The Collison Newsletter January 2013

                 DRUGS  -  The  Top  2  for  2011 - 2012*              

 

Each year, the Commonwealth of Australia (Drug Utilisation Sub-Committee Database) provides details of the top 10 subsidised drugs by prescription counts and cost to the Government. This information is published in the Australian Prescriber. Those for 2011 - 2012 were set out in Volume 15: Number 6: December 2012.

 

The 'Top 10 Drugs' have been discussed previously in my newsletters of February 2007, January 2008, January 2009 and February 2010. Because there was very little variation in the Top 10, they were not the subject of a newsletter in the last two years.

 

This newsletter will only look at No.1 and No.2 of the Top 10 for 2011-2012.

 
    
DrugCost to government DDD/1000 pop/dayPrescriptions
 (A$)PBS/RPBSPBS/RPBS
    
    
atorvastatin606,051,75582.9910,855,535
    
    
rosuvastatin369,088,99738.147,035,996
    
 

The defined daily dose (DDD/thousand population/ day) shows how many people in every thousand Australians are taking the standard dose of a drug every day.

 

Prescriptions PBS/RPBS does not include private prescriptions or prescriptions under PBS co-payment.

 

Atorvastatin is the generic name and is marketed by Pfizer as Lipitor. The patent on this drug expired in November 2011 and the generic form is now available.

 

Rosuvastatin is the generic name and is marketed by AstraZeneca as Crestor. The patent on this drug does not expire until 2016.

 

Lipitor and Crestor are statin drugs.

 

'Statins' are a class of drugs used to treat high cholesterol levels in the blood. Statins act by blocking the enzymes responsible for the conversion of 3-hydroxy-3-methylglutarte to mevalonate, which is the rate limiting step of cholesterol synthesis. For more details, see my August 2009 newsletter Statins - Adverse Effects.

 

There are clear guidelines for the prescribing of these drugs. They are spelt out in detail by the manufacturers, as well as in publications such as MIMS Australia (published by UBM Medica Australia, see www.mims.com.au). Criteria are set out to determine patient eligibility for subsidisation under the PBS (pharmaceutical benefits scheme). In writing a PBS prescription, the prescriber is certifying that the patient satisfies the qualifying criteria.

 

Consistently over the years, the Top 10 drugs have included at least two statin drugs. In the year July 2011 - June 2012, the numbers 1 and 2 of the Top 10 were statins. The cost to the government (the tax payer) of these two was A$975,140,752, almost a billion dollars! There were almost 18 million prescriptions and 121 people in every 1000 Australians were the recipients and taking the standard dose every day.

 

In my newsletter referred to above, the adverse side effects of statin drugs were detailed.

What are the Benefits of Statin Drugs? 

Dr David Newman published an article in June 2010 entitled Statin Drugs Given for 5 Years for Heart Disease Prevention (Without Known Heart Disease) (see www.thennt.com/statins-for-heart-disease-prevention-without-prior-heart-disease). Full details of the source material for the following numbers are provided as well as discussion.

 

"In summary, for those who took the statin for 5 years:

  • 98% saw no benefit 
  • 0% were helped by being saved from death 
  • 1.6% were helped by preventing a heart attack 
  • 0.4% were helped by preventing a stroke 
  • 1.5% were harmed by developing diabetes 
  • 10% were harmed by muscle damage.

In other words:

  • None were helped (life saved) 
  • 1 in 60 were helped (preventing heart attack) 
  • 1 in 268 were helped (preventing stroke) 
  • 1 in 67 were harmed (developing diabetes) 
  • 1in 10 were harmed (muscle damage)."

Dr Newman concludes that whether statins are an appropriate choice for primary prevention may be best left to individual preference. He believes that "benefits are best-case and harms may well be underestimated." He believes that diabetes, a chronic condition with serious long term morbidity, is more important to avoid for most patients than a single event such as a nonfatal heart attack or stroke. He believes that lifestyle interventions [weight loss, diet, exercise] are substantially more powerful than statin medications in achieving cardiovascular benefits, and come without harm.

How Important is Cholesterol in the Genesis of Heart Disease and Stroke? 

The following myths regarding cholesterol were published in a December 2012 newsletter issued from www.naturalhealthsherpa.com.

  • "Myth #1.   High cholesterol is the cause of heart disease.
  • Fact.   Cholesterol is a fairly insignificant player in heart disease.

  • Myth #2.   High cholesterol is a good predictor of heart attacks.
  • Fact.   High cholesterol is a lousy predictor of heart attacks. Half the people admitted to hospitals with heart disease have normal cholesterol, and plenty of people with elevated cholesterol have perfectly healthy hearts.

  • Myth #3.   Lowering cholesterol with statin drugs will prolong life.
  • Fact.   There is no data showing statins have any impact on longevity.

  • Myth #4.   Statin drugs are perfectly safe.
  • Fact.   Statin drugs have significant side effects, including loss of memory and libido, muscle pain and fatigue, and approximately 65% of doctors do not report side effects.

  • Myth #5.   Statin drugs are suitable for men, women, children and the elderly.
  • Fact.   The only group in which statins have been shown to have even a modest effect is in middle-aged men who’ve already had a heart attack.

  • Myth #6.   Saturated fat is dangerous.
  • Fact.   Saturated fat is mostly neutral and may even have some health benefits. Recent peer-reviewed studies have shown no association of saturated fat with heart disease.

  • Myth #7.   The higher your cholesterol, the shorter your lifespan.
  • Fact.   In the Framingham Study, the people who actually lived the longest had the highest cholesterol.

  • Myth #8.   A high-carbohydrate diet protects you from heart disease.
  • Fact.   Diets that substitute carbohydrates for saturated fat actually increase the risk for heart disease." 

Conclusion

Statin drugs are estimated to be a $25 billion industry. 

The unnecessary prescribing of statins in Australia, in the majority of people, is placing a significant burden on the government.

 

A lifestyle that includes reaching then maintaining the correct weight (BMI of less than 25), a diet that is dominantly (at least 75%) made up of alkali-forming foods (see my September 2005 newsletter Acid/Alkaline Balance- The Ideal Diet and my March 2009 newsletter Foods for Heath) and regular exercise will mean that there will be no indication for the prescribing of statin drugs in the majority of people.

 

Needless to say, fatty foods, especially transfats, and animal products with their saturated fats should not be a part of a healthy diet.

 

Unfortunately, lifestyle change is not easy to do and continue for life, but it is the way to health and longevity. See my book How to Live to 100+ Years Free from Symptoms and Disease (homepage). Drugs are a "quick fix" and do not give health. They but treat symptoms and generally do not address the cause.

 

Amazingly poor recommendations are being put forth concerning statin drugs, and the following are but three to illustrate:

  • The polypill is making a comeback. One of the ingredients is a statin. It is being recommended in the UK that everyone over 50 years should be on it (see my November 2005 newsletter Polymeal verses Polypill) 
  • Independent of the polypill, Public Health experts have called upon GP's to offer statins to all patients over the age of 50 years. 
  • A doctor from the Imperial College of London, in a study published in the American Journal of Cardiology, has stated that people who eat burgers and milkshakes at fast food restaurants should be given free statin drugs to counteract the adverse effects of the fatty foods.

The following book, published November 2012, is suggested reading: The Great Cholesterol Myth: Why Lowering Cholesterol Won't Prevent Heart Disease and the Statin-Free Plan that Will. Authors: Jonny Bowden and Stephen Sinatra. (Available from www.bookdepository.co.uk and www.amazon.com)

 

*Copyright 2013: The Huntly Centre.

Disclaimer: All material in the huntlycentre.com.au website is provided for informational or educational purposes only. Consult a health professional regarding the applicability of any opinions or recommendations expressed herein, with respect to your symptoms or medical condition.  

 

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