Pharmagangsters

Sidney Wolfe (Nader's health care raider) in the new BMJ tells the outrageous story of rosuvastatin. As you undoubtedly know, there are several medications in the statin class, very widely prescribed for the primary and secondary prevention of heart disease and stroke. They lower LDL ("bad" cholesterol) and probably have anti-inflammatory properties that contribute to their effect.

There is controversy over whether these medications in general are overprescribed, but that's beside the point here. Rosuvastatin was approved much later than other drugs in the class, it's still under patent (I won't mention the brand name) and it is also the most widely prescribed statin in the U.S.

Oh yeah -- according to Dr. Wolfe, it's also the one with the worst risk/benefit profile. It is a associated with a much higher risk of diabetes. Obviously, if you're trying to prevent heart disease, causing diabetes is not helpful. It also appears to present a higher risk of rhabdomyolysis -- destruction of muscle tissue -- and kidney damage.

So why is it the most commonly prescribed statin? Quoth the good doctor:

A prescient answer can be found in an October 2003 Lancet editorial, “The statin wars: why AstraZeneca must retreat.”20 It stated that AstraZeneca’s chief executive, Tom McKillop, “has pledged to do whatever it takes to persuade doctors to prescribe rosuvastatin, including launching an estimated $1 billion first-year promotional campaign. ‘We’ve got to drive the momentum’, he [McKillop] said at a recent investors meeting. ‘You get one shot at launching a major new product. This is our shot.’” 

But McKillop responded with denial, and an advertisement in the Washington Post claiming, utterly falsely, that "The scientists at the FDA who are responsible for the approval and ongoing review of [Brand Name]  have, as recently as last Friday, publicly confirmed that [Brand Name]  is safe and effective; and that the concerns that have been raised have no medical or scientific basis." The FDA wrote a letter to AstraZeneca stating that the ad was false, with no basis in reality, and that the agency had substantial concerns about the product.

Dr. Wolfe concludes, "The patent for rosuvastatin expires in 2016, and with it AstraZeneca’s need to promote it. But for the sake of the public’s health, we must hope that the drug’s disadvantages will lead to a sharp decline in its use before next year."

I conclude, however, that the pharmaceutical industry appears to be largely run by psychopaths. We are talking about people's lives here, which McKillop and other pharmaceutical executives are perfectly happy to destroy for the sake of their insatiable greed. This has tremendous repercussions in undermining public trust in science and medicine, and we must constantly struggle against that mistrust. It's getting very old.