be cut by five years in the coming decades if obesity continued to increase. Douglas Smallwood, chief executive of Diabetes UK, said: “These are truly alarming figures. Part of why we have seen such a huge increase can be attributed to improved screening from healthcare services and greater awareness amongst those at high risk of type 2 diabetes. However, there is no getting away from the fact that this large increase is linked to the obesity crisis.

“Diabetes is one of the biggest health challenges facing the UK. It causes heart disease, stroke, amputations, kidney failure and blindness and more deaths than breast and prostate cancer combined. The NHS already spends £1m an hour on diabetes. The soaring diabetes prevalence will continue to put a massive strain on an already struggling NHS and, unless it can respond, people’s health could spiral downwards. We need to do all we can to raise awareness of the seriousness of diabetes and help people understand how a healthy lifestyle can help reduce their risk.”

Diabetes is a disorder in the metabolism of carbohydrate, leading to excessive thirst and the production of large amounts of urine caused by lack of insulin. Nine out of 10 sufferers have Type 2 diabetes, which usually affects older people but is now seen in younger people and children as weight has risen. The risk is 10 times higher in those who are obese, defined as having a body-mass index of more than 30.

Diabetes: The risks, the costs

*The condition causes blood-sugar levels to rise because of a lack of insulin. The risk is 10 times higher in people who are obese.

*Raised sugar levels lead to high blood pressure, increased risk of heart attack, stroke, blindness, kidney damage and ulceration of the feet.

*It costs the NHS £1m an hour to treat. One pound in every £10 spent on the hospital service is for diabetes and its complications.

*Type 2 diabetes can be treated by diet and exercise and the effects are reversible if the damage has not gone too far.

*In more severe cases, drug treatment with tablets or injections of insulin is necessary.

*For up to 10 years, there are no symptoms, but doctors believe that the earlier that treatment begins, the less damage it causes.

Posted in diabetes, Type 2, diet, moral hazard, statins | Tagged: , , , , , , , | Leave a Comment »

Free Online CME – Drug Dealers’ Propaganda

Posted by Colin Rose on July 26, 2008

Here is a classical example of “free” online CME (Continuing Medical Education) funded by drug dealers and given legitimacy by association with presumably ethical institutions, like “prestigious educational institutes”. Doctors have to accumulate CME credits to maintain their licenses, so they are obliged to look at this propaganda. It seems doctors don’t make enough to pay for their own continuing education and have to depend upon the drug dealers to keep them informed. Shed a tear.

How much is McGill paid to allow it’s logo on this propaganda? McGill is a publicly chartered and funded institution. One should be able to find out but good luck.

Both members of the “Planning Committee” are compromised by financial connection to one or more drug dealers.

David Fitchett is particularly notorious for multiple connection to drug dealers.

But Dr. Fitchett is labeled an “expert”. What has Dr. Fitchett ever done, any more than any other graduate of a medical school, to be considered and expert? I have no idea.

Dr. David Fitchett, Expert

Dr. David Fitchett, Expert

Watch a medical terrorist in action. Take that “powerful” statin to reach “target”, get that muscle pain. If you don’t you will die.

We are advised that “…it is unlikely that lipid targets can be achieved in the absence of pharmacological therapy” and we are given references for these targets. Who sets these targets, anyway? You haven’t guessed by now? In Canada it’s the “Working Group“, all of whom have financial connections with multiple drug dealers and who are chosen to be the conduits of divine revelation by groups like the Canadian Cardiovascular Society that get most of its funding from drug dealers.

And those “resources”? Again, paid for by drug dealers.

So, what appears on the surface to be a scientifically legitimate educational exercise turns out to be propaganda funded by drug dealers at multiple levels. Drug dealers pay doctors and their organizations to promote “targets” for blood  cholesterol, pay “prestigious” institutions for their approval, pay for the web sites, like mdbriefcase, for CME to promote measurement of blood cholesterol and drugs to lower it and doctors must read it to keep their qualifications. What a wonderful marketing machine! And it’s all legal. But what happened to medical professionalism?

Posted in cardiology, cholesterol, drugs, professionalism, statins | Tagged: , , , , , , , , , , , , , , , , | Leave a Comment »

CALIPSO

Posted by Colin Rose on July 9, 2008

Here is a good example of a “study” of statins written by a non-medically licenced employee of a statin-peddling drug company, Merck Frosst Schering, with the names of prominent “experts”, many known to be financially associated with drug companies, shown as secondary authors.

What a nice name! Reminds one of sunny Caribbean islands. Except they had to use an “I” instead of a “y”. Guess they couldn’t find an acronym that fit easily. What was done? Doctors were paid to collect data on patients to whom they prescribed statins. Results? Horrors of horrors, many of them did not reach “target” LDL (bad blood cholesterol). Conclusion? You guessed it. Not enough people are taking enough statins. Suggestion? “Strategies should be implemented to promote achievement of lipid treatment goals…”

Who sets these “targets” anyway? Again, you guessed it, the same sort of doctors as the authors listed in CALIPSO, most paid by drug dealers in one way or another. See the evidence in the US and Canada.

More than half of the subjects had no history of cardiovascular disease, so statins were being used for primary prevention and there is no overall benefit of statins this class of patient.

Note that the first author is employed by a Merck, a big seller of statins.

No attempt was made to alter high risk lifestyles (42% had abdominal obesity and 17% smoked). That’s hard work and takes a lot of time. But, why bother? Surely, after years of medical terrorism by drug dealers, everyone knows that atherosclerosis is caused by bad blood cholesterol and there is a very profitable strategy for attaining “lipid treatment goals”; pay doctors to give statins to reach those arbitrary targets as is now happening in parts of the USA.

The Canadian Journal of Cardiololgy, at least 80% of whose revenue comes from drug companies, does not require financial disclosure by authors but we have found them from another source. In the Acknowledgements those nice people at Merck and  BioMedCom, contracted to do the “study”, are thanked.

While BioMedCom claims to do “scientifically rigorous” work, CALIPSO is not science at all. It is a highly biased sample of what doctors will do if paid to report on the patients to whom they prescibe statins. There is no proof that if the patients had reached “target” they would have benefitted at all. There is no control group who did not receive statins and there is no indication of outcome at all. This is not science, but another attempt at medical terrorism to sell more drugs and any doctor who would put his name on such a study cannot claim to be an expert in “hypercholesterolemia” nor should he or she be part of any group advising other doctors like the “Working Group” in Canada.

Why would all those “experts” in the author list need to hire BioMedCom, to do this “study”? What did these doctors do to justify putting their names on the “study”? And why is an employee of Merck first author? We leave the answers to the reader’s imagination.

 

Financial Conflicts of Interest Not Reported in CALIPSO Paper

 

Posted in atherosclerosis, cardiology, cholesterol, drugs, obesity, professionalism, statins | Tagged: , , , , , , , , , , , , , , , | Leave a Comment »

Get With The Guidelines – Do as the drug salesmen say

Posted by Colin Rose on May 4, 2007

Here is a classic example of drug dealers influencing the prescribing habits of doctors. If you read this GWTG-CAD carefully you will find a litany of insinuations WITHOUT PROOF. The data presented here are only observational. There is no control group. What were the lipids of the population that didn’t have a heart attack? The main insinuation is that the only cause of atherosclerosis is “dyslipidemia” and if the whole population of the world achieved “ideal” lipid levels by taking enough statins to lower their LDL to less than 70 mg/DL and somehow managed to also get their HDL higher than 60 mg/DL, there would be no heart attacks. There is NO PROOF for this hypothesis. 21% of the heart attack patients were on statins before their heart attack but still had one!

Now, if you want to know how such stupidity gets into print and gets the backing of the AHA, just look at the disclosures which are in small print at the bottom left. Enough said.

Posted in cholesterol, coronary artery disease, drugs, professionalism, statins | Tagged: , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a Comment »

Cubans do not measure “cholesterol” and live longer than Americans

Posted by Colin Rose on March 10, 2007

Cubans don’t measure their blood cholesterol obsessively as recommended by “guideline” committees in the US, Canada and Britain, on which sit doctors paid in various ways by statin manufacturers. Statins are almost impossible to get in Cuba but Cubans live longer than Americans who spend $US billions on statins like Lipitor. Cubans eat mostly a unrefined plant-based diet, have few cars and have less obesity. And Cuba spends only 4% of what the US does on “health” care per capita. Just think of what we could do with more than a trillion dollars PER YEAR. That would fund a few manned trips to Mars every year not not to mention funding free university education, cleansing the environment, obliteratiing infectious disease and poverty…

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U.S. healthcare costs more than Cuba’s and may not have an edge in helping people live longer, but Cubans often lack prescription drugs and over-the-counter remedies.

BY JOHN DORSCHNER

jdorschner@MiamiHerald.com

The average Cuban lives slightly longer than the average American, but the American’s healthcare costs $5,711 a year while the Cuban’s costs $251.

Those are the figures of the World Health Organization. Some experts question the accuracy of the Cuban numbers, but no one doubts the underlying revelation: There is little relationship between the cost of your healthcare and how long you’ll live.

”Medical care is responsible for only a small portion of the variation in life expectancy,” says Gerard Anderson, a Johns Hopkins professor specializing in health policy. “Behavioral factors such as diet and exercise are much more important. The U.S., which spends much more than any other industrialized country on healthcare, is getting little value for much of the spending.”

These factors have moved to the forefront of the American political discussion as leaders in both major parties work toward solving what almost everyone agrees is a ”healthcare crisis,” with soaring costs threatening to increase the numbers of the uninsured, which already include 46 million Americans.

In such a discussion, Cuba serves as the starkest possible contrast, a completely government-controlled system in which ailing leader Fidel Castro benefits from the best possible care, including consultations with a Madrid surgeon, while many Cubans struggle to get basic treatment.

Here are the numbers: The average American has a life expectancy of 77.8 years, as of 2006. The average Cuban lives 78.3 years. Even if the Cuban figure is inflated, no one disputes the statistics from European countries, where people tend to live a year or two longer than in the United States — at about half the healthcare costs per capita.

At its highest level, most people agree, the United States has top-quality care. The country offers the latest magnetic resonance imaging, robotic-arm surgeries and drugs to deal with cholesterol, acid reflux and arthritis pain.

Americans want the biotech drug to target tumor cells, but many don’t get basic preventive screening tests. That’s particularly true for the uninsured, who often avoid treatment until their condition sends them to the emergency room.

Cuba offers universal healthcare and has twice as many doctors per capita as the United States. The Cuban government did not respond to The Miami Herald’s request for comment via telephone or e-mail, but its publications have boasted that the country is one of the world’s leaders in healthcare. Ann C. Seror, a professor at Laval University in Quebec, Canada, says Cuba has “achieved a remarkable level of healthcare quality of life for its citizenry.”

But six Cuban doctors The Miami Herald interviewed — two dissidents still on the island, four now in Miami — say many prescription drugs and even over-the-counter remedies are nearly impossible to get, and patients sometimes have long waits in clinics unless they pay bribes.

One irony is that poverty has forced Cubans into a healthier lifestyle. Juan A. Asensio, a University of Miami trauma surgeon and a Cuban American who is certainly no friend of the Castro regime, put it this way: “No McDonald’s, and Cubans walk everywhere or ride bikes because they can’t afford cars.”

About one in 10 Cubans are obese, according to the Pan American Health Organization. In the United States, one in three are obese, ”increasing risks of high blood pressure, type 2 diabetes, stroke, heart disease and osteoarthritis,” according to the Agency for Healthcare Research and Quality.

Still, the aging American, no matter his weight, can lay claim to a more comfortable life, with access to everything from Advil to Pepto-Bismol and Viagra — products virtually nonexistent in Cuba.

As Nestor Viamonte, a physician who left Cuba in 2003, puts it: “There’s a difference between a 75-year-old with quality of life and a 75-year-old without quality of life.”

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