Taking pills is more like Vegas than we thought
Taking pills is more like Vegas than we thought
By: Bill Mead
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Posted by editor Tue Nov 30, 1999 00:00:00 PST
Viewed 365 times
0 responses 0 comments If you're like me, you assume that when the doctor hands you a prescription it's going to help you live longer or at least make you feel better. I haven't assumed that for a long time because I have suffered so many backlashes from taking prescription drugs. But I keep trying. When one pill tears up my digestive system or ties my muscles into painful knots, I stubbornly move on to another pill, hoping the next cure won't be worse than the ailment.
Now comes Michael D. Lemonick, a medical journalist for Time magazine, claiming there is a strong chance that a given prescription drug won't help most people but it can carry the the risk of side effects for everybody who takes it. If you're lucky, he implies, the only good result of many expensive drugs will be no result at all.
Since the stuff in Time is copyrighted I'll try to explain what Lemonick means without getting myself thrown in the hoosegow. He refers to a mysterious figure known as “Number Needed to Treat,” or NNT, that pharmaceutical companies aren't anxious for you to hear about. Lemonick says the NNT is a far more realistic measure of a drug's usefulness than the misleading figures you get from the drug makers’ PR departments. He calls the NNT “medicine’s secret stat.”
One example he gives has to do with statin drugs which are supposed to reduce blood cholesterol and, by implication, reduce heart attacks and strokes. Lemonick says that while some tests have suggested that statins reduce the chances of coronary and circulatory problems by as much as 30 percent the way drug companies figure it, when those same results are subjected to NNT scrutiny, it turns out that 50 people have to take statins in order to prevent one heart attack. The 49 people who won't get any benefit from statins will continue to be candidates for the downsides of these drugs, however, which include the aforementioned muscular agony plus liver damage. I think you can get better odds at a Nevada casino.
Lemonick isn't attacking the medical establishment when he calls attention to the NNT statistic. Neither am I. The pharmaceutical companies do a fantastic job most of the time and I'm still alive because of them. What irritates me is the oversimplified, hard sell nature of most drug commercials. I sometimes think the TV industry would go bankrupt if it wasn't for restless leg syndrome. I suppose it's real. I just don't know anybody who has it. Actress Sally Field speaks of the horrors of having to set aside time once a week to take a pill when the one she's peddling, which I suspect costs 10 times as much, can be taken once a month. Is anybody that busy?
But putting aside Madison Avenue baloney, there's another side to this. After giving up on a couple of diabetes medications that made me hope my condition was terminal, my doctor found one that seems to work great and keeps me feeling like a human. Score another one for the pill pushers.
And I don't mean to imply that statins are a ripoff. They are just over-hyped. Even if only one in 50 persons benefits from taking statins, as Lemonick says, it could mean thousands of lives saved every year. If you're the lucky 50th guy, you won't pay any attention to the NNT. If you're one of the 49 others, which is far more likely, it might be a good idea to ask about the NNT when good old doc hands you a prescription of any kind. That's the number you need most when making your own decisions about what's worth taking.
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