James5

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Slate recently had a pair of great articles on some of the intricacies of Big Pharma and the darker side of a medical system that needs to make a profit.

Firstly, Sanghavi writes about different ways of measuring/marketing drug effectiveness. Cholestrol-lowering drugs being publicised as having a 31% lowering of the risk of heart attacks in men, uses a relative measure to tout the drug’s efficacy - in reality it would only require 50 people to get treatment for one person to get benefit from the drug.

Suppose that 100 people with high cholesterol levels took statins. Of them, 93 wouldn’t have had heart attacks anyway. Five people have heart attacks despite taking Pravachol. Only the remaining two out of the original 100 avoided a heart attack by taking the daily pills. In the end, 100 people needed to be treated to avoid two heart attacks during the study period—so, the number of people who must get the treatment for a single person to benefit is 50. This is known as the “number needed to treat.”

This raises some issues as to whether you should really be taking this drug to help you lower your cholesterol. Sure you might be that one person out of fifty who benefits, but what the side effects and monetary cost?

It turns out this sort of thing happens all the time. Amoxicillin to treat ear infection only helps one out of every 20 children; aspirin to avoid heart attacks helps 1 our of 208 people. People are bad enough at measuring risk and their vulnerability. Drug companies using fudgy numbers doesn’t really help.

The second article was by Emily Yoffe and was about drug companies declining to research the effect of old (ie. cheap) drugs on different conditions. Drug companies won’t make much money if old, cheap medicines are used to make you better, so they don’t bother funding studies to see if they work or not. Hopefully government funded research will pick up the slack and help save people who can’t afford Big Pharma’s high-priced solutions.

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