Matt Herper has done a quite-admirable job of sorting through all the latest statin-hype, this morning -- and putting together 10 plain-English slides to help ordinary people parse the whole Crestor's "Jupiter" findings v. generics v. diet-and-exercise matrix.
If [over a ten-year period, as cogently noted by Marilyn Mann] an otherwise pretty-healthy American adult has perhaps a two-in-one-hundred chance of having a heart-attack -- after age 50 -- is it really worthwhile to lower that risk to one-in-one-hundred, if the cost (at $100 per month, for life) and side-effects (potential muscle weakness, and pain) of taking statins is fully-factored-in?
I dunno. But that, I think, is what healthy patients ought to ask their doctors -- before starting a generic, or branded, statin regimen.
Do go take the Forbes-provided Reynolds Risk Calculator for yourself -- it will help you be prepared for the above-dialogue with your doctor -- Bonus: it is linked in Herper's fine ten-slide sidebar to the article, as is the Framingham assessment calculator, available directly from the NIH website, right here.
Herper's most relevant paragraph, insofar as this blog's topics are concerned, may be his last -- he is certainly spot-on, about a coming "second-wave" of Vytorin/Zetia sales declines, as the AstraZeneca-Crestor "Jupiter" tide rolls through doctors' offices, nation-wide:
. . . .There is disagreement over whether statins work just by lowering LDL or also by preventing inflammation in the arteries, which also may have a role in heart attacks. That could explain why Jupiter outperformed previous statin trials, Ridker argues, and could lead some doctors to prescribe Crestor over generics. Use of Zetia, the non-statin cholesterol drug from Merck and Schering-Plough that is also part of the combo pill Vytorin, could continue to drop, because it may not have the same anti-inflammatory effects, and there's no evidence it stops heart attacks. Pfizer could catch a tailwind as health plans fearing Crestor's long patent life encourage docs to prescribe the similar Lipitor [Editor: or generics] instead.
That leaves plenty for scientists, investors and marketers to fight over. But statins have proved their worth in 18 clinical trials stretched out over two decades. If these drugs aren't worth using widely, pharmaceutical chemists better get out of the prevention business entirely. Statins may be as good as drugs get. . . .
I might quibble, just a bit about that last line -- it may be a little over the top, but in the main, this is a tremendous article -- be sure to walk through his ten slides!
You'll be a far-better-informed "American pill-popper" for having done so.