Recent research suggests that patients who are on statins may not be seeing the benefits promised them. If true, this would mean that the majority of the 24 million Americans taking statins are only contributing to record sales for a very profitable class of drugs instead of making lifestyle changes that could actually have a greater impact on improving their health. Far too few stories take a critical view of the science behind statins.
The story could have spent a little more time on the actual data that are in dispute – even one paragraph on both the benefits that statins offer as a "secondary prevention" and the false hope they may offer to patients as a "primary prevention."
Statins have been touted as one of modern medicine’s greatest breakthroughs, and statin makers have been trying to build on the success of the drugs as a potential cure for heart disease by expanding their scope into Alzheimer’s, arthritis, cancer and other areas. Because statins are a drug most patients take for the rest of their lives, they contribute to a big portion of health care spending and have been shown to create some serious side effects in some patients. Stories like this are helping to keep the scientists and the industry accountable.
The story doesn’t discuss the costs to consumers (or the health system). It does a great job, though, of tallying the sales and the growth in prescriptions of statins.
It perhaps is unfair to compare a newspaper story with its space limitations to a magazine piece, but John Carey in BusinessWeek did a tremendous job in 2008 taking on this same topic. He burrowed into the numbers supporting statin use and came to many of the same conclusions that are discussed in this piece. At least some of the same attention could have been spent in a graph or two to both the benefits that statins offer as a "secondary prevention" and the false hope they offer to patients as a "primary prevention."
The harm here is what Dr. John Abramson calls "the conspiracy of false hope." It is well described and, in a way, quantified. If it turns out to be true that more than half of the 24 million Americans on statins have been pinning their hopes falsely on statins, then much damage has been done to public health. These people could have concentrated more on altering their diets and exercising more, for one. And cardiology may have stagnated in recent years because of an overreliance on statins as a cure-all.
This story walks readers through the recent debate around the effectiveness of statins and provides a nice summary of some of the areas where statins have been found wanting. A little more detail about the numbers in these stories would have been good to include.
This story is the exact opposite of a typical disease mongering piece. Unlike so much reporting about statins, the reporter breaks down clearly that statins are being used to treat two classes of people, those who are seeking "primary prevention" and those who are seeking "secondary prevention." Many in the group in the first class — the majority of statin users — may be using statins unnecessarily.
The story clearly draws on many voices and many publications about statins. It could have used a more forceful argument from the community of physicians with no ties to pharma but with strong feelings about prescribing statins as a primary prevention. The paraphrase from Steve Nissen at the Cleveland Clinic toward the end of the story is quite weak compared to all the evidence stacked in the preceding paragraphs.
There could have been more discussion of what people in the "primary prevention" category could be doing other than taking statins. The research on the effects of diet and exercise on heart health and cholesterol levels is well established. Instead of just having Abramson allude to better lifestyle choices — "exercise regularly, not smoke, drink in moderation and eat a healthy Mediterranean-style diet" — the story could have drawn on some of the science behind drug-free options for avoiding a heart attack. Nonetheless, because the story at least mentioned these lifetsyle choices – and ended with them – we’ll give it a satisfactory score.
The whole reason for the story is the wide use of statins.
The story isn’t really about the treatment being new or novel. It’s about the debate around the effectiveness of statins, and the widespread use of statins is well established in the story.
The story did not rely on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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