Statins, the best-selling drugs in the United States, lower LDL (bad) cholesterol and decrease blood vessel inflammation to decrease the risk of heart disease in certain people. The top selling statin drugs are Lipitor, Mevacor and Pravachol. People with heart disease benefit from taking these drugs, but there is controversy about the use of statins by people who simply have high cholesterol. There is also controversy about the prescribing of 80 mg of Lipitor (rather than lower doses) that Pfizer, the pharmaceutical giant, appears to be recommending.
The actual benefit of using statin drugs, including Lipitor, may surprise you. While the benefit of statin drugs for people with heart disease is proven, according to Dr. John Abramson and Dr. James Wright, if 50 men who are at high risk of developing heart disease take the drug every day for five years, just one man will avoid a heart attack or heart-related death.
One out of 50 men avoiding a heart attack, or death, over a five-year period might be a reasonable outcome for many of us, if the downside of taking drugs like Lipitor was not significant. Each person probably needs to make that judgment individually.
Side effects from statin drugs include some liver injury, muscle pain and weakness, joint pain and memory problems. Some research has also implicated statin drugs as a cause of cancer. Seventy five percent of consumers who are prescribed statin medications stop using them within one to 24 months. Presumably this is due in part to the side effects.
Side effects from Lipitor and other statin drugs are dose related. In other words, as the dosage level of the drug is increased, the more likely the user will suffer from side effects. This is why the issue of taking 80 mg of Lipitor instead of lower doses is important.
In a recent campaign by Pfizer, sales reps have been attempting to persuade doctors to use 80 mg of Lipitor, rather than lower doses to prevent heart attack and strokes. A 2005 study did reveal that the high-dose Lipitor lowered LDL cholesterol more than the 10 mg low-dose pill. According to Dr. Jay Cohen and Dr. Bertram Pitt, however, while the higher dose of Lipitor did reduce heart attacks, more subjects on 80 mg of Lipitor died of other causes including cancer, than did those on lower doses of Lipitor. Pitt said, “the high-dose Lipitor showed no benefit on overall mortality.”
According to Cohen, the reason Pfizer is recommending the high dose of Lipitor is financial. The 80 mg Lipitor pill costs $3.33 while the 10 mg pill costs $2.44. When you consider that millions of people take Lipitor, that difference can mean the loss or gain of significant dollars.
The other issue Cohen said he feels is driving Pfizer to market the 80 mg tablet is that competitors of Lipitor are
becoming available in generic form. This change puts Lipitor at a significant price disadvantage.
According to Cohen, if you are a person who is in serious need of lowering your LDL cholesterol, you and your doctor should work together to have you eat a good diet, use a low- or moderate-dose statin, and use a drug that blocks cholesterol absorption from the gut or other means to lower your cholesterol.
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