Today, there’s a front page story in the New York Times about Astra-Zeneca’s move to market their cholesterol pills (known as statins, and as the NYT reports, already the most prescribed drugs in the US) at healthy people in spite of unresolved concerns about risks, namely an elevated risk of developing Type 2 diabetes.
Gee. This sure sounds familiar: a product aimed at healthy people, approved by the FDA, even before there’s ample evidence of safety.
I am imagining the new ad campaign…”Why let cholesterol worries slow you down? Choosing healthy foods and getting adequate exercise is sooooooo 20th century.Take a pill. Done.”
Of course, the comparison I am hinting at here is flawed. High levels of cholesterol ARE a genuine hazard. Heart disease is deadly. Conversely, menstruation is NOT a disease and under most conditions, need not be treated.
But my point here is to call attention to Big Pharma’s too-quick impulse to sell drugs of questionable safety to healthy people and FDA collusion in this. Marketing cycle-stopping contraception (a.k.a. menstrual suppressive contraception a la brands Lybrel and Seasonique, for example) to healthy women is not an isolated incidence of the premature and high-risk mainstreaming of prescription medications. See recent critiques here and here (and the official Society for Menstrual Cycle Research position statement on cycle-stopping contraception here).
In the eyes of Big Pharma, if we aren’t sick, we will be soon. If we aren’t dosing The. Next. New. Drug, we aren’t taking charge of our health.
Sick? I think THAT’S sick.
Bravo.
There’s another issue here as well, and that is gender- and sex-differences. Women are more likely than men to be concerned about prevention, and might be more likely to look for this kind of opportunity. But, as with most research on cardiovascular disease, the science about statins has mostly been done on men, and there are serious concerns that women may be different biologically from men, that the benefits of statins for women are not proven, and that taking statins may in fact cause harm that is due to both gender- (because of differential health-seeking behaviours) and sex-differences (because of biological differences in how women’s bodies react to statins, and in the types of heart disease women get).
For a somewhat dated (2007) review of the issues, visit the Canadian Women’s Health Network site on this issue
And here is a more recent article
Rosenberg, H., & Allard, D. (2008). Women and statin use: A women’s health advocacy perspective. Scand Cardiovasc J, 1-6.
This paper is based on a longer report on the benefits, safety and modalities of information representation with regard to women and statin use, situated within the historical context of Women’s Health Movement which has advocated for unbiased, appropriate medical research and prescribing for women based on the goals of full-disclosure, informed consent, evidence-based medicine and gender-based analysis. The evidence base for prescribing statins for women, especially for primary prevention is weak, yet Canadian data suggest that half of all prescriptions are for women. Safety meta-analyses do not disaggregate for women; do not consider female vulnerability to statin induced muscle problems, and women-centred concerns such as breast-cancer, miscarriage or birth defects are under-researched. Many trials have not published their non-cardiac serious adverse event data. These factors suggest that the standards of full-disclosure, informed consent, evidence-based prescribing and gender-based analysis are not being met and women should proceed with caution.
I wouldn’t touch statins with a 10 foot pole. And I’ve told everyone of my friends to talk to me first before they agree to take them.