T Nation

Medical Field/Drugs and Death


#21

[quote]Consul wrote:

[quote]kakno wrote:
I’m so sick of this bullshit. Doctors don’t prescribe drugs for shits and giggles, they do it to decrease the risk of death, quite successfully. How many would die without medicine or surgery?

If you don’t want pharmaceutical companies to bribe doctors, ban it. It works here. Instead, we get the problem of patients being confused by having both original and generic drugs in their homes and they someimes end up taking both, cause that’s what the label says. You get generic drugs by default unless you specifically ask for the original.

This leads to a new problem: The pharmaceutical companies that actually try to develop new drugs, instead of being greedy copy cats like many, don’t get paid. Their research budget shrinks and we see less new drugs. And the few new drugs they do invent are seldom used because they’re so expensive. So why would they research a new drug in the future?

If anyone were to develop a new antibiotic (the way some people sprinkle vancomycin we’re going to need it) they wouldn’t get paid for years because we’d save it until it was our last option. An industry that saves lives is constantly being shit on by self proclaimed experts who can’t see the big picture.

I’m all for exercise and diet before blood pressure meds and statins, checking for interactions between meds, evidence based medicine and cheap angiotensin receptor antagonists, but this black and white “evil big pharma” shit is getting old.[/quote]

Finally, a voice of reason on this forum. [/quote]

really? explain the most popular prescribed drug in the world (or at least revenue wise) statins… Hint, unless you’ve read up on the subject of cholesterol and/or statins you may not know what I’m getting at. That’s not meant to be an arrogant statement either. So my words don’t get twisted.


#22

some may find these videso interesting… the part where they are over in India is just plain crazy…


#23

what about doctors that prescribe bisphosphonates? I realize for some, it may seem that these types are the last resort in a population that may not want to do anything about it, but I deal a lot with folks that are willing to make the changes, but the docs still prescribe these drugs that DO NOT do what they are advertised to do, and cause problems.


#24

[quote]jehovasfitness wrote:

really? explain the most popular prescribed drug in the world (or at least revenue wise) statins… Hint, unless you’ve read up on the subject of cholesterol and/or statins you may not know what I’m getting at. That’s not meant to be an arrogant statement either. So my words don’t get twisted.
[/quote]

Statins are immoral and purely a money grab. There is no evidence that cholesterol is a cause of CVD.

Applying the same logic that people used to conclude that animal fat gives us CVD they should also have said that eating animal flesh will lower our chances of being hit by a bus.


#25

[quote]rehanb_bl wrote:

[quote]jehovasfitness wrote:

really? explain the most popular prescribed drug in the world (or at least revenue wise) statins… Hint, unless you’ve read up on the subject of cholesterol and/or statins you may not know what I’m getting at. That’s not meant to be an arrogant statement either. So my words don’t get twisted.
[/quote]

Statins are immoral and purely a money grab. There is no evidence that cholesterol is a cause of CVD.

Applying the same logic that people used to conclude that animal fat gives us CVD they should also have said that eating animal flesh will lower our chances of being hit by a bus.[/quote]

I’m with ya man, however even I will admit based upon the evidence statins do appear beneficial for a very tiny tiny part of the population, but let’s face it that’s like 1% of the people that are on them.

hell, they’re even trying to get cholesterol screening as part of the normal routine for kids as young as 9… why? well, many would like to think it’s to “prevent” later problems, but you better be sure that if you can’t make more money selling more items to one customer, you get new customers :wink: But, hey that’s just me being crazy I guess.


#26

[quote]jehovasfitness wrote:

[quote]rehanb_bl wrote:

[quote]jehovasfitness wrote:

really? explain the most popular prescribed drug in the world (or at least revenue wise) statins… Hint, unless you’ve read up on the subject of cholesterol and/or statins you may not know what I’m getting at. That’s not meant to be an arrogant statement either. So my words don’t get twisted.
[/quote]

Statins are immoral and purely a money grab. There is no evidence that cholesterol is a cause of CVD.

Applying the same logic that people used to conclude that animal fat gives us CVD they should also have said that eating animal flesh will lower our chances of being hit by a bus.[/quote]

I’m with ya man, however even I will admit based upon the evidence statins do appear beneficial for a very tiny tiny part of the population, but let’s face it that’s like 1% of the people that are on them.

hell, they’re even trying to get cholesterol screening as part of the normal routine for kids as young as 9… why? well, many would like to think it’s to “prevent” later problems, but you better be sure that if you can’t make more money selling more items to one customer, you get new customers :wink: But, hey that’s just me being crazy I guess.
[/quote]

just to let you know that one percent you are talking about. (Genetically unlucky with low LDL receptor activity levels ) are now being treated with gene therapy as the method was just approved for human use.

I know all about the money grabbing scheme, in the UK they wanted to put healthy people on statins as a prophylactic measure.


#27

[quote]rehanb_bl wrote:

[quote]jehovasfitness wrote:

[quote]rehanb_bl wrote:

[quote]jehovasfitness wrote:

really? explain the most popular prescribed drug in the world (or at least revenue wise) statins… Hint, unless you’ve read up on the subject of cholesterol and/or statins you may not know what I’m getting at. That’s not meant to be an arrogant statement either. So my words don’t get twisted.
[/quote]

Statins are immoral and purely a money grab. There is no evidence that cholesterol is a cause of CVD.

Applying the same logic that people used to conclude that animal fat gives us CVD they should also have said that eating animal flesh will lower our chances of being hit by a bus.[/quote]

I’m with ya man, however even I will admit based upon the evidence statins do appear beneficial for a very tiny tiny part of the population, but let’s face it that’s like 1% of the people that are on them.

hell, they’re even trying to get cholesterol screening as part of the normal routine for kids as young as 9… why? well, many would like to think it’s to “prevent” later problems, but you better be sure that if you can’t make more money selling more items to one customer, you get new customers :wink: But, hey that’s just me being crazy I guess.
[/quote]

just to let you know that one percent you are talking about. (Genetically unlucky with low LDL receptor activity levels ) are now being treated with gene therapy as the method was just approved for human use.

I know all about the money grabbing scheme, in the UK they wanted to put healthy people on statins as a prophylactic measure.[/quote]

haha, yeah, wasn’t it some doctor over there said they should put them in the drinking water?

btw- I was referring to males under the age of 65 who have CVD already, but of course goes without saying to you probably that it’s not because they lower cholesterol, so makes you wonder could same benefits be seen through lifestyle modification for that group as well, or is it too late by then

Either way, I know numerous women that are on these pills and are just 'trusting" their doctors


#28

“Emergency Hospitalizations for Adverse Drug Events in Older Americans”

  • The elderly are seven times as likely as younger people to have adverse drug events.
  • From 2007 and 2009, almost 100,000 elderly people (per year) were estimated to be hospitalized due to ADEs.
  • Almost half were over the age of 80.
  • Almost two-thirds of these hospitalizations are thought to be the result of unintentional overdose.
  • The majority of ADEs (41%) were seen in those taking between 5 and 9 medications.

What drugs were most widely implicated? Antithrombotics and antidiabetics, specifically: warfarin (33%), insulin (14%), oral antiplatelet agents (13%) and oral hypoglycemic agents (11%).

http://www.nejm.org/doi/full/10.1056/NEJMsa1103053

The narrator of the video seems intent on placing the blame almost solely on the doctors, the pills and Big Pharma. Where is the mention that, more often than not, these adverse events are ENTIRELY AVOIDABLE BY THE PATIENT???

But, what’s the alternative? Would the narrator rather we DIDN’T make every effort to treat these diseases? Maybe forgo the prescription pad in favor of brochures and maps to the nearest Jamba Juice (I’m sure “Natural News” is BIIIG on the antioxidants)?

Yes, I feel throwing the pharmacy at every elderly individual, many of whom lack adequate supervision, is an issue that needs to be addressed. Warfarin is a particularly nasty drug to play around with and a lot has gone into finding ways of streamlining the dosage adjustments for hitting the target INR (e.g., tests for CYP2C9 and VKORC1 polymorphisms)… but a dialed-in dose means diddly-squat for those who routinely forget whether or not they have taken all of their 5+ daily meds.

So, as far as the dangers of prescription drugs goes: while saying this is an issue of us needing to discuss “doctor control” rather than “gun control” might be close to the truth, it is almost certainly NOT for the reasons the narrator is preaching. I think it is fairly safe to assume that the biggest dent in those figures will come from finding ways to better supervise the administration of prescription drugs (particularly the “at risk” ones), be it from telling the nursing home staff to be more attentive or perhaps through advising doctors to properly educate the elderly on ways to make their pill-popping more “fool-proof” (those daily pill containers are mad convenient). Whining about medical conspiracies isn’t gonna cut it.

As for the other ~1/3 who have legitimate adverse reactions… again, a lot of this stems from living longer than our ancestors ever have and witnessing all of the extra aches, pains and maladies that stem from our death grip on life. I know there’s a lot to be said for preventative medicine, but – and stay with me on this – there are just some things that Superfood and fish oil ain’t gonna cure. The likelihood, is that most of us here are gonna be on one thing or another once we starting dipping more than just the tips of our toes in the grave. Until pharmacogenetics/genomics swoops in to tell us what the right dose of the right drug for the right indication for the right person at the right time actually is… we’re just gonna have to accept the fact that throwing more ingredients into a recipe can very likely result in a funky taste.


#29

I question the statistics in the video which never mentions that people that are dying got to a doctor.

How many would die no matter what the doctor did too try and save them?
How many died of complications after some form of last ditch surgery?
How many died from self inflicted overdoses from pharmaceuticals?
How many died at while being cared for at home?

The list goes on and on, and what Kakno said is my opinion to the T.


#30

[quote]anonym wrote:
Medications are also often prescribed because the doctor feels “pressured” into it by the patient, who comes to the office/clinic with the expectation that there will be a pill for whatever ails him/her. A classic example would be in the case of antibiotics, where (for example), it is easier to just prescribe an ophthalmic ab ointment for every instance of pinkeye than it is to argue with an entitled patient over the difference between viral/allergic/bacterial cases and convince him/her of the limited therapeutic efficacy of antibiotics across all common causes.

Most people want to leave their doc thinking they are getting fixed, and the easiest way to make that happen is via a prescription. Being told to “wait and see” if something resolves on its own, or to “eat right, exercise and quit smoking” doesn’t usually cut it and many patients leave feeling gypped out of their copay.

This is not to place the blame on the physician, “Big Pharma” or any single patient, but it is a reflection of society’s attitude towards “quick fixes”, “instant results” and really just a poor education (e.g., the clinical significance of a viral/bacterial infection wrt pharmaceutical interventions would fly over the head of most people, despite the fact that any 8th grader could be made to understand it).[/quote]
True, and pretty hard to do anything about. If you refuse to prescribe antibiotics to someone with a cold there’s a chance they’ll keep looking until they get it, and eventually you might think it’s better to just fold immediately and save time for everyone. I think we’re on the right track over here but it won’t stop the resistant strains that are just a three hour flight away.

Very good posts!


#31

[quote]Cuso wrote:
I question the statistics in the video which never mentions that people that are dying got to a doctor.

How many would die no matter what the doctor did too try and save them?
How many died of complications after some form of last ditch surgery?
How many died from self inflicted overdoses from pharmaceuticals?
How many died at while being cared for at home?

The list goes on and on, and what Kakno said is my opinion to the T.
[/quote]

very valid points

i still think that all these numbers when taken into account leaves a very high number after subtractions


#32

[quote]kakno wrote:
This leads to a new problem: The pharmaceutical companies that actually try to develop new drugs, instead of being greedy copy cats like many, don’t get paid. Their research budget shrinks and we see less new drugs. And the few new drugs they do invent are seldom used because they’re so expensive. So why would they research a new drug in the future?[/quote]

Getting away from the topic here, but don’t many companies get around this by simply making their own generics? That allows them to recoup the costs of research without having to charge a brand premium. From that point it is really the responsibility of the pharmacist to properly explain to the patient what they are paying for.

Anyway, despite my reservations about some of these drugs and how readily they are prescribed, I agree with you and anonym. Good posts.


#33

Just watched the video.

Ridiculous sensationalist nonsense. I had to lol.


#34

[quote]Cimmerian wrote:

[quote]kakno wrote:
This leads to a new problem: The pharmaceutical companies that actually try to develop new drugs, instead of being greedy copy cats like many, don’t get paid. Their research budget shrinks and we see less new drugs. And the few new drugs they do invent are seldom used because they’re so expensive. So why would they research a new drug in the future?[/quote]

Getting away from the topic here, but don’t many companies get around this by simply making their own generics? That allows them to recoup the costs of research without having to charge a brand premium. From that point it is really the responsibility of the pharmacist to properly explain to the patient what they are paying for.
[/quote]
Being the 15th company selling omeprazol doesn’t pay anywhere near as well as being the only one who can sell the drug you put billions of dollars into making.


#35

[quote]kakno wrote:

[quote]Cimmerian wrote:

[quote]kakno wrote:
This leads to a new problem: The pharmaceutical companies that actually try to develop new drugs, instead of being greedy copy cats like many, don’t get paid. Their research budget shrinks and we see less new drugs. And the few new drugs they do invent are seldom used because they’re so expensive. So why would they research a new drug in the future?[/quote]

Getting away from the topic here, but don’t many companies get around this by simply making their own generics? That allows them to recoup the costs of research without having to charge a brand premium. From that point it is really the responsibility of the pharmacist to properly explain to the patient what they are paying for.
[/quote]
Being the 15th company selling omeprazol doesn’t pay anywhere near as well as being the only one who can sell the drug you put billions of dollars into making.[/quote]

Fair point. I came across this snippet in WP that puts things in a perspective that many likely haven’t thought about. I know I hadn’t.

“For instance, only one out of every ten thousand discovered compounds actually becomes an approved drug for sale. Much expense is incurred in the early phases of development of compounds that will not become approved drugs.[5] In addition, it takes about 7 to 10 years and only 3 out of every 20 approved drugs bring in sufficient revenue to cover their developmental costs, and only 1 out of every 3 approved drugs generates enough money to cover the development costs of previous failures. This means that for a drug company to survive, it needs to discover a blockbuster (billion-dollar drug) every few years.[5]”


#36

[quote]Cimmerian wrote:

[quote]kakno wrote:

[quote]Cimmerian wrote:

[quote]kakno wrote:
This leads to a new problem: The pharmaceutical companies that actually try to develop new drugs, instead of being greedy copy cats like many, don’t get paid. Their research budget shrinks and we see less new drugs. And the few new drugs they do invent are seldom used because they’re so expensive. So why would they research a new drug in the future?[/quote]

Getting away from the topic here, but don’t many companies get around this by simply making their own generics? That allows them to recoup the costs of research without having to charge a brand premium. From that point it is really the responsibility of the pharmacist to properly explain to the patient what they are paying for.
[/quote]
Being the 15th company selling omeprazol doesn’t pay anywhere near as well as being the only one who can sell the drug you put billions of dollars into making.[/quote]

Fair point. I came across this snippet in WP that puts things in a perspective that many likely haven’t thought about. I know I hadn’t.

“For instance, only one out of every ten thousand discovered compounds actually becomes an approved drug for sale. Much expense is incurred in the early phases of development of compounds that will not become approved drugs.[5] In addition, it takes about 7 to 10 years and only 3 out of every 20 approved drugs bring in sufficient revenue to cover their developmental costs, and only 1 out of every 3 approved drugs generates enough money to cover the development costs of previous failures. This means that for a drug company to survive, it needs to discover a blockbuster (billion-dollar drug) every few years.[5]”

While I hate your reference source (wiki) this is a very true statement, everyone wants the cure for cancer but nobody wants to pay to get it.

Statins were not a money grab, they were developed due to the science and technology that is/was available. Very easy to arm chair QB when YOU are not the one with your license on the line. If your patient has a MI or Stroke and you knew they had elevated LDL and didnt treat it then you get sued for malpractice plain and simple. Good luck trying to convince a jury that [i]Well we spoke of eating grass fed llama and rare African bird eggs with yak milk to balance out his cholesterol.[i] How is it my fault that the patient didnt follow my directions.


#37

This seems appropriate here. lol


#38

[quote]Iron Dwarf wrote:
This seems appropriate here. lol[/quote]

Some where in Florida…Gods waiting room.


#39

#40

[quote]Derek542 wrote:

[quote]Cimmerian wrote:

[quote]kakno wrote:

[quote]Cimmerian wrote:

[quote]kakno wrote:
This leads to a new problem: The pharmaceutical companies that actually try to develop new drugs, instead of being greedy copy cats like many, don’t get paid. Their research budget shrinks and we see less new drugs. And the few new drugs they do invent are seldom used because they’re so expensive. So why would they research a new drug in the future?[/quote]

Getting away from the topic here, but don’t many companies get around this by simply making their own generics? That allows them to recoup the costs of research without having to charge a brand premium. From that point it is really the responsibility of the pharmacist to properly explain to the patient what they are paying for.
[/quote]
Being the 15th company selling omeprazol doesn’t pay anywhere near as well as being the only one who can sell the drug you put billions of dollars into making.[/quote]

Fair point. I came across this snippet in WP that puts things in a perspective that many likely haven’t thought about. I know I hadn’t.

“For instance, only one out of every ten thousand discovered compounds actually becomes an approved drug for sale. Much expense is incurred in the early phases of development of compounds that will not become approved drugs.[5] In addition, it takes about 7 to 10 years and only 3 out of every 20 approved drugs bring in sufficient revenue to cover their developmental costs, and only 1 out of every 3 approved drugs generates enough money to cover the development costs of previous failures. This means that for a drug company to survive, it needs to discover a blockbuster (billion-dollar drug) every few years.[5]”

While I hate your reference source (wiki) this is a very true statement, everyone wants the cure for cancer but nobody wants to pay to get it.

Statins were not a money grab, they were developed due to the science and technology that is/was available. Very easy to arm chair QB when YOU are not the one with your license on the line. If your patient has a MI or Stroke and you knew they had elevated LDL and didnt treat it then you get sued for malpractice plain and simple. Good luck trying to convince a jury that [i]Well we spoke of eating grass fed llama and rare African bird eggs with yak milk to balance out his cholesterol.[i] How is it my fault that the patient didnt follow my directions. [/quote]

Of course they weren’t a money grab at first, at the time the “science” seemed to support them, albeit it flawed science. But, nowadays with all that is known about CVD, diet and the latest statin trials.

I mean WTF, and even worse even when docs do prescribe them vast majority of the time, there’s no mention of the need to supplement with CoQ10, absurd.