Interesting discussion on drug studies with a pharmacist

[AllyCat]

Our hospital pharmacist presented some info on cholesterol-lowering and hypertension drugs to our group of new nurses. After he talked about the risks (usually muscle pain that can debilitate to life-threatening rhabdomyolysis), he mentioned how the evidence tells us that reducing cholesterol decreases certain risks of heart disease. He was specifically addressing mortality in study groups taking the meds.

Then he talked about how looking at societies with very low blood cholesterols (usually under 100), they had almost no incidence of heart disease. Intrigued, I asked him which societies these happened to be. "African populations", he said. Well, this does not take into account other factors such as earlier death from other disease, lifestyle, and diet, I said. He was unphased saying that's what the research shows.

Then I asked about the stories in the media lately about the drug companies seemingly arbitrarily pressuring medical groups to lower ranges for blood glucose, blood pressure, and blood cholesterol. He said it was all media hype and that studies show these lowered values to be beneficial and decrease mortality. "Who funded the studies?" I asked. "The drug companies," came his reply. Almost immediately, he realized how this sounded and then spent the next 3-4 minutes defending corporate pharmaceuticals that if they didn't fund the studies, no one would so we have to take what we get. They are in this to make money...the gist of his argument.

"Right," I said. "They are in this to make money, not necessarily to make people healthier." He responded that most of the drug companies were ethical organizations.

What do you think??

[Child_Of_Isis]

1. If folks didn't take drugs

he would be out of a job.

[oscar111]

2. Ethical? Orphan drugs. HIV patients vs. hi priced drugs in Brazil and MS

In mississippi, i read last year that a few dozen poor folks with HIV and who were currently getting the life sustaining drugs for it,

would no longer get them as the budget was getting cut.
Lower pill prices to begin with, would let the pills fit into even a smaller state budget.
{ok, two villans in this example}

Saw no followup on it.

In brazil, the gov just announced if Big Pill did not lower HIV pill prices, brazil would ignore the patent and make the pills themselves. Same situation in Africa, with many never seeing HIV pills due to the price.

Orphan drugs.. too few patients to make the known cures, and still profit.

Big Pill profit rate 17%. Fortune 500 average, 3%. So BP is not straining to get enough profit to do its research, as is the excuse offered for hi prices in the USA while nations limit prices overseas. As is done in Canada. {data from former editor of NEJM, in her new book. think her name is Snow, not sure.}

Contrary studies suppresed by BP.

the list goes on and on.

Ethical? LOL.
=====================
The concept

SOCIAL COST

is important in this whole issue.
BP cannot absorb social cost concerns in its cash bottom line.
Nationalized pill factories could.
Try Demopedia or Wikipedia for a definition. Might have it.

[oscar111]

3. Gov should fund ALL drug studies

gov can be neutral.

we just need funds to do it this way. President Kucinich would get it done.

[SnowGoose]

4. Of course he's biased. Buuuuut.

I work in a school of Public Health. One thing worth keeping in mind about epidemiologists is that they have the souls of accountants. Anal retentive accountants. These people sit around all day thinking about their data, and what it means, and how it might be biased.

There are standards, particularly if one wants to publish in good journals. And, seriously, drug companies are not doing (or funding) all the studies on risk factors for cardiovascular disease. Plenty of academics are doing this type of research as well.

If you're forming an opinion on a question such as this, I strongly recommend that you go to pubmed at http://www.ncbi.nlm.nih.gov/entrez

This site is run by the National Library of Medicine, and has virtually all the major (and zillions of minor) journals in the life sciences. It's free to use, and in addition to reading the abstracts, you can frequently find free full-text articles as well. If I were you, I'd pick up a couple of recent review articles, then you can form an opinion that is informed by the current best understanding of science.

Yes, drug reps are prostitutes. That doesn't mean they're always wrong or deceitful.

[Sgent]

5. There was one study

done here in the last couple of years (published in Heart I think) that showed our current goals of 240 is too high for people who have suffered from one event.

They lowered it to 180, and increased the drugs to meet it. Decreased 5yr mortality by 40%.

[bemildred]

6. I think you find what you look for.

As the "African populations" show, there are other ways to address this "problem", if one wishes to.