Stop Me if You’ve Heard This One

A traveling salesman knocks on your front door and offers a life-saving drug.

Your first thought is to slam the door and slide the deadbolt. But you’re feeling charitable so you listen to the offer. The drug is a cholesterol-lowering statin. The salesman claims it’s proven to lower risk of fatal heart attack and stroke.

• You: No thanks. My cholesterol levels are just fine. [You slam the door.]
• Salesman: Yaaaaaa!
• You: Sorry. Was that your foot?
• Salesman [Through a forced smile]: As a matter of fact, a recent study showed that this fine product actually lowered heart attack and stroke risk in healthy subjects with normal cholesterol levels.
• You: Why would anyone test a drug on healthy people?
• Salesman: Uh…well…so more people can enjoy that drug, of course!
• You: And your drug company can make a lot more money.
• Salesman: Well, maybe. But lives will be saved! That’s the important thing!
• You: And who conducted this study?
• Salesman: Our own company produced the study with 14 highly respected researchers.
• You: So the only study that shows these benefits was a study that YOU paid for.
• Salesman: True. But don’t forget those highly respected researchers.
• You: How many of those researchers also received consulting fees or individual grant support from your company?
• Salesman: Well let’s see…[counting on his fingers]…there was…and uh…10.
• You: WHAT?! That seems like a glaring conflict of interest.
• Salesman: Well, you know, things aren’t always what they seem.
• You: So how much does this drug cost?
• Salesman: About $1,200 per year. But health insurance should cover that.
• You: My insurance will cover medication for which I have no medical need?
• Salesman: Well, when you put it that way, no, probably not.
• You: What sort of side effects showed up in the study?
• Salesman: Diabetes, confusional state, and death due to gastrointestinal disorder.
• You: Confusional state?
• Salesman: It’s a fancy researcher way of saying “confusion.”
• You: Okay, fair warning – I’m going to slam the door on your foot again.
• Salesman: But wait. A number of cardiovascular experts believe the benefits outweigh the risks – yaaaaaa!
• You: Have a nice day.

Dangerously premature

This joke was brought to you by AstraZeneca, maker of the statin drug Crestor. And except for the part about AZ salesmen going door-to-door, every word is true.

But here’s the real joke: An FDA panel recently recommended that the agency approve the use of Crestor in healthy men over the age of 50 and healthy women over the age of 60. This would expand the potential U.S. market for Crestor by more than six million customers.

Normally I’d use the world “patients,” but when drug users have no medical need…yeah, they’re just customers.

My favorite comment about this insane recommendation comes from Dr. Michael Good of ProHealth Physicians in Connecticut. Dr. Good told ABC News that the recommendation is a “dangerously premature development.”

Why dangerous? Let’s review: risk of diabetes, confusional state, and death due to gastrointestinal disorder. And as if that weren’t enough to send you running for the hills, Dr. Good adds this note about statin drugs: “About one in 10 patients experience muscle pain and weakness, some have liver function changes and the statins as a group have many, many drug interactions.”

Even by the FDA’s very low standards, this recommendation is a colossal blunder.

Sources:

“FDA Confirms Benefits of Crestor in More Patients” Matthew Perrone, Associated Press, 12/11/09, ap.org

“FDA Panel Recommendation on Crestor Spurs Debate” Dan Childs and Peggy Peck, ABC News, 12/16/09, abcnes.go.com “Should Flowers be Banned in Hospitals?” Ivanhoe Newswire, 12/30/09, ivanhoe.com

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