Even though I record all the TV shows I want to watch and skip through the commercials during playback, I’ve been half-consciously aware that pharmaceutical ads seem to dominate commercial airtime. As I was watching a Biography Channel episode about Arnold Schwarzenegger a few days ago, it seemed as if every other commercial I skipped past was for some sort of drug. So today, I played the episode again and tallied them.
There were 27 commercials, not counting promos for upcoming episodes on Biography. Seven were for prescription drugs. (There was also an ad for a cream to remove dark circles under the eyes, and one claiming that NutriSystem will help type 2 diabetes keep their blood sugar under control.)
Something is very, very wrong when a quarter of the prime-time ads on TV are directed at sick people. And these aren’t even products you can just walk into a store and buy — you must, as the ads remind you, “talk to your doctor about …”
Here are some of the medical products I saw advertised, along with the conditions they’re intended to treat and abbreviated version of the obligatory warnings.
Advair (asthma). May increases risk of death from complications of asthma. May increase risk of hospitalization for asthma in children and adolescents.
Symbicort (chronic obstructive pulmonary disease). Do not take more than twice per day. Increases risk of lung infections, osteoporosis, and some eye problems.
Oracea (rosacea) Side effects include stomach upset, sore throat, sinus infections. Stay out of direct or artificial sunlight while taking. Talk to your doctor if you’re taking blood thinners or have kidney disease, as there may be serious side effects.
Nexium (heartburn, acid reflux). Talk to your doctor about an increased risk of osteoporosis-related bone fractures if you take multiple daily doses. Side effects include headache, diarrhea and abdominal pain.
Fabulous. While you’re in traction because of an osteoporosis-related femur fracture, you’ll be delighted you’re not experiencing heartburn.
Cymbalta (chronic pain, osteoarthritis) Taking with aspirin or blood thinners may increase bleeding risk. Severe liver problems, some fatal, were reported, as were abdominal pain and yellowing of the skin or eyes. Dizziness or fainting may occur upon standing. Other side effects include confusion, dry mouth and constipation. Tell your doctor if you experience unusual changes in behavior, mood swings, or thoughts of suicide, as these can increase in children, teens and young adults.
By the time the announcer finished with the long list of warnings for Cymbalta, I was laughing out loud — mostly because I was seeing all these happy-looking people going by on the screen while hearing about fatal liver problems, confusion and suicides. Look! We’re happy! Or maybe we’re just confused!
I half-expected one of the happy people to face the camera and say, “Let’s see … my chronic back pain is finally gone, but I’m constipated, I have yellow eyes, I faint when I stand up, I’m confused, my belly hurts, and I my liver isn’t working anymore. You know what? I think I’ll kill myself.”
I’m grateful drugs exist for the people who need them. But we shouldn’t need so many of them, and as Dr. Mary Vernon emphasized in a recent podcast interview, taking a drug to mask the symptoms of disease isn’t the same as being healthy. We learned that lesson again (well, some of us; many doctors and researchers won’t) a few days ago when yet another drug that artificially raises HDL failed to reduce heart disease:
The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health has stopped a clinical trial studying a blood lipid treatment 18 months earlier than planned. The trial found that adding high dose, extended-release niacin to statin treatment in people with heart and vascular disease, did not reduce the risk of cardiovascular events, including heart attacks and stroke.
During the study’s 32 months of follow-up, participants who took high dose, extended-release niacin and statin treatment had increased HDL cholesterol and lowered triglyceride levels compared to participants who took a statin alone. However, the combination treatment did not reduce fatal or non-fatal heart attacks, strokes, hospitalizations for acute coronary syndrome, or revascularization procedures to improve blood flow in the arteries of the heart and brain.
The DSMB also noted a small and unexplained increase in ischemic stroke rates in the high dose, extended-release niacin group. This contributed to the NHLBI acting director’s decision to stop the trial before its planned conclusion.
Triglycerides were pushed down, HDL was pushed up, but the rate of heart disease didn’t change. Why? Because chemically improving the markers for health isn’t the same as improving health. As I pointed out in a previous post, my neighbor’s grass is a beautiful shade of green because he constantly fusses over his lawn to keep it healthy. My lawn is patchy because I don’t care about lawns. If I paint my lawn green, that won’t make it any healthier. Sadly, many researches just can’t seem to grasp that concept:
“As we continue to search for new approaches to treating cholesterol problems, it is important to remember the value of existing treatments. The key to treating high cholesterol so patients can reduce their risk of cardiovascular disease is to lower the level of LDL cholesterol, through well-established drug treatments such as statins and lifestyle changes,” said Patrice Desvigne-Nickens, M.D., NHLBI project officer for the AIM-HIGH trial.
Head. Bang. On. Desk.
We just saw a drug that successfully manipulates cholesterol levels fail to reduce heart disease — while slightly increasing strokes — and yet the good doctor is still promoting chemical manipulation. By gosh, if you change the risk factors, you must be changing the actual outcomes. Riiiiight. Paint your lawn green, and the grass becomes healthy.
This doesn’t even provide the entertainment value of being a new story. Some years ago, Pfizer announced it had developed a combo drug that significantly improved cardiovascular risk factors. The early press releases were breathless: the miracle combo boosted HDL by 44 to 66 percent, while lowering LDL by 41 to 60 percent. Wow!
The results were somewhat less spectacular: Pfizer had to pull the plug on a clinical trial of the combo drug three years early because people taking the combo drug had a 60% higher mortality rate. Hmmm … maybe Mother Nature, unlike NHLBI researchers, doesn’t think it’s a good idea to chemically manipulate our production of cholesterol.
We’re going to see this story repeated at least two more times. Merck is currently developing and testing a drug that artificially raises HDL. And earlier this week, a reader sent me a link to this online article:
Polypill ‘halves risk of stroke and heart attack’
A new 10p-a-day ‘polypill’ containing aspirin and statins halves the risk of heart disease and stroke, according to the world’s first international trial of the drug, reported The Daily Telegraph. The news story is based on a randomised controlled trial of a polypill in 378 people who all had a slightly increased risk of vascular disease. The researchers found that people who took the polypill had improvements in their blood pressure and levels of “bad” LDL cholesterol (equivalent to a 46% reduction in cardiovascular risk) over 12 weeks, compared to those who took a dummy pill.
If you’ve seen my Science For Smart People speech, you know what “lowers your risk” actually means. So the polypill “halves the risk” of heart disease, does it? Whoop-ti-do. I’ve got news for you: Pfizer’s combo drug dramatically raised HDL and lowered LDL, which means it dramatically “lowered the risk” of heart disease for the people taking it. The only bad news is that more of those people died.
High HDL and low triglycerides don’t confer good health. They’re markers for good health. Chemicals that remove the blotches from your face, beat down your elevated blood sugar, or mask the pains of heartburn and arthritis don’t eliminate the underlying imbalances that caused those conditions in the first place.
If you want real health, eat real food. Get some real exercise and some real sleep. You’re not going to find real health in a little brown bottle, no matter how many times you “talk to your doctor about …”