I had a doctor tell me late last year that once these results start coming out, doctors will start prescribing statins "as if they are candy". And why not? Look at this claim:
The company [Pfizer] said the FDA expanded the drug's indication to include reducing the risk of stroke and heart attack in Type 2 diabetics without evidence of heart disease but with other risk factors [my emphasis]
Other risk factors could be any one of many common factors such as high blood pressure, family history, smoking, being over 55, obesity, etc. How many people with high LDL have one of these factors? Let's be conservative and say at least half, especially if you have a strict definition of obesity. Even when the LDL counts come down, it is in the patient's interest to continue these drugs, perhaps at a lower dose, to capture the benefit of reduced stroke/heart attack risk. The "without evidence of heart disease" language is phenomenal. Who can argue with these results:
The diabetes approval was based on a clinical trial following more than 2,800 patients with Type 2 diabetes and near normal cholesterol and at least one other risk factor for stroke or heart disease....The study showed that the group of patients taking Lipitor rather than placebo had 50 percent fewer strokes [my emphasis].
And
Another clinical trial of more than 10,300 people with normal cholesterol but with at least three other risk factors found that the Lipitor group had 26 percent fewer strokes compared to the placebo group.
So, you may not see many more patients using statins, but you may see patients taking these drugs for longer periods of time, for the purpose of preventing strokes and/or heart attacks. Lipitor is already a $8+ billion drug. This may push it over $10 billion by 2007.
The question in my mind is whether or not there is still an opportunity to develop statins with a better safety profile. With these data in hand, a physician may not accept marginally better safety profile for a new, unproven statin which does not have this additional stroke/heart attack data (and corresponding claim).
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