An Anecdote

About six years ago the family genes for congestive heart disease kicked in. My internist looked at my routine EKG and sent me to a cardiologist. I had had symptoms that suggested something was changing. The cardiologist wasn't sure what the echo stress test showed so sent me to the angiography center of one of NYC's big hospitals. 60% occlusion of the left ventricular artery, said they -- to me and to the cardiologist via phone. Within half an hour they placed a stent in the artery. I stayed flat on my back in the hospital overnight and went home early the next day. I've had no symptoms since.

The cardiologist stopped in to see me. He gave me two prescriptions, one for Plavix, the latest and greatest blood thinner which was recommended to be taken for two years after the placement of a stent. I don't know how that recommendation came about -- what tests were done, etc. I do know that the stent put in my artery was the latest and greatest, one with enough drug adhering to it to keep the artery clear [or so they said] for many months. I wasn't happy about the Plavix but my drug plan covered it as it was a AMA recommendation.

The cardiologist also wrote a prescription for Lipitor. "You'll be taking this the rest of your life," said he. As it happened I knew a great deal about Lipitor, in fact, had heard about it before he did. I did work in a second hand fashion for Pfizer, [sort of like a cousin twice removed] as I transcribed many meetings for Pfizer's PR company which often included informational meetings about up and coming drugs. By that time Lipitor had been on the market for 10 or 12 years and was bringing in billions of dollars to Pfizer. I had heard of their methods of teaching their reps how to market it and the perks that those reps got for a good job. As it happened, two or three months before my stent placement I had transcribed a talk at an AHA meeting by one of the two MD researches who had discovered statins [the cholesterol fighting drug that Lipitor -- and many me-too drugs -- are]. The MD was one of two who won a Nobel prize for their discovery of the compound and its effects.

During his keynote speech the immanent doc said that in the years since he had made the discovery he had continued working on the cholesterol problem. He could not understand why, when the data had been gathered for some 15 years now, it showed that only 17% of the people on the drug benefited from it. 17%!!! This is a drug that the AHA recommends EVERY heart disease patient and every patient with a RISK of heart disease [even if he doesn't have it] should be on FOR THE REST OF THEIR LIVES. Is it any wonder Pfizer was making billions! I told my cardiologist about the speech; he listened with that look experts give the lowly cranks who come in with odd bits of information and said, "Whatever the odds, you should be on statins the rest of your life."

By the way, when the two years on Plavix ended I said to the cardiologist, "I guess I can finally stop taking this." He said, "They've change the recommendation to three years." Honest to god! Who was massaging whose bottom line in that little change?