Merrill Lynched

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  • 11/17/2005

The following from Dr. Bob Goldberg — the real public citizen …

Merrill Goozner is a one of the many haters of medical progress at the Nader organization Public Citizen. Nader is the man who hates drug prices but loves to profit from drug companies by investing in their stocks, but that’s another matter. He has his own blog with the Seussian name of Goozner never misses an opportunity to apply a careful misreading of medical journals and pharmaceutical statistics to make the case the most drugs are worthless and that the rest that aren’t were developed largely by government researchers. He most recent assault on an article in JAMA reporting on the results of the Incremental Decrease in End Points Through Aggressive Lipid Lowering Study Group (IDEAL) is a case in point. Actually if he had read the full title of the study perhaps he wouldn’t have wasted his copious brainpower attacking the research. The study was designed to determine is substantial reductions in cholesterol levels could be achieved and if so, could they incrementally reduce death due to heart attacks, non-fatal heart attacks or cardiac arrest with resuscitation for people that already had one heart attack. The study had an interesting wrinkle: patients knew what drug they were getting and some even entered the study taking one of the two medicines taken at the most aggressive dose for Lipitor and the normal dose for Zocor.

Turns out that whatever reduction in major events could not be associated with a reduction in cholesterol. However, there were a strong relationship between use of Lipitor and a decline in the incidence of coronary heart disease. On the downside, about 10 percent of people on Lipitor stopped using due to adverse events compared to 5 percent of Zocor patients.

That’s what the study said. And it also said that overall the benefits of additional cholesterol reduction were incrementally beneficially at best for people that have already had one heart attack. No more and no less. But Goozner tries to paint the study as a cover-up of more people dying from heart attacks on Lipitor than Zocor (4 patients). Actually, the data is there on table three of the study. And he screams that there is no discussion of greater incidence of adverse events associated with Lipitor. Again untrue. It’s on page 2443 of the article. (JAMA Nov. 16, 2005 Vol 294, No 19)

Maybe Goozner, who in the past has trashed targeted cancer drugs as worthless or too expense, should read more carefully. Or less selectively. Or with greater intellectually honesty. Or with more intelligence. Or all of the above.


Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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