The Collison Newsletter July 2006

        DRUGS - THE QUICK FIX.  THE TOP 10*

 

      “The ‘quick fix’mentality is what is expected from orthodox medicine. In the Doctor’s pharmacopoea there are literally thousands of drugs. There is always one or more that can be prescribed to ‘treat’the symptom (for example, pain) or the sign (for example, elevated cholesterol). Such medicines, most of which are very expensive (P.B.S, the Pharmaceutics Benefits Scheme, costs the Australian Taxpayer several billion dollars each year) are expected to work immediately. If they do not do so, the patient returns to the prescribing Doctor to give him or her another try at being successful with a quick fix.

      Restoration of genuine optimal health by lifestyle change, including correct diet and supplements, takes time and patience, which the ‘quick fix’mindset will never allow. Realistic expectations for realising improved health through nutrition are essential.”(extract from “Feeling Worse Before Feeling Better”, Collison 2002)

 

      In the ‘Australian Prescriber’(volume 29, Number 1, February 2006), the ‘Top 10 Drugs’were listed. These were the subsidised drugs (part paid by the Australian Government) in 2004-2005. The following tables do NOT include private prescriptions. Subsidised drugs are prescribed under the PBS –Pharmaceutical Benefits Scheme or RPBS –Repatriation PBS.

      Table 1 sets out the “Top 10 drugs supplied by DDD/1000 pop/day”. The defined daily dose (DDD) / 1000 population / day is said to be a more useful measure of drug utilization than prescription counts. It shows how many people, in every thousand Australians, are taking the standard dose of a drug every day.

 

Table 1.   Top 10 drugs supplied by DDD/1000 pop/day


Drug

          PBS/RPBS

1

atorvastatin

98.173

2

simvastatin

55.967

3

ramipril

33.741

4

diltiazem hydrochloride

30.097

5

omeprazole

20.628

6

irbesartan

20.169

7

salbutamol

18.844

8

frusemide

18.775

9

aspirin

18.162

10

sertraline

17.604

 

atorvastatin

Brand Name: Liptor

HMG CoA reductase inhibitor, a ‘statin’. Hypolipidaemic agent.

simvastatin

Brand Names: multiple, including Lipex, Zocor, Zimstat

HMG CoA reductase inhibitor, a ‘statin’. Hypolipidaemic agent.

ramipril

Brand Names: Ramace, Tritace

ACE inhibitor. Antihypertensive agent.

diltiazem

Brand Names: multiple, including Cardizem, Coras, Dilzem, Vasocardol

Ca channel blocker. Antihypertensive agent.

omeprazole

Brand Names: Klacid, Meprazol, Probitor

Proton pump inhibitor. Treatment of reflux, gastric and duodenal ulcers.

irbesartan

Brand Names: Avapro, Karvea

Angiotensin 11 receptor antagonist. Antihypertensive agent.

salbutamol

Brand Names: multiple, best known Ventolin

Bronchodilator, eg treatment of asthma. Short acting β2 agonist.

frusemide

Brand Names: multiple, best known is Lasix. Others include Furosemide, Frusid.

Loop diuretic.

aspirin

Brand Names: multiple, eg Aspro, Disprin

Simple analgesic and antipyretic

sertraline

Brand Names: Xydep, Zoloft.

Selective serotonin (5HT) reuptake inhibitor (SSRI). Antidepressant

 

Table 2.   Top 10 drugs by prescription counts


Drug

           PBS/RPBS

1

atorvastatin

8,074,202

2

simvastatin

6,275,577

3

paracetamol

4,772,865

4

omeprazole

4,411,857

5

irbesartan

3,370,315

6

atenolol

3,247,475

7

salbutamol

3,062,355

8

esomeprazole

2,983,645

9

irbesartan with hydrochlorothiazide

2,938,448

10

ramipril

2,903,048

 

paracetamol

Brand Names: multiple, best known is Panadol. MIMS list 102 products with paracetamol.

Simple analgesic and antipyretic (generally combined with other drugs, eg codeine)

atenolol

Brand Names: multiple, eg Tenorimin

Beta adrenergic blocking agent. Antihypertensive and anti-arrhythmic agent.

esomeprazole

Brand Name: Nexium

Proton pump inhibitor. Treatment of reflux and peptic ulcers.

hydrochlorothiazide

Brand Name: Dithiazide.

Thiazide diuretic.

Generally combined with other drugs, eg irbesartan.

 

Table 3 sets out the Top 10 drugs by COST to the Australian Government. (Combination drugs do not have a DDD allocated)

 

Table 3.  Top 10 drugs by cost to Government.


 

Drug

Cost to Government ($A)

DDD/1000/day PBS/RPBS

Prescriptions

PBS/RPBS

1

atorvastatin

460,930,251

98.173

8,074,202

2

simvastatin

369,659,052

55.967

6,275,577

3

omeprazole

177,075,832

20.628

4,411,857

4

fluticasone with salmeterol

165,690,424

-

2,764,969

5

clopidogrel

151,235,466

7.551

1,925,546

6

olanzapine

149,497,256

2.892

710,453

7

esomeprazole

143,233,727

11.465

2,983,645

8

pravastatin

119,587,717

13.983

2,102,171

9

alendronic acid

108,587,183

8.543

2,115,898

10

pantoprazole

104,291,272

10.971

2,586,383

fluticasone with salmeterol

Brand Name: Seretide

For asthma proplylaxis

clopidogrel

Brand Names: Plauix, Iscover

Platelet aggregation inhibitor anticoagulant, antithrombotic

olanzapine

Brand Name: Zyprexa

Antipsychotic agent, treatment of schizophrenia related psychoses

pravastatin

Brand Names: Lipostat, Pravachol

HMG CoA reductase inhibitor, a ‘statin’.Hypolipidaemic agent

alendronic acid

Brand Name: Alendro, Fosamax

Biphosphonate. Treatment of osteoporosis

pantoprazole

Brand Name: Somac

Proton pump inhibitor. Treatment of reflux and peptic ulcers.

 

      The total cost to the Government (ie to the taxpayer) of the 10 drugs listed in Table 3 is A$1,949,788,180 –just under 2 billion dollars.

      Looking at just the three ‘statins’(atorvastatin, simvastatin and pravastatin):

  • They cost the government A$950,177,020 –almost one billion dollars
  • The number of prescriptions was 16,451,950.
  • The DDD/1000/day (ie the number of people, in every thousand Australians, who were taking the standard dose every day) was respectively 98, 56 and 14, totalling 168. This would mean that close to one in every six people were taking a statin to lower their blood lipids (cholesterol and/or triglycerides). This is independent of private prescriptions and prescriptions for other statins, eg flurastatin (Lescol, Vastin).

      Combining all the drugs in the 3 tables, the therapeutic applications were as follows: there were four antihypertensive drugs, three hypolipidaemic agents (‘statins’), three used in the treatment of reflux and peptic ulcers, two bronchiodilators, two simple analgesic and antipyretic drugs and one each of a diuretic, an antidepressant, an anticoagulant/antithrombotic, an antipsychotic and one used ‘in the treatment of osteoporosis’.

 

 

      With a lifestyle change, how many of the drugs listed in the above three tables would need to be consumed by so many people, at such a tremendous expense to the Australian government and the taxpayer?

      The lifestyle change needed to dramatically reduce the intake of these drugs would need to:

  • address in particular the epidemic of overweight/obesity
  • include a diet as outlined in ‘How to Live to 100+ Years Free from Symptoms and Disease’- dominantly vegetarian, raw and aiming for 75%-80% of foods consumed to be alkali forming (see November 2005 newsletter “Acid Alkali Balance –The Ideal Diet”),
  • include regular exercise and stress management, as well as adequate relaxation and rest.

      To take a drug is a quick fix. It takes time, discipline, motivation and understanding to embrace a healthy lifestyle, to prevent disease, and to reverse disease if already present. It is all too easy for the doctor to write a script for the quick fix, but surely the best approach is to identify the cause of the symptom and rectify it. A correct diet is one of the most significant aspects of the lifestyle that leads to Health and Longevity.

      This is the year 2006, a time when we have more scientific knowledge than ever before. It is therefore educational to meditate on the following quote from the writings of Dr H.M.Shelton, written some 50 years ago:

“What is falsely called “modern Scientific Medicine”contents itself with experimental toying with a never ending succession of drugs and with symptoms, while utterly neglecting the laws of life.  ……. the medical man ……plies his victims with innumerable expedients of medication, suppressing symptoms and ignoring causes until the condition of the poor sufferer becomes so intolerable that even his most potent poisons will no longer afford the so much coveted temporary respite from misery. During the past twenty years the medical profession and the drug manufacturers have entertained us with a rapid succession of “wonder drugs,”each of which enjoyed its brief heyday of popularity and then passed into that ever expanding Limbo reserved for the “cures”that pass in the night. Although they have held out to man great hope for the final eradication of suffering, the miracle drugs have proved to be as illusory as the drugs of yesteryear. These is no hope for man in poisons –violations of the laws of life cannot be remedied by poisons”.

      We must remember that the word ‘MEDICINE’is derived from the Latin Medico, and the literal translation of this word is ‘I drug’.

      From the orthodox medical point of view, the profession being driven by the pharmaceutical industry, unfortunately drugs will always remain the quick fix. Intelligent and thoughtful people, who are interested in health, disease prevention and longevity will be willing to take the time, energy and effort to address the underlying reasons for the epidemic of ill health and dis-ease which affects mankind in this, the twenty-first century.

 

* Copyright 2006: The Huntly Centre.

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