As we Americans haplessly continue to search for a way to bring human decency — a.k.a. public non-profit “single-payer” universal coverage, a.k.a. actual insurance — to health insurance, we remain miles from raising the next obvious topic: the extreme underlying conflict between money-making and medical practice.
The latest evidence of this un-discussed elephant-in-the-room lies in today’s New York Times, and involves our old friend, Vytorin:
When the Food and Drug Administration approved a new type of cholesterol-lowering medicine in 2002, it did so on the basis of a handful of clinical trials covering a total of 3,900 patients. None of the patients took the medicine for more than 12 weeks, and the trials offered no evidence that it had reduced heart attacks or cardiovascular disease, the goal of any cholesterol drug.
The lack of evidence has not stopped doctors from heavily prescribing that drug, whether in a stand-alone form sold as Zetia or as a combination medicine called Vytorin. Aided by extensive consumer advertising, sales of the medicines reached $5.2 billion last year, making them among the best-selling drugs in the world. More than three million people worldwide take either drug every day.
But there is still no proof that the drugs help patients live longer or avoid heart attacks. This year Vytorin has failed two clinical trials meant to show its benefits. Worse, scientists are debating whether there is a link between the drugs and cancer.
Researchers reported last month that patients in three clinical trials had a 40 percent higher chance of dying from cancer if they took Vytorin instead of a sugar pill or another medicine, although the leader of that study says the finding might be due to chance.
Now some prominent cardiologists say that the evidence has swung so decisively against the drugs that they should not be sold. “The only place people should be taking it is in a clinical trial,” Dr. Allen J. Taylor of the Walter Reed Army Medical Center said of Zetia. (Vytorin is a single pill that combines Zetia with a statin, an older form of cholesterol-lowering medicine whose effectiveness and safety are not in question.)
Merck and Schering-Plough, which jointly make Vytorin and Zetia, strongly defend their medicines. The companies say that ezetimibe, the generic name for Zetia, showed no cancer risk in animal trials and argue that the cancer finding is probably a result of chance.
Just a few issues there, no?
The response? None. The market simply cannot be interfered with. The people need their only-possibly cancer-causing worse-than-placebos. Clearly, public enterprise could never achieve such superb results!