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Medical Forum / General / General / August 2005selling sickness to the well
Selling Sickness to the Well A new book looks at how pharmaceutical companies are using aggressive marketing campaigns to turn more people into patients. WEB EXCLUSIVE By Jennifer Barrett Newsweek Updated: 8:01 a.m. ET Aug. 2, 2005 Aug. 2, 2005 - There are few Americans these days who arenât popping pills to treat a complaint, or to prevent one. From headache medicine to cholesterol-lowering drugs to sexual-dysfunction aids, there seems to be a remedy for every disorder out thereâ"and even some we didn't realize existed (until we saw the ad, that is). In their new book, âSelling Sickness: How the Worldâs Biggest Pharmaceutical Companies Are Turning Us All Into Patients: (Nation Books), Ray Moynihan and Alan Cassels examine how the drug industry has transformed the way we think about physical and mental health and turned more and more of us each year into customers. NEWSWEEK's Jennifer Barrett spoke with Moynihan, a medical writer for the Milbank Memorial Fund in New York and a regular contributor to the British Medical Journal, about howâ"and whyâ"drug makers have begun targeting people who aren't sick. Excerpts: NEWSWEEK: You write that drug makers now aggressively target the âhealthy.â Why? Ray Moynihan: The book opens with a quote from a former Merck CEO that it was a shame he wasn"t able to make Merck more like the chewing-gum maker, Wrigley's, because then he'd be able to "sell to everyone." I think that does drive the marketing machinery of the drug companies now. Drug companies target lots of sick people and make fabulous drugs that extend lives and ameliorate suffering. But the so-called preventives are where the big money are: like the bone-density drugs or the cholesterol [-lowering] drugs. Increasingly we're seeing the marketing shift to those types of drugs. People talk about the "worried well." There are many ways in which the drug companies target those people. You mean people who are well but worried about being sick? How are they targeted? The use of celebrities is now a standard way in which drug companies don't just promote their drugs but try and change public awareness, public thinking and public perceptions about illness. In some cases the disease phrasing is legitimate and welcome. But when you have celebrities trying to change the way we think about sexual difficulties or stomach problems or symptoms of stages of life, these are insidious campaigns. Why celebrities? I might take Serena Williams' advice on a brand of tennis racket's but menstrual migraine medication? [Laughs.] There's actually a whole mini industry of celebrity brokers who bring together celebrities and drug companies. I've interviewed one of the brokers who talked about the reason celebrities work so well in getting people to think about conditions and to go to their doctors. Why do they work so well? Because people trust celebrities. But they are not telling you often enough that they are on the [drug company's] payroll. Of course, if they did tell you as often as they should, your trust might diminish somewhat. Aren't there enough sick people that the drug companies can target? Why try and convince others they're sick? The marketing people and the sophisticated PR people who work for them are doing what shareholders demand of them. They're looking for ways to maximize markets. One way is to redefine more and more people as sick. There's an informal alliance between the drug companies and aspects of the medical profession and aspects of the patient advocacy world who all seem to have interests in defining more and more people as ill. We look at this condition by condition in the book, and what you see is a similar formula or process at work. Every time a panel of experts come together, they want to nudge the boundaries a little further out, whether it's mental illness, cholesterol or high blood pressure. How do you think this is affecting the American psyche? Asclepius was the Greek god for healing and one of his children was Panacea. She is one we all worship no matter if we're Jewish or Christian or Muslim. We all want a panacea, particularly if we're vulnerable or sick. The trouble is that there are vast commercial and professional forces trying to exploit the vulnerability we have and exploit our desire for a panacea. I don't know what is happening to the American psyche. But I see a country bombarded with advertisements. We're seeing fear of disease, decay and death becoming a central part of life. I'd like people to investigate the psychic impact of being told 10 times a day you might actually be sick. You're from Australia, though you focus on the United States for this book. Is America unique? The marketing strategies of pharmaceutical companies play out globally. However, the U.S. is the epicenter of the selling of sickness, of disease-mongering. Americans make up less than 5 percent of the worldâs population but the U.S. makes up 50 percent of the drug market. Really That doesn't mean the U.S. takes 50 percent of pills. That's a relief. But it does account for half of total spending on drugs. It's still extraordinary. And it's at the high end of pill taking. Why is that? The U.S. is different because it allows direct-to-consumer advertising [of prescription medications], which has taken off in a huge way in the past eight to 10 years. Itâs been around a long time, but there was a loosening of the regulations in the mid- to late '90s. New Zealand, too, is [unusual] in the world that way. In Australia and other countries, there is a strict ban on direct to consumer marketing. But so-called disease awareness programs, heavily funded by pharmaceutical companies, are not banned. So marketing strategies do play out in other places as well. Have you heard from any drug companies since your book came out? It's been out for a month in Australia, and there hasn't been anything out there to counter the journalism in my book. There's been a very strong silence. The worrying thing about that is that it makes me think that I might be right. If so, what do you hope would come from the book? I hope a few more people become a bit more skeptical about the claims being made to them about drugs and disease, about the labels that are being attached to them, and the conditions they're being told they have. It's time for all of us to be a bit more skeptical. © 2005 Newsweek, Inc. Selling Sickness to the Well A new book looks at how pharmaceutical companies are using aggressive marketing campaigns to turn more people into patients. The medical/industrial complex is as greedy today as the military/industrial complex was in Eisenhower's time. > Selling Sickness to the Well > A new book looks at how pharmaceutical companies are using aggressive > marketing campaigns to turn more people into patients. > > The medical/industrial complex is as greedy today as the > military/industrial complex was in Eisenhower's time. Hi George Found this It is a business first you know. No longer have to mentions Lipitor by name. Ah what a brand!! Genius How Nobel ! Bill ................. http://www.forbes.com/facesinthenews/2005/08/11/pfizer-drugs-advertising -cx_mh_0811autofacescan11.html Jump | Pfizer's Kelly Calls Consumer Ads 'Positive' Matthew Herper, 08.11.05, 4:01 PM ET NEW YORK - Pfizer today announced new guidelines for direct-to-consumer advertising for prescription drugs. But don't take that as a comment on the validity of advertising to consumers. "Direct to consumer advertising has caused 60 million Americans to go see their doctor," says J. Patrick Kelly, president of Pfizer U.S. Pharmaceuticals. "That's a tremendously positive impact on the public's health." Still, he says, there is room for improvement, and Pfizer (nyse: PFE - news - people )and other drug firms are seizing on the opportunity. "We believe that the changes we are undertaking will serve to take this very powerful medium and make it even more productive in terms of improving physician and patient dialogue, in terms of getting earlier diagnosis and treatment of disaese," says Kelly. Sure, that might improve the drug industry's tarnished image, but Kelly says that improving the public's perceptions is not the point of the new initiative. "The new added benefit is to take a powerful tool for improving the public's health and make it even better," says Kelly. What improvements are in store? For one thing, Pfizer's new ads will make clearer the potential risks of medicines, and will also note that other drugs might be a better choice for some patients and doctors than the ones Pfizer sells. The new ads will also contain information on Pfizer's Helpful Answers program, which can help low-income patients get necessary medicines paid for. Some of the changes still need approval from the U.S. Food and Drug Administration. Pfizer will also be doing more advertisements that focus on diseases, not individual drugs. For instance, an advertisement might raise awareness about high cholesterol, but not mention Pfizer's top-selling Lipitor.  SignatureGarden Shade Zone 5 S Jersey USA in a Japanese Jungle Manner.39.6376 -75.0208 This article is posted under fair use rules in accordance with Title 17 U.S.C. Section 107, and is strictly for the educational and informative purposes. This material is distributed without profit. >> Selling Sickness to the Well >> A new book looks at how pharmaceutical companies are using aggressive [quoted text clipped - 30 lines] > Pharmaceuticals. "That's a tremendously positive impact on the public's > health." Gee, so that was planned all along? We didn't even need the direct to the consumer advertising, just the Lipitor, to get to see the doctor. That first year off the Lipitor, we had over 52 appointments with specialists and major tests (biopsy, MRI, PET, nerve conduction, NP, etc.) in search of how to keep my husband alive and restore his health after the debilitating and disabling adverse effects he suffered on 10mg Lipitor for 4 years. Now, over 3 1/2 years off the Lipitor, we still get to go see our doctors often. Just this week, we got to see the Urgent Care doctor, the Emergency Room doctor, the Internist and a specialist, all thanks to the ongoing nightmare of damage done by the Lipitor. I can see it now, a new direct-to-the-consumer ad campaign, not mentioning Lipitor, just promising "YOU WILL NEVER BE LONELY AGAIN......Thank Pfizer!" ><snip> >Pfizer will also be doing more advertisements that focus on diseases, >not individual drugs. For instance, an advertisement might raise >awareness about high cholesterol, but not mention Pfizer's top-selling >Lipitor. > Selling Sickness to the Well Thanks Zee! Bill Look at the reviews here some time. http://www.amazon.com/exec/obidos/tg/detail/-/0375508465/qid=1123018096/s r=1-3/ref=sr_1_3/002-7144342-8957643?v=glance&s=books SignatureGarden Shade Zone 5 in a Japanese Jungle manner. This article is posted under fair use rules in accordance with Title 17 U.S.C. Section 107, and is strictly for the educational and informative purposes. This material is distributed without profit. Yes. I've read bits and pieces of all of them. But there's soooo much. Right now, reading this one. The co-author is Canuck. (Shhh. Don't tell SlasherBoi Harris). Zee > > Selling Sickness to the Well > [quoted text clipped - 11 lines] > This article is posted under fair use rules in accordance with Title 17 U.S.C. Section 107, and is strictly for the educational and informative purposes. > This material is distributed without profit. > Look at the reviews here some time. > > http://www.amazon.com/exec/obidos/tg/detail/-/0375508465/qid=1123018096/s > r=1-3/ref=sr_1_3/002-7144342-8957643?v=glance&s=books COMMENT: > Look at the reviews here some time. > > http://www.amazon.com/exec/obidos/tg/detail/-/0375508465/qid=1123018096/s > r=1-3/ref=sr_1_3/002-7144342-8957643?v=glance&s=books COMMENT From a doctor of medicine: I don't think my blood pressure can stand much of this book. I'm taking a "me-too" blood pressure drug, too. But one that (at last) has no side effects. According to this book, I'm deriving no benefit from the stuff (since consumers are said not to benefit from me-too drugs), and thus, I should still be taking Aldomet, or whatever the proto-primal blood pressure pill is considered to be. Well, I refuse to take Aldomet. Marcia Angell is a physician and former editor of the New England Journal of Medicine (NEJM). Supposedly, that makes her uniquely qualified to write a nasty book about drug companies, which she has. But somehow, she appears to have quit paying attention to her own professional behavior. For example, I'll bet she doesn't prescribe Aldomet for all her hyertensive patients, either, but instead something developed in the last couple of decades (i.e., a me-too drug). Of course, it's rather difficult to define what a me-too drug is. Dr. Angell opines that it's a minor change in a same basic molecular entity. Sort of like the difference between Vioxx and Celebrex, which is to say, the drug now off the market due to side effects, vs. the one still sold. Or perhaps between Rezulin and Avandia. You remember Rezulin? The premier drug in its class, now off the market for causing liver failure? Which a little tweeking of the molecule prevented. It seems there's a problem with Angell's argument-- it costs a lot of money to do tweaking, and tweaking is how people in technology get things right. Dr. Angell wants people to just stop that tweaking. At least when it comes to drugs. So perhaps we would and should be stuck with Rezulin and Vioxx, and perhaps Inderal and penicillin G? But who will we blame for THAT? Dr. Angell spends some time arguing that drug companies spend all their research money on me-too drugs for high blood pressure and depression, instead of drugs for killer diseases in third world countries. But, now a second problem: WHY exactly are the third world's medical problems to be laid at the door of drug companies? After all, the agricultural industry in the West spends a lot of time putting expensive foods like steak and ham on the tables of Americans and Canadians, while children in African starve for lack of a little of the grain we feed these expensive animals. But why don't we read about "me-too Canadian Bacon"? Strangely, there are no progressive books about "Big Farm-a" in which the starving children of Africa are discussed. Why? Because even the Left cannot go that far, without losing their straight faces. And ours. So what is so special about the technology of the drug industry, which allows this kind of argument to happen? Which allows an entire industrial sector in the West to get blamed for some of the poverty in the Third World (say what??). My own feeling is that it's because most of us understand food a little better than drugs, which is why we end up listening to doctors like Angell when it comes to judging drugs. And why we don't feel that the average North American farmer (say) has some secret black spot of evilness and greed which presents him from thinking about starving Africans rather than ham-eating Canadians. But are willing to allow that the same may not be the case with drug company executives.... And so we come to another problem. Just how ARE the public and doctors to find out about the latest medical research involving drugs? Dr. Angell doesn't like most drug advertising. Certainly not direct advertising to patients, so that means she really wants doctors to control the information flow. And she doesn't like drug company advertising even to doctors when it involves giving them small gifts, or even taking up much of their time. However, it seems that time reading ads in magazines is not to be counted. Here is the problem. Dr. Angell was editor of a journal which informs doctors of the latest breakthroughs in medicine (that's education!), but that journal, the New England Journal of Medicine, would simply not survive without massive drug company advertising. Most of their bills are paid that way, just like the doctor-education companies that Dr. Angell has problems wants to do away with. Therefore, it is a fact that Big Pharma paid most of Dr. Angell's salary for years. Thus, not only did drug company money make the modern NEJM possible, but Dr. Angell herself spent a long time sucking full strength on the drug company money teat, while now accusing doctors of putting a little milk in their coffee. Now, it would be one thing if Dr. Angell had seen the light, had the scales fall from her eyes, and had lost her job as NEJM editor in a titanic battle to wean them from drug company advertising. I would love that story! But if that happened, the story would be too good to omit from her book, and it's not there. So I presume it didn't happen (unless the woman is not only saintly but modest also--corrections invited). Instead, I presume she left her job or was fired, and THEN began to become angry at the money people behind what she did for a living. That's a much more familiar and human story. But one expects people who live it, to have some self-insight. Dr. Angell worked in the very industry that she wants to destroy in its present form, which is getting information to doctors on the ticket of Big Pharma. It's one thing to do something antisocial (though profitable) for a living, but it's something else to be fired and THEN suggest that everyone ELSE not do it. Please! We'd all like drug companies to not pay for so much medical education, myself included. It distorts facts. But Dr. Angell made her living as a broker at this game, and never found a solution for it, except to quit or be kicked out. Nor does she really suggest one in her book, either, apparently, except that doctors need to spend their own money. As though doctors didn't already spend enough on their educations. I don't think THAT will work. I want to be fair. This is not to say that some of Angell's "fixes" don't make sense. It would be good (as Angell points out) if the NIH, in their grant processing, looked very hard at the design of trials to make sure that generic drugs and non-drug therapies didn't get short shrift in therapy trial designs. And it would be nice if the FDA's regulations didn't put the economic bar so high on development of new drugs. But a book fully addressing all this would have had to put the "blame" in many places for the distressing fact that we know more about new drugs than we'd like to in medicine, and less that we'd like to about almost everything else. And some of that blame would have to go to places where drug companies could not be blamed for it. The truth is the FDA has every incentive not to speed drug development if it carries any risks, even if they never took a nickel from Pharma. Why? Because the FDA isn't ill or dying, and the only pain it feels is political pain, when it approves a new drug which causes problems later. So the immortal FDA is naturally far more conservative than patients and doctors are about trying new treatments, and that's not good. A book about drug-related evils in the medical world should at least acknowledge this very simple one. I have a last problem with this book, and that's one of economic honesty. Dr. Angell looks at the profits the top 10 drug companies made up to 2002, and then cuts off her analysis there. But those same companies took quite a beating in 2003 and 2004 (Vioxx!), and some notice of that in the book, would have been instructive. It's not like the data had no time to make into the manuscript in this electronic era-- these companies report quarterly, and we well know editing is now done by email at the speed of light. Basically, the latest drug company profit figures were inconvenient to Dr. Angell's arguments. But leaving out inconvenient data is dishonest. Here's an economic truth that Dr. Angell doesn't confront. Drug discovery is risky, and (despite what you would think from this book) there is in fact no license which congress has somehow given the drug companies which allows them to print money. (A license to practice medicine would actually be closer to such a thing, but I won't go there). The point about Big Pharm and its supposed guaranteed profits, should be obvious. Why? If it weren't true, then anybody who needed money in medicine could simply make all they liked, by **investing in a small stock fund made of the 10 top drug companies.** The NEJM could do this to run itself, and could then stop accepting specific drug advertising. Medical schools could do it, and could then stop accepting deals with specific drug companies. Even people feeling the pinch of expensive drugs in their lives could make up for it, by re-financing the home and putting the proceeds into a pharma sector stock fund, and then simply using the profits to buy Crestor with. There's not limit: charities who want new drugs for children in African could finance their development with drug company stock-funds also. It's all so simple, if the world is as Dr. Angell paints it. Except, in real life, it wouldn't work. In real life, the last two years would have bankrupted anybody who wanted to try it. And when Dr. Angell comes to grips with this simple fact, she (and all who criticize the fat-cats in pharma) will have a better understanding of just how it is that we win even the knowledge of drugs that forms the basis of standard medical practice. Fact: we do it at great risk. And if you don't think so, let's see you put YOUR money where your mouth is. When we win the knowledge of how to treat a disease with a drug, we do so ONLY because our legal system has "figured out" how to make people who benefit from the knowledge, pay for it. When we stop doing that, new knowledge will mostly go away (I won't go into that, but see the case of India, which suffered a 95% collapse in drug discovery when they temporarily stopped protecting it with IP rights). The solution, then, is not so much to attack medical drug and device companies, but to adopt some of their methods, and to structure a patent system and discovery system which will allow the drug industry's methods and progress to become available in ALL areas of medical care. THEN, we'll really have medical progress, which is knowledge progress, on all fronts. Steve Harris, MD (And no, I don't work for the pharm industry, and never have). >> Look at the reviews here some time. >> [quoted text clipped - 9 lines] > > COMMENT From a doctor of medicine: > Here is the problem. Dr. Angell was editor of a journal which informs > doctors of the latest breakthroughs in medicine (that's education!), > but that journal, the New England Journal of Medicine, would simply not > survive without massive drug company advertising. Most of their bills > are paid that way, There is no reason why the AMA's expenses have to be so high that they need to depend on drug advertising to run a journal. Other disciples have loads of journals which run quite nicely without ads, mainly because they are not available or needed. Medicine is big, big money, and there is no reason for this. It is simply the burden which makes USA medicine the most expensive in the world for horribly marginal benefits over Canada or Europe as a whole, where results are better and expenses run HALF what they are here. Drug companies are only one fraction of the problem, but we in the USA do seem to pay for drug development for the rest of the world. If the AMA wanted to get rid of drug ads, it could do so tomorrow and survive nicely. ASR and AJS do not do drug ads....no need. > There is no reason why the AMA's expenses have to be so high that they > need to depend on drug advertising to run a journal. Other disciples have > loads of journals which run quite nicely without ads, mainly because they > are not available or needed. COMMENT: Oh, really? Okay, George, let me call you on that. Name me some peer-reviewed professional journals that go for $3.50 an issue to non-society members (since otherwise society dues count), and which do not charge a per-page publication-defrayment charge to authors (which in many other smaller medical journals goes can run $70 to 100 per page), and carry NO advertising. This should be amusing. Don't try to BS me, because I *WILL* check what you come up with. >If the > AMA wanted to get rid of drug ads, it could do so tomorrow and survive > nicely. ASR and AJS do not do drug ads....no need. COMMENT: Another person deciding what other people outside their profession and institutions, of which they know nothing, NEED. Are you Canadian, George? Or just one of those academic socialists who is disconnected even from the finances of the academic institution he belongs to? You're certainly not a department chairmen, or you wouldn't be so cavelier about how much money people and institutions NEED to opperate. SBH It really is quite an expensive process to produce a quality medical journal. It's an intensive review process. The number of submissions is enormous. Journals typically try to provide discounts for medical schools, students, and residents, who can't afford the full price of the journal otherwise. That costs can be defrayed via adds is not a bad thing so long as equal advertising is assured. >> There is no reason why the AMA's expenses have to be so high that they >> need to depend on drug advertising to run a journal. Other disciples [quoted text clipped - 29 lines] > > SBH > > There is no reason why the AMA's expenses have to be so high that they > > need to depend on drug advertising to run a journal. Other disciples have [quoted text clipped - 28 lines] > > SBH Seems he is making a list and checking twice. He "WILL" check . All my goodness!! Must be special kind of guy or is that god speaking? I'm really scared as I know the truth resides in something he was assigned to read. Talk of socialist inclinations ...no comment. Robert is this enough treating Sbhubris with respect? Bill SignatureGarden Shade Zone 5 in a Japanese Jungle manner. This article is posted under fair use rules in accordance with Title 17 U.S.C. Section 107, and is strictly for the educational and informative purposes. This material is distributed without profit. > In article <1123083772.972863.277780@g44g2000cwa.googlegroups.com>, > Seems he is making a list and checking twice. > > He "WILL" check . All my goodness!! > > Must be special kind of guy or is that god speaking? COMMENT: Nope, just somebody giving notice that I won't let you get away with giving obviously wrong statistics here, as part of some bogus argument against economics or science in general and medical science in particular. Anymore than I expect to be able to get away with it myself. Sharon Hope insisted on giving incorrect data about Lipitor side effects in PIs and study results, and got her arugment handed back to her in thin slices. Not long before that I made the remark that HRT doesn't increase incontience in women, and got myself shown that the latest and best studies show otherwise. Wups, I was out of date. We all stand equal before the study results. The only way of trying to duck out of THAT is to accuse the study reporters and designers of gross dishonesty, graft, and general wide conspiracy (since they have make independent results from different groups agree, too). Which tactic of course has been tried here repeatedly, though not by me. But we have a spacial pen for paranoids and conspiracy theorists here on sci.med also. It's not a nice place to be, because you lose a lot of credibility rattling those bars. > I'm really scared as I know the truth resides in something he was > assigned to read. Talk of socialist inclinations ...no comment. COMMENT Feel free to comment all you like. You can claim the TRUTH resides in anything you like. Just be prepared to take the heat for what you claim. It's called "responsiblity." SO you are going to play the defiant student and claim the truth isn't in anything you were "assigned" to read? LOL. Guess what, this is the adult world, and it (mostly) doesn't operate that way. Nobody assigns you anything, and you can believe whatever you like. You can believe in a hollow earth and qi and flying saucers. All society demands is that you follow certain laws (and traffic rules if you drive). You can refuse to read at all, if you like, so long as you know what the traffic signs mean. The world of science and medicine has its own standards, and if you don't agree with them, nobody will put you in the pokey the way they will if you presistantly refuse to agree on what a stop sign rqeuires you to do. So far as *science* goes, you're free to join alt.kooks or play in the corner. Or you can come here and argue your viewpoint. > Robert is this enough treating Sbhubris with respect? COMMENT: LOL. You can treat ME any way you like. Whatever respect a poster get on usenet, or not, is earned by what they write over the long haul. The only way to duck THAT is to change your name and/or go anonymous. Changing your name just resets you back to zero (until you're recognized). As for going anonymous, it sets you back many points from post #1. Some people manage to make up for that, and others never do. SBH > > In article <1123083772.972863.277780@g44g2000cwa.googlegroups.com>, > [quoted text clipped - 60 lines] > > SBH I stand by what I write for over 20 years. William Wagner B2wagner Bill Wagner Always a defiant student till I die. Thanks for the compliment. Also also a retraction on the Hubris add on to SB. Not called for apologia given. Bill SignatureGarden Shade Zone 5 in a Japanese Jungle manner. This article is posted under fair use rules in accordance with Title 17 U.S.C. Section 107, and is strictly for the educational and informative purposes. This material is distributed without profit. >> > In article <1123083772.972863.277780@g44g2000cwa.googlegroups.com>, >> [quoted text clipped - 76 lines] > > Bill Are you, like, uh, nuts? Get out in the sun more. L. > >> > In article <1123083772.972863.277780@g44g2000cwa.googlegroups.com>, > >> [quoted text clipped - 88 lines] > > L. What is it this time L? A new computer again. Remember you kill filed me. I'm tired of telling you to get it right. I am insane...Happy....?? You are such a well balanced individual that I imagine folks are seeking you out for dinner conversation. Charming comes to mind. Thanks for all your words of wisdom usually in a line or two. Look in the mirror sweet heart. You contribute so much I can't remember any of your drivel. Write a poem! Bill SignatureGarden Shade Zone 5 in a Japanese Jungle manner. This article is posted under fair use rules in accordance with Title 17 U.S.C. Section 107, and is strictly for the educational and informative purposes. This material is distributed without profit. >> > In article <1123083772.972863.277780@g44g2000cwa.googlegroups.com>, >> [quoted text clipped - 77 lines] > > Bill Well done! Apparently the web bots have stumbled onto some troubling posts. Witness the EVERYONE-MUST-TAKE-STATINS-AND-LIKE-IT goon squad that recently descended to play tag team flame war. Somehow they have given themselves to believe that unfounded sarcasm and rudeness make their positions credible. Many of us read their posts and visualize Rumplestilskin in his last moments. >> In article <1123083772.972863.277780@g44g2000cwa.googlegroups.com>, > > Sharon Hope insisted on giving incorrect data about Lipitor > side effects in PIs and study results, and got her arugment handed back > to her in thin slices. Interesting, all my posts were supplied with source links and the math (correct and decimal error, favoring the other side) were carefully explained. Distinctly unlike the detractors' comments. Bottom line, regardless of all the uproar, is that amnesia occurs far more frequently among Lipitor users than among the general population. But then, multiple published books and studies alread attest to this. That you have some snide and disrespectful comment for each does not diminish these well-referenced published sources. >>> In article <1123083772.972863.277780@g44g2000cwa.googlegroups.com>, >> [quoted text clipped - 14 lines] > you have some snide and disrespectful comment for each does not diminish > these well-referenced published sources. You are absolutely lying again and again. You did provide multiple reference but you lied by quoting them falsely. Did you not say that 2% of people on Lipitor experience Amnesia according to the Lipitor PI? Is this not false? If not provide the quote from the Lipitor PI. Did you not say that .0025% of the General Population experience amnesia? Is that not false? If not, provide the quote to show that it is true. Did you not then compare the two false numbers above to each other to come to your false conclusion without even having any idea if the populations were the same. (age, race, etc.) If not, show how you reached your conclusion. And did you not ignore multiple studies that contradicted your lies? Bill Any and all can see I posted the PI accurately. Further, I posted the link to the PI. It was your responses that were not factual. >>>> In article <1123083772.972863.277780@g44g2000cwa.googlegroups.com>, >>> [quoted text clipped - 36 lines] > > Bill > Any and all can see I posted the PI accurately. > > Further, I posted the link to the PI. > > It was your responses that were not factual. You are lying again. The PI says that less than 2% of Lipitor users had amnesia. That could be 1 in a million. You claimed it was 2%. Here is what the PI said. How can you deny it. Bill http://www.lipitor.com/cwp/appmanager/lipitor/lipitorDesktop?_nfpb=true&_pageLab el=prescribingInformation http://tinyurl.com/2bxy5 "The following adverse events were reported, regardless of causality assessment in patients treated with atorvastatin in clinical trials. The events in italics occurred in 2% of patients and the events in plain type occurred in <2% of patients. Body as a Whole: Chest pain, face edema, fever, neck rigidity, malaise, photosensitivity reaction, generalized edema. Digestive System: Nausea, gastroenteritis, liver function tests abnormal, colitis, vomiting, gastritis, dry mouth, rectal hemorrhage, esophagitis, eructation, glossitis, mouth ulceration, anorexia, increased appetite, stomatitis, biliary pain, cheilitis, duodenal ulcer, dysphagia, enteritis, melena, gum hemorrhage, stomach ulcer, tenesmus, ulcerative stomatitis, hepatitis, pancreatitis, cholestatic jaundice. Respiratory System: Bronchitis, rhinitis, pneumonia, dyspnea, asthma, epistaxis. Nervous System: Insomnia, dizziness, paresthesia, somnolence, amnesia, abnormal dreams, libido decreased, emotional lability, incoordination, peripheral neuropathy, torticollis, facial paralysis, hyperkinesia, depression, hypesthesia, hypertonia. Musculoskeletal System: Arthritis, leg cramps, bursitis, tenosynovitis, myasthenia, tendinous contracture, myositis. Skin and Appendages: Pruritus, contact dermatitis, alopecia, dry skin, sweating, acne, urticaria, eczema, seborrhea, skin ulcer. Urogenital System: Urinary tract infection, urinary frequency, cystitis, hematuria, impotence, dysuria, kidney calculus, nocturia, epididymitis, fibrocystic breast, vaginal hemorrhage, albuminuria, breast enlargement, metrorrhagia, nephritis, urinary incontinence, urinary retention, urinary urgency, abnormal ejaculation, uterine hemorrhage. Special Senses: Amblyopia, tinnitus, dry eyes, refraction disorder, eye hemorrhage, deafness, glaucoma, parosmia, taste loss, taste perversion. Cardiovascular System: Palpitation, vasodilatation, syncope, migraine, postural hypotension, phlebitis, arrhythmia, angina pectoris, hypertension. Metabolic and Nutritional Disorders: Peripheral edema, hyperglycemia, creatine phosphokinase increased, gout, weight gain, hypoglycemia. Hemic and Lymphatic System: Ecchymosis, anemia, lymphadenopathy, thrombocytopenia, petechia." >>>>> In article <1123083772.972863.277780@g44g2000cwa.googlegroups.com>, >>>> [quoted text clipped - 36 lines] >> >> Bill > Any and all can see I posted the PI accurately. > > Further, I posted the link to the PI. > > It was your responses that were not factual. In addition to your lies about the Lipitor PI you have been unable to respond to any of the following: Did you not say that .0025% of the General Population experience amnesia? Is that not false? If not, provide the quote to show that it is true. Did you not then compare the two false numbers above to each other to come to your false conclusion without even having any idea if the populations were the same. (age, race, etc.) If not, show how you reached your conclusion. And did you not ignore multiple studies that contradicted your lies? >>>>> In article <1123083772.972863.277780@g44g2000cwa.googlegroups.com>, >>>> [quoted text clipped - 36 lines] >> >> Bill The post: >===start quoted post========= >Newsgroups: sci.med.cardiology >Sent: Saturday, July 23, 2005 1:51 PM >Subject: Lipitor users experience Amnesia 38,461% more frequently than the >normal >population > In a recent discussion, I was reminded that the PI for Lipitor mentions > Amnesia as a known adverse effect at a rate ~2% or less. [quoted text clipped - 31 lines] > 23.5% of the over 50 years old population experiences Amnesia (23.5 per > 100,000 people) SH: This was incorrect math, should have been 0.0235% for 50 years and over - but then the parameters were given, as was the link they came from, so any and all could check, and correct if necessary, the calculation. > So, that equates to: > [quoted text clipped - 60 lines] > to your false conclusion without even having any idea if the populations > were the same. (age, race, etc.) What part of "the general population" don't you understand? > If not, show how you reached your conclusion. > > And did you not ignore multiple studies that contradicted your lies? Again, you have pretended something that, if it existed, you would be able to supply links for. Further, conflicting studies exist in many areas. So what? The >2% comes from Pfizer on the Lipitor PI, so, once again, if you see that as a lie, you should complain to the FDA and to Pfizer, as it would be their lie. >>>>>> In article <1123083772.972863.277780@g44g2000cwa.googlegroups.com>, >>>>> [quoted text clipped - 38 lines] >>> >>> Bill > The post: >>===start quoted post========= [quoted text clipped - 5 lines] >> In a recent discussion, I was reminded that the PI for Lipitor mentions >> Amnesia as a known adverse effect at a rate ~2% or less. It does say 2% or less. That could be 1 in a million. You assumed 2% and continued to defend that - saying that is what the PI says. That is wrong. >> BTW, all the statin drugs have similar adverse effects, so that would >> include Atorvastatin (aka Lipitor), fluvastatin (aka Lescol), lovastatin [quoted text clipped - 21 lines] >> >> 2% on Lipitor experience Amnesia You see your error. What you say here contridicts what you say directly above. >> 0.0052% of the normal population experiences Amnesia (5.2 per 100,000 >> people) That is also false. The original study said: "Transient global amnesia: clinical characteristics and prognosis. Miller JW, Petersen RC, Metter EJ, Millikan CH, Yanagihara T. We studied the clinical characteristics of transient global amnesia (TGA) in 277 patients with an average follow-up of 80 months. The syndrome occurred most frequently after age 50. There was a history of migraine in 14.1% and cerebrovascular diseases in 11.2% of patients, but these conditions were usually not temporally linked to TGA. Characteristic antecedent events and activity such as exertion existed in 33.4%. The incidence of TGA was 5.2 per 100,000 per year in Rochester, MN. Although 23.8% of the patients had recurrent episodes, they were not at increased risk for subsequent stroke." What they are talking about is Transient Global amnesia. Is that not true? It says it right there. This is a particular type of Amnesia. You can not claim that TGA = all forms of amnesia. Further the population of Rochester is not represenitive of the US. >> 23.5% of the over 50 years old population experiences Amnesia (23.5 per >> 100,000 people) [quoted text clipped - 67 lines] > > What part of "the general population" don't you understand? I understand that. The study was in Rochester and you have no idea of the population of the Lipitor study. You lied about it again and again. You have no quote that says .0052% of the general population experiences amnesia. If you, do supply it. You just make things up and then make irrelevant comments about them as if it were some sort of argument. You also have nothing to say that the Lipitor study reflected the same population. If you do supply it. You also have nothing to support your claim that 2% of Lipitor users experience amnesia. So you compare 2 false numbers with populations that you have not proved to be the same to come up with a false conclusion, What about the above is incorrect? >> If not, show how you reached your conclusion. >> [quoted text clipped - 3 lines] > to supply links for. Further, conflicting studies exist in many areas. So > what? You don't have a study. I have provided this link several times and quoted the entire text. http://www.medscape.com/viewarticle/458867_print "Statin-Associated Memory Loss: Analysis of 60 Case Reports and Review of the Literature Leslie R. Wagstaff, Pharm.D., Melinda W. Mitton, Pharm.D., Beth McLendon Arvik, Pharm.D., P. Murali Doraiswamy, M.D. Pharmacotherapy 23(7):871-880, 2003. © 2003 Pharmacotherapy Publications Posted 07/25/2003" "Conclusion: Current literature is conflicting with regard to the effects of statins on memory loss. Experimental studies support links between cholesterol intake and amyloid synthesis; observational studies indicate that patients receiving statins have a reduced risk of dementia. However, available prospective studies show no cognitive or antiamyloid benefits for any statin. In addition, case reports raise the possibility that statins, in rare cases, may be associated with cognitive impairment, though causality is not certain." "The cardiovascular benefits of statins are established; we reviewed the emerging links between statins and human memory. Research using MedWatch data has many limitations, such as incomplete data, lack of controls, and various biases, such as detection or attribution bias. Nevertheless, MedWatch reports can provide a signal for infrequent adverse events. In particular, the reports of statin-associated memory loss suggest that some patients may experience subjective memory loss after statin therapy is begun. In some patients the memory loss appeared to resolve after discontinuation of the statin. The relationship between statin dosage, lipid levels, and memory loss could not be determined in our series because of lack of information. More reports of memory loss were associated with lipophilic statins (e.g., atorvastatin and simvastatin), although it is not clear whether atorvastatin actually crosses the blood-brain barrier. Until causality is assessed in more rigorous studies, awareness of this issue may help clinicians better counsel patients and improve monitoring of adverse events. Neither observational studies nor case reports can prove causality. There is no prospective evidence of any neurocognitive benefits or risks associated with statins. Overall, statins clearly offer substantial cardiovascular benefits, and a small number of case reports of memory loss should not discourage appropriate statin administration. Because cholesterol synthesis is essential for neuronal function, greater attention to cognitive outcomes in patients receiving statins is warranted, especially in populations already at risk for memory loss. Although the evidence does not yet support routine administration of serial bedside memory tests in otherwise healthy patients receiving statins, clinicians must be able to detect memory changes among their patients and routinely inquire about mental status. Given the high background rate of memory loss in the population receiving statins, prospective controlled studies comparing the short- and long-term effects of various statins on cognitive function are warranted." It gives an analysis of many articles on the topic pro and con. You may wish to look through its references particularly 1.. Heart Protection Study Collaborative Group. MRC/BHF heart protection study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomized placebo-controlled trial. Lancet 2002;360:7-22. > The >2% comes from Pfizer on the Lipitor PI, so, once again, if you see that > as a lie, you should complain to the FDA and to Pfizer, as it would be their > lie. I provided the quote for you showing showing that is not true. The PI said it was less than 2%. You provide a quote showing it is 2% or greater since you are making the claim. Here is a link. Anyone can check out if you or I am lying. http://www.lipitor.com/Images/Lipitor/Lipitor_PI.pdf This shows what you do. It clearly says less than 2%, But you claim it says greater than or equal to 2%. It is on page 4 just after table 7 and I urge all to check it out. Bill >>>>>>> In article <1123083772.972863.277780@g44g2000cwa.googlegroups.com>, >>>>>> [quoted text clipped - 36 lines] >>>> >>>> Bill >> The post: >>>===start quoted post========= [quoted text clipped - 8 lines] > It does say 2% or less. That could be 1 in a million. You assumed 2% and > continued to defend that - saying that is what the PI says. That is wrong. Read the preface to that table. Pfizer wrote it, not me. It is NOT 1 in a million. PFIZER WROTE AND THE FDA APPROVED: " In controlled clinical studies of 2502 patients, < 2% of patients were discontinued due to adverse experiences attributable to atorvastatin. " NOT 1 in a Million. >>> BTW, all the statin drugs have similar adverse effects, so that would >>> include Atorvastatin (aka Lipitor), fluvastatin (aka Lescol), [quoted text clipped - 283 lines] >>>>> >>>>> Bill >>> The post: >>>>===start quoted post========= [quoted text clipped - 18 lines] > > NOT 1 in a Million. That is not even on the subject of amnesia. Also 1 in a million could be less than 2%. It demonstrates your inability to think rationally on this subject. >>>> BTW, all the statin drugs have similar adverse effects, so that would >>>> include Atorvastatin (aka Lipitor), fluvastatin (aka Lescol), lovastatin [quoted text clipped - 27 lines] >> You see your error. What you say here contridicts what you say directly >> above. You did not address the conficts between your two statements and that the Pfizer PI clearly says that less than 2% on the patients on Lipitor experience amnesia. Not 2% as you claimed. >>>> 0.0052% of the normal population experiences Amnesia (5.2 per 100,000 >>>> people) [quoted text clipped - 19 lines] >> claim that TGA = all forms of amnesia. Further the population of Rochester >> is not represenitive of the US. You did not address any of this. What you claimed as the rate for amnesia was really the rate for TGA. >>>> 23.5% of the over 50 years old population experiences Amnesia (23.5 per >>>> 100,000 people) [quoted text clipped - 177 lines] >> >> Bill You simply ignore your errors. Bill >>>>>>>>> In article <1123083772.972863.277780@g44g2000cwa.googlegroups.com>, >>>>>>>> [quoted text clipped - 38 lines] >>>>>> >>>>>> Bill >>>> The post: >>>>>===start quoted post========= [quoted text clipped - 23 lines] > less than 2%. It demonstrates your inability to think rationally on this > subject. Read the PI and take your argument to Pfizer. I have repeated what they wrote and the FDA approved. Your pro-statin religion is rendering you incapable of accepting any factual information that is counter to your pro-statin beliefs. Talk to Pfizer about putting together an alternate PI for those of your pro-statin religion that is less threatening, and omits all the adverse effects data. Oh, wait, no need to go to all that expense - you look at it over and over and still can't see any of the Pfizer evidence. If that works for you, great. Good for you. >>>>> BTW, all the statin drugs have similar adverse effects, so that would >>>>> include Atorvastatin (aka Lipitor), fluvastatin (aka Lescol), [quoted text clipped - 301 lines] >>>>>>> >>>>>>> Bill > Read the PI and take your argument to Pfizer. I have repeated what they > wrote and the FDA approved. You are simply lying. Right below Table 7 it says the following. Indicating that less than 2% of the people on Lipitor had amnesia. You claimed it was 2%. Where exactly does it say that? (Amnesia is not in italics.) I put some ***s next to the relevant part. What about that do you not see. I have pointed out where in the PI my statement is confirmed. If you are not lying you should be able to point to where yours is confirmed. http://www.lipitor.com/cwp/appmanager/lipitor/lipitorDesktop?_nfpb=true&_pageLab el=prescribingInformation http://tinyurl.com/2bxy5 The following adverse events were reported, regardless of causality assessment in patients treated with atorvastatin in clinical trials. The events in italics occurred in greater than or equal to 2% of patients and the events in plain type occurred in less than 2% of patients. Body as a Whole: Chest pain, face edema, fever, neck rigidity, malaise, photosensitivity reaction, generalized edema. Digestive System: Nausea, gastroenteritis, liver function tests abnormal, colitis, vomiting, gastritis, dry mouth, rectal hemorrhage, esophagitis, eructation, glossitis, mouth ulceration, anorexia, increased appetite, stomatitis, biliary pain, cheilitis, duodenal ulcer, dysphagia, enteritis, melena, gum hemorrhage, stomach ulcer, tenesmus, ulcerative stomatitis, hepatitis, pancreatitis, cholestatic jaundice. Respiratory System: Bronchitis, rhinitis, pneumonia, dyspnea, asthma, epistaxis. ******Nervous System: Insomnia, dizziness, paresthesia, somnolence, amnesia, abnormal dreams, libido decreased, emotional lability, incoordination, peripheral neuropathy, torticollis, facial paralysis, hyperkinesia, depression, hypesthesia, hypertonia. Musculoskeletal System: Arthritis, leg cramps, bursitis, tenosynovitis, myasthenia, tendinous contracture, myositis. Skin and Appendages: Pruritus, contact dermatitis, alopecia, dry skin, sweating, acne, urticaria, eczema, seborrhea, skin ulcer. Urogenital System: Urinary tract infection, urinary frequency, cystitis, hematuria, impotence, dysuria, kidney calculus, nocturia, epididymitis, fibrocystic breast, vaginal hemorrhage, albuminuria, breast enlargement, metrorrhagia, nephritis, urinary incontinence, urinary retention, urinary urgency, abnormal ejaculation, uterine hemorrhage. Special Senses: Amblyopia, tinnitus, dry eyes, refraction disorder, eye hemorrhage, deafness, glaucoma, parosmia, taste loss, taste perversion. Cardiovascular System: Palpitation, vasodilatation, syncope, migraine, postural hypotension, phlebitis, arrhythmia, angina pectoris, hypertension. Metabolic and Nutritional Disorders: Peripheral edema, hyperglycemia, creatine phosphokinase increased, gout, weight gain, hypoglycemia. Hemic and Lymphatic System: Ecchymosis, anemia, lymphadenopathy, thrombocytopenia, petechia. > Your pro-statin religion is rendering you incapable of accepting any factual > information that is counter to your pro-statin beliefs. You are simply lying once more because you have to. You do not have any truth to support your statements. Did I not already acknowledge several times that I accept the fact that statins have side effects and in some cases serious ones? Bill >Talk to Pfizer about putting together an alternate PI for those of your >pro-statin religion that is less threatening, and omits all the adverse >effects data. > Oh, wait, no need to go to all that expense - you look at it over and over > and still can't see any of the Pfizer evidence. [quoted text clipped - 303 lines] >>>>>>>> >>>>>>>> Bill >> Read the PI and take your argument to Pfizer. I have repeated what they >> wrote and the FDA approved. > > You are simply lying. You simply have not gotten over the schoolyard thrill of chanting liar liar pants on fire. If you had bothered to pay attention in class AFTER recess, you would have learned what the characters " ~2% or less" mean. At least, I hope it is just a childish thrill. I do notice that every time you call me a liar it is a lead in to a misrepresentation of something I posted that you have twisted. (If it were you, you would call your misrepresentation a lie, and yourself a liar.) >Right below Table 7 it says the following. Indicating that less than 2% of >the people on Lipitor had amnesia. You claimed it was 2%. No, the post said " ~2% or less" - Here is the OP from that thread in its entirety: Newsgroups: sci.med.cardiology Sent: Saturday, July 23, 2005 1:51 PM Subject: Lipitor users experience Amnesia 38,461% more frequently than the normal population In a recent discussion, I was reminded that the PI for Lipitor mentions Amnesia as a known adverse effect at a rate ~2% or less. BTW, all the statin drugs have similar adverse effects, so that would include Atorvastatin (aka Lipitor), fluvastatin (aka Lescol), lovastatin (aka Mevacor), pravastatin (aka Pravachol), simvastatin (aka Zocor), rosuvastatin (aka Crestor), and cerivastatin (Baycol), and now Vytorin (Zocor and Zetia (ezetimibe/simvastatin) combination). All are known to cause transient global amnesia and cognitive damage. OK, let's put this into perspective. Also, unless amnesia is witnessed, it is not recognized. The person experiencing it typically does not remember. Since no all Lipitor patients in the study were monitored 24x7, the 2% would only be those who suffered amnesia, AND were observed by someone who knew them well enough to know they had lost their memory, AND it was reported to Pfizer, AND someone associated with the study decided to add it to the list of known AEs. For example, many Lipitor patients report 'big holes' in their memory, but they do not use the term 'amnesia' when discussing or describing it. Do you think there are 2 in every 100 people NOT on statins running around with amnesia? 2 people in 100 experiencing AMNESIA is an exceedingly high percentage. 2% on Lipitor experience Amnesia 0.0052% of the normal population experiences Amnesia (5.2 per 100,000 people) 23.5% of the over 50 years old population experiences Amnesia (23.5 per 100,000 people) So, that equates to: People on LIPITOR have THREE HUNDRED EIGHTY FOUR TIMES THE RATE OF AMNESIA OVER THE GENERAL POPULATION. Lipitor users have 384.6 TIMES the normal frequency of Amnesia!!!!!!!!!!!!! That is 38,461% MORE AMNESIA than people NOT on Lipitor! People on LIPITOR have EIGHTY FIVE TIMES THE RATE OF AMNESIA OVER THE GENERAL OVER 50 POPULATION. Lipitor users have 85 TIMES the normal frequency of people over 50!!!!!!!!!!!!!!!!!!!!!!!!!!! That is 8,500% of the incidence of amnesia among the normal over 50 population! Reference for rate in the NORMAL population: Frequency: a.. In the US: Based on data from Rochester, Minnesota, Miller et al determined an incidence of 5.2 per 100,000. However, among individuals older than 50 years, the incidence was 23.5 per 100,000 per year. per http://www.emedicine.com/neuro/topic380.htm Transient Global Amnesia Last updated April 21, 2005 Synonyms and related keywords: transient memory loss, paroxysmal loss of memory, transient loss of memory, immediate recall ability, remote memory, retrograde memory loss, semantic memory, syntax memory, visual-spatial skills, amnesia, TGA, vertebrobasilar system, migraine variant, temporal lobe seizure, transient ischemic attack, emotional stress, cold-water exposure, Valsalva maneuver, venous anatomy anomalies, jugular vein valves, ischemia to memory areas in brain, back-pressure in jugular venous system, disruption of intracranial arterial flow, increased sympathetic activity, increased intrathoracic pressure, disrupted blood flow to thalamic structures, disrupted blood flow to mesial temporal structures, increased venous return to superior vena cava BTW, all the statin drugs have similar adverse effects, so that would include > Where exactly does it say that? (Amnesia is not in italics.) I put some > ***s next to the relevant part. What about that do you not see. [quoted text clipped - 391 lines] >>>>>>>>> >>>>>>>>> Bill >>> Read the PI and take your argument to Pfizer. I have repeated what they >>> wrote and the FDA approved. [quoted text clipped - 6 lines] > If you had bothered to pay attention in class AFTER recess, you would have > learned what the characters " ~2% or less" mean. Sharon... I have had both under and upper division statistics the symbol ~ means "about" or "approximately"... when followed by 2% or LESS ...this can be read as "about 2 % or LESS" etc etc thus...yes..it can well mean an N of 1....NOT 2% of N.. if it meant 2% for SURE,,,there would be no reason to have the symbol ~ depending upon how large N is or is not..."less than 2% can be a very small number"... and ..your continuing to intermingle the definitions of amnesia and TGA is really muddying the waters amnesia CAN be defined as what happens when taking a multitude of meds...sleepers,,psychotropics..etc... > At least, I hope it is just a childish thrill. I do notice that every > time you call me a liar it is a lead in to a misrepresentation of [quoted text clipped - 492 lines] >>>>>>>>>> >>>>>>>>>> Bill >>> Read the PI and take your argument to Pfizer. I have repeated what they >>> wrote and the FDA approved. [quoted text clipped - 6 lines] > If you had bothered to pay attention in class AFTER recess, you would have > learned what the characters " ~2% or less" mean. You have this strange need to use ridicule when it is obvious that you are wrong. I don't think I ever ridicule you, then you claim that I am being childish. Listen. Did you not say? "2% on Lipitor experience Amnesia" (In other words you contridicted yourself.) It is right from the post YOU quoted below. (Right above the .0052%) Yes or no? Is that not false? Yes or no. Did you then not take that number (2%) and compare that with a not typical form of amnesia (TGA) to conclude that 5.2 people out of 100,000 experience amnesia when in fact 5.2 people out of 100,000 experience TGA? Yes or no? Then you compared two false numbers (2%) and 5.2 out of 100,000 to counclude that people on Lipitor have 384 times the rate of amnesia as the general population. Yes or no? Bill > At least, I hope it is just a childish thrill. I do notice that every time > you call me a liar it is a lead in to a misrepresentation of something I [quoted text clipped - 477 lines] >>>>>>>>>> >>>>>>>>>> Bill > Here is the OP from that thread in its entirety: > [quoted text clipped - 30 lines] > > 2% on Lipitor experience Amnesia Shouldn't that have read "2% or less on Lipitor experience Amnesia"? L. >> Here is the OP from that thread in its entirety: >> [quoted text clipped - 34 lines] > > L. There are also many bad side effects of the standard drugs which are not recognized. Some make your situation worse, even if it is a standard treatment. Further, selling sickness to the well has gone to new lengths: everyone now is pre-diabetic, pre-hyptertensive or pre-death. .................. >>> " In controlled clinical studies of 2502 patients, < 2% of patients were >>> discontinued due to adverse experiences attributable to atorvastatin. " >>> NOT 1 in a Million. Less than 2% means 50 or less. I suspect it is more than 25, or they would have written < 1% instead. SignatureThis address is for information only. I do not claim that these views are those of the Statistics Department or of Purdue University. Herman Rubin, Department of Statistics, Purdue University hrubin@stat.purdue.edu Phone: (765)494-6054 FAX: (765)494-0558 > .................. > [quoted text clipped - 5 lines] > Less than 2% means 50 or less. I suspect it is more than > 25, or they would have written < 1% instead. No. They have only 2 catagories. More than 2% or less than or equal to 2%. There are about 100 in the less than or equal to 2% catagory and none listed as less than 1%. If they meant between 1 and 2% I think they would have said so. Since they did not, one can not assume they meant that. Bill > This address is for information only. I do not claim that these views > are those of the Statistics Department or of Purdue University. > Herman Rubin, Department of Statistics, Purdue University > hrubin@stat.purdue.edu Phone: (765)494-6054 FAX: (765)494-0558 >> .................. >> [quoted text clipped - 12 lines] > listed as less than 1%. If they meant between 1 and 2% I think they would > have said so. Since they did not, one can not assume they meant that. Where, exactly, do you see Pfizer specify on the PI that they only have 2 categories of damage done to patients by Lipitor? Again, the incidence of Transient Global Amnesia due to Lipitor is far higher than the normal population. Transient Global Amnesia is the only form of Lipitor amnesia reported on Pub Med, and in the three books available now on statin adverse effects: "Lipitor, Thief of Memory" by Duane Graveline, MD "What you must know about Statin Drugs & their Natural Alternatives" by Jay S. Cohen, MD "Statin Drugs Side Effects and the Misguided War on Cholesterol" by Duane Graveline, MD Splitting hairs between 1% and 2% of Patients on Lipitor experiencing TGA is absurd when 0.0052% of the normal population experiences Transient Global Amnesia (5.2 per 100,000 people) Keep in mind, too, that the normal population TGA reports are for all reasons, not just adverse effects of drugs (i.e., not from AE reporting). The Lipitor TGA reports come only from voluntary Adverse Event reporting by physicians. The FDA claims that no more than 10% of Adverse Events are reported under this voluntary system. So, per the FDA's own estimate, patients on Lipitor may well be experiencing Transient Global Amnesia at rates of 10% to 20%. Another reason why quibbling between 1% and 2% is such a waste of effort. That 20% on Lipitor vs 0.0052% of the normal population is a significant difference is the understatement of the year. >> This address is for information only. I do not claim that these views >> are those of the Statistics Department or of Purdue University. >> Herman Rubin, Department of Statistics, Purdue University >> hrubin@stat.purdue.edu Phone: (765)494-6054 FAX: (765)494-0558 >>> .................. >>> [quoted text clipped - 14 lines] > Where, exactly, do you see Pfizer specify on the PI that they only have 2 > categories of damage done to patients by Lipitor? They only list 2 categories for well over 100 items. They list greater than 2% and less than or equal to 2% which covers all possibilities. > Again, the incidence of Transient Global Amnesia due to Lipitor is far > higher than the normal population. Transient Global Amnesia is the only > form of Lipitor amnesia reported on Pub Med, and in the three books > available now on statin adverse effects: As I have pointed out to you several times, by definition Transient Global Amnesia lasts less than 24 hours. Is this what you are talking about in relation to Lipitor. Is this what you believe you husband has? http://serendip.brynmawr.edu/bb/neuro/neuro02/web1/mwhite.html http://www.emedicine.com/neuro/topic380.htm "The period of amnesia can last anywhere from one to twenty-four hours." From the first reference. I believe Dr. Gaveline's problems lasted more than 24 hours and thus could not be TGA. I don't understand what you are missing about this. Could you point out a single referance that descibes just one case of TGA associated with Lipitor. It must say TGA not amnesia. > "Lipitor, Thief of Memory" by Duane Graveline, MD > [quoted text clipped - 7 lines] > absurd when 0.0052% of the normal population experiences Transient Global > Amnesia (5.2 per 100,000 people) Again 1. It could be any number less than 2% which could be 5/100,000. 2. There were no instances of TGA reported in the Lipitor trials. Only Amnesia. > Keep in mind, too, that the normal population TGA reports are for all > reasons, not just adverse effects of drugs (i.e., not from AE reporting). > > The Lipitor TGA reports come only from voluntary Adverse Event reporting by > physicians. We were talking about the initial trials. > The FDA claims that no more than 10% of Adverse Events are reported under > this voluntary system. > > So, per the FDA's own estimate, patients on Lipitor may well be experiencing > Transient Global Amnesia at rates of 10% to 20%. Where does this come from? Why could there not be, say, 10% reporting myopthy and none repoting TGA. Further if 5% of the US population were on Lipitor and the TGA incidence was 10% for Lipitor than .5% of the US population would have TGA - which contidicts your 5/100,000 in the overall population. In other words if it is true that 5/100,000 have TGA than the rate for Lipitor must be low because if it were high it would make the number greater than 5/100,000. > Another reason why quibbling between 1% and 2% is such a waste of effort. > > That 20% on Lipitor vs 0.0052% of the normal population is a significant > difference is the understatement of the year. Again you are simply making up numbers. Your 20% comes from no where. And if it were true, your .0052% would be impossible. Bill >>> This address is for information only. I do not claim that these views >>> are those of the Statistics Department or of Purdue University. >>> Herman Rubin, Department of Statistics, Purdue University >>> hrubin@stat.purdue.edu Phone: (765)494-6054 FAX: (765)494-0558 >>>> .................. >>>> [quoted text clipped - 19 lines] > They only list 2 categories for well over 100 items. They list greater > than 2% and less than or equal to 2% which covers all possibilities. You have confused an observation with a policy or a category. >> Again, the incidence of Transient Global Amnesia due to Lipitor is far >> higher than the normal population. Transient Global Amnesia is the only [quoted text clipped - 3 lines] > As I have pointed out to you several times, by definition Transient Global > Amnesia lasts less than 24 hours. Thus the name. Why restate the obvious? Why the circular definition? The name is clear. >Is this what you are talking about in relation to Lipitor. Is this what you >believe you husband has? [quoted text clipped - 9 lines] > I believe Dr. Gaveline's problems lasted more than 24 hours and thus could > not be TGA. I don't understand what you are missing about this. Obviously, you have not read the book, nor the website, nor any of the many, many interviews. > Could you point out a single referance that descibes just one case of TGA > associated with Lipitor. It must say TGA not amnesia. [quoted text clipped - 7 lines] >> "Statin Drugs Side Effects and the Misguided War on Cholesterol" by Duane >> Graveline, MD You can start with the THREE BOOKS listed above, each of which have many, many reports of TGA. >> Splitting hairs between 1% and 2% of Patients on Lipitor experiencing TGA >> is absurd when 0.0052% of the normal population experiences Transient >> Global Amnesia (5.2 per 100,000 people) > > Again 1. It could be any number less than 2% which could be 5/100,000. 2. This is a complete lie, and you are fully aware of it, as the PI, which contains the information clearly states: "Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) In ASCOT (see CLINICAL PHARMACOLOGY, Clinical Studies) involving 10,305 participants treated with Lipitor 10 mg daily (n=5,168) or placebo (n=5,137), the safety and tolerability profile of the group treated with Lipitor was comparable to that of the group treated with placebo during a median of 3.3 years of follow-up. The following adverse events were reported...Amnesia" The fewest possible, per Pfizer's Lipitor population on only 10mg/day, the lowest starting dose, would have to be 1 in 5, 137. Get out your calculator (or look at the full list of calculations below): THE NUMBER OF PATIENTS WITH AMNESIA < 2% IN A POOL OF 5, 137 RANGES FROM 1 to 102 in 5, 137. Note that if it were only 1 patient in 5,137, the percentage rate is 0.0195%, which is THREE HUNDRED SEVENTY FOUR TIMES the normal rate of 0.0052% in the normal population. 374 times higher! That's 37,400% higher! That is 37,400% MORE amnesia in the Lipitor population than in the normal population. BUT, to be "less than 2%" Pfizer could have had as many as 102 patients of 5, 137. See the math (to get percentage incidence, you divide the number of people with the problem by the total number of people): NORMAL AMNESIA POPULATION PATIENTS PERCENTAGE 100000 5.2 0.000052 LIPITOR PI AMNESIA POPULATION PATIENTS PERCENTAGE 5137 102 0.019856 <--- Less than 2% 5137 101 0.019661 5137 100 0.019467 5137 99 0.019272 5137 98 0.019077 5137 97 0.018883 5137 96 0.018688 5137 95 0.018493 5137 94 0.018299 5137 93 0.018104 5137 92 0.017909 5137 91 0.017715 5137 90 0.01752 5137 89 0.017325 5137 88 0.017131 5137 87 0.016936 5137 86 0.016741 5137 85 0.016547 5137 84 0.016352 5137 83 0.016157 5137 82 0.015963 5137 81 0.015768 5137 80 0.015573 5137 79 0.015379 5137 78 0.015184 5137 77 0.014989 5137 76 0.014795 5137 75 0.0146 5137 74 0.014405 5137 73 0.014211 5137 72 0.014016 5137 71 0.013821 5137 70 0.013627 5137 69 0.013432 5137 68 0.013237 5137 67 0.013043 5137 66 0.012848 5137 65 0.012653 5137 64 0.012459 5137 63 0.012264 5137 62 0.012069 5137 61 0.011875 5137 60 0.01168 5137 59 0.011485 5137 58 0.011291 5137 57 0.011096 5137 56 0.010901 5137 55 0.010707 5137 54 0.010512 5137 53 0.010317 5137 52 0.010123 5137 51 0.009928 5137 50 0.009733 5137 49 0.009539 5137 48 0.009344 5137 47 0.009149 5137 46 0.008955 5137 45 0.00876 5137 44 0.008565 5137 43 0.008371 5137 42 0.008176 5137 41 0.007981 5137 40 0.007787 5137 39 0.007592 5137 38 0.007397 5137 37 0.007203 5137 36 0.007008 5137 35 0.006813 5137 34 0.006619 5137 33 0.006424 5137 32 0.006229 5137 31 0.006035 5137 30 0.00584 5137 29 0.005645 5137 28 0.005451 5137 27 0.005256 5137 26 0.005061 5137 25 0.004867 5137 24 0.004672 5137 23 0.004477 5137 22 0.004283 5137 21 0.004088 5137 20 0.003893 5137 19 0.003699 5137 18 0.003504 5137 17 0.003309 5137 16 0.003115 5137 15 0.00292 5137 14 0.002725 5137 13 0.002531 5137 12 0.002336 5137 11 0.002141 5137 10 0.001947 5137 9 0.001752 5137 8 0.001557 5137 7 0.001363 5137 6 0.001168 5137 5 0.000973 5137 4 0.000779 5137 3 0.000584 5137 2 0.000389 5137 1 0.000195 It seems to me I heard somewhere that Sharon Hope wrote in article <4badnYfwgpOGmJ_eRVn-ig@comcast.com>: >>>>>>>> " In controlled clinical studies of 2502 patients, < 2% of patients >>>>>>>> were >>>>>>>> discontinued due to adverse experiences attributable to >>>>>>>> atorvastatin. " >>>>>>>> NOT 1 in a Million. >>>>> Less than 2% means 50 or less. I suspect it is more than >>>>> 25, or they would have written < 1% instead. >>>> No. They have only 2 catagories. More than 2% or less than or equal to >>>> 2%. There are about 100 in the less than or equal to 2% catagory and >>>> none listed as less than 1%. If they meant between 1 and 2% I think they >>>> would have said so. Since they did not, one can not assume they meant >>>> that. >>> Where, exactly, do you see Pfizer specify on the PI that they only have 2 >>> categories of damage done to patients by Lipitor? >> They only list 2 categories for well over 100 items. They list greater >> than 2% and less than or equal to 2% which covers all possibilities. >You have confused an observation with a policy or a category. >>> Again, the incidence of Transient Global Amnesia due to Lipitor is far >>> higher than the normal population. Transient Global Amnesia is the only >>> form of Lipitor amnesia reported on Pub Med, and in the three books >>> available now on statin adverse effects: >> As I have pointed out to you several times, by definition Transient Global >> Amnesia lasts less than 24 hours. >Thus the name. >Why restate the obvious? Why the circular definition? The name is clear. >>Is this what you are talking about in relation to Lipitor. Is this what you >>believe you husband has? >> http://serendip.brynmawr.edu/bb/neuro/neuro02/web1/mwhite.html >> http://www.emedicine.com/neuro/topic380.htm >> "The period of amnesia can last anywhere from one to twenty-four hours." >> From the first reference. >> I believe Dr. Gaveline's problems lasted more than 24 hours and thus could >> not be TGA. I don't understand what you are missing about this. >Obviously, you have not read the book, nor the website, nor any of the many, >many interviews. >> Could you point out a single referance that descibes just one case of TGA >> associated with Lipitor. It must say TGA not amnesia. >>> "Lipitor, Thief of Memory" by Duane Graveline, MD >>> "What you must know about Statin Drugs & their Natural Alternatives" by >>> Jay >>> S. Cohen, MD >>> "Statin Drugs Side Effects and the Misguided War on Cholesterol" by Duane >>> Graveline, MD >You can start with the THREE BOOKS listed above, each of which have many, >many reports of TGA. >>> Splitting hairs between 1% and 2% of Patients on Lipitor experiencing TGA >>> is absurd when 0.0052% of the normal population experiences Transient >>> Global Amnesia (5.2 per 100,000 people) >> Again 1. It could be any number less than 2% which could be 5/100,000. 2. >This is a complete lie, and you are fully aware of it, as the PI, which >contains the information clearly states: >"Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) >In ASCOT (see CLINICAL PHARMACOLOGY, Clinical Studies) involving 10,305 >participants treated with Lipitor 10 mg daily (n=5,168) or placebo >(n=5,137), the safety and tolerability profile of the group treated with >Lipitor was comparable to that of the group treated with placebo during a >median of 3.3 years of follow-up. Excuse me for jumping in, but doesn't that say that during an average of 3.3 years of observation the safety and tolerance of Lipitor and of placebo were the same (and there's no mention of amnesia)? SignatureDon Kirkman |
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