Good Grief!

I’m sad. I thought he was kind of cute.

I avoid Lipitor like the plague.

PFE would have more credibility if they had pulled the ad prior to Congressional inquiry. Not only does Jarvik lack a valid medical license, he has never had one.

I switched off Lipitor because of those ads. I was so sick and tired of seeing them. No wonder the cost is so high.

He is introduced in the ad as the inventor of the artificial heart, not an M.D., isn’t he? Do not many advertisements show ordinary people without any medical background at all talking about the medication they are on? I would think the advice of this inventor who is telling people how to keep the heart they were born with healthy and not have to use one of his artificial hearts, would be worth listening to.

A frivolous brouhaha over whether or not Dr. Jarvik can row.

A bad creative decision? Certainly. But what are the unintended consequences of this pseudo-debate and Pfizer’s decision to pull the ad?

First, it further feeds the resolve of the “Ban DTC” bund.
Second and more importantly, this may very well negatively impact current statin compliance levels while detering people from asking their physicians about high cholesterol.

And so the question to those enjoying the media feeding frenzy on this issue is — are the negative public health consequences worth the “oar-gasm?”

Does PhRMA pay you by the post, Peter, or do you have a post-quota that you much fulfill before you receive your check? Do you have data to shows a correlation between statin compliance and the jarvik ads? If not, then spare us your chicken little routine.

Does Sidney Wolfe pay you to post, Bill? Save your histrionics for the Nader chat rooms or the red phone on Alex Berenson’s desk. There are hardly any data to support the myriad and incessant posts in this blog claiming pharma to be the root of all evil, so apply your standard of rigor evenly, por favor.

There’s plenty of science to go around - you both should go and read up.

Maybe Dr. Stephen T. Colbert can be their next spokesman.

it’s been 18 months since I’m often statins and still all the side effects are not gone….

Congress needs to carefully choose the easiest targets that will win them the most popularity with the voters. Right now it’s the pharmaceutical companies (since the pereceived evilness of tobacco companies faded with limited DTC), so the biggest one is the logical choice. The substance of the inquiry is completely immaterial, they just need to put pressure on Pfizer and so they look for stunt doubles and white coats in the commercial. So arguing about merits of it is pretty pointless, because that is absolutely not the point.

I was on Lipitor for about 5 years but stopped because of right ankle pain and swelling with no cause determined. When left ankle started having same type pain my Doctor and I agreed best to stop the statins. Have been off Lipitor for over a year but still have difficulity walking where before I was good for full court basketball.

Why are all the DTC drugs significantly more expensive than ones NOT advertised? Or is it me?

Am I the only one here who thinks that Congress investigating these ads is a bizarre waste of our $$?

The US is only one of two countries that allowed branded DTC advertising on television. In all other countries, pharma is limited to reminder ads where the name of the brand is mentioned but not what it does or ads educational ads about the therapeutic category with no brand mention.

I don’t believe that misleading product advertising/marketing which has led to multiple lawsuits is a waste of congress’s time; but at the same time, i believe Pfizer pulled Jarvik because of the stories which detailed the emperor had no clothes in the mainstream media. I don’t mind jarvik wasn’t actually prescribing or rowing but i do find it completely disingenuous that he only personally began the drug months after the commercials were shot and began airing so the entire time he was providing a “testimonial” he was probably on what a generic statin??

Still don’t see what the big deal is, Jarvik had an MD and thus can use the preface Dr. infront of his name. As a cardiovascular scientist he probably understands as much about cardiovascular disease as an md. Furthermore, why is it that there isn’t any broohaha about the dtc advertising for non-FDA approved compounds, such as lipozyne and other diet “drugs” and “male enhancement drugs that are advertised. These comercials often have “doctors” in lab coats recomending there product. Granted if your freeze your dvr, pull out your magnifing glass and stare at the real fine print at the bottom of the screne, you can find out that they are not fda approved, results have not been validated by clinical trials and the results are not typical. If all of you all want to go after Pfizer and Jarvik, why don’t you take on these as well???

Peter, I wasn’t aware I was making any claims about possible collapses in public health or plagues of locusts if we didn’t all bow down and worship at the altar of holy pharma to be fed the drivel that they attempt to serve the American public. I simply asked where you got your information on the correlation between pharma’s inability to run a DTC and an increase in non-compliance with statins. The fact that you somehow justify making such ridiculous insinuations by saying that, “all the kids are doing it,” lends you about as much credibility as you warrant. All hail the Karl Rove of drug companies….

Filling prescriptions saves lives:
The study used hospital records from patients included in the Enhanced Feedback for Effective Cardiac Treatment registry, which included records from 104 Ontario hospitals between 1999 and 2001. Researchers then linked AMI patient records to the Ontario Drug Benefit prescription claims database, looking specifically at whether patients filled prescriptions for ACE inhibitors, antiplatelet drugs, beta blockers, calcium-channel blockers, lipid-lowering drugs, nitrates, or statins within seven to 120 days. During the study period, 73% of 4591 post-AMI patients filled their CV prescriptions within one week of hospital discharge, a number that rose to 79% within the first 120 days after discharge. Compared with people who filled all of their prescriptions, people who filled some of their prescriptions faced a 44% increased risk of dying within one year, while people who filled none of their CV prescriptions face an 80% increased risk of dying.[1]

Another study showed full coverage of CV medications in post-MI patients would save lives and be cost effective [2].

[1]Jackevicius CA, Li P, Tu JV. Prevalence, predictors, and outcomes of primary nonadherence after acute myocardial infarction. Circulation 2008; DOI: 10.1161/CIRCULATIONAHA.107.706820. Available at: http://circ.ahajournals.org.
[2]Choudhry NK, Patrick AR, Antman EM, et al.
Cost-effectiveness of providing full drug coverage to increase medication adherence in post-myocardial infarction Medicare beneficiaries. Circulation 2008; DOI: 10.1161/CIRCULATIONAHA.107.735605. Available at: http://circ.ahajournals.org.

I knew Jarvik was a phony the first time I saw the Lipitor ad. I will never buy any medication that is heavily advertised.

Is this study supposed to prove anything other than patients that had a heart attack were at a greater chance of dying if they didn’t fill and take their Plavix after they left the hospital? Is there an issue where someone is disputing that fact? I was under the assumption we were attempting to see the data that shows that there is a decrease in statin compliance when a drug company is not allowed to show a DTC? That was the claim, and this data has nothing to do with that claim.

I will agree that there are many ridiculous, anecdotal, and ignorant claims made on these boards. Most are made by individuals that do not know better because they are not educated on health care to any degree. Mr. Pitts is educated on health care, more so than most of the United States. My feeling is that if a person who is directly involved in the day to day advocacy of the drug industry makes a claim, then it should be a claim that is backed up by some data.

To make claims such as those, or to even insinuate them, is to attempt to use the knowledge that one has and prey on the fears of those who do not have the luxury of being so educated on medical and pharmaceutical knowledge. It is comments such as these, coupled with a, “we know better than you do what is best for you,” mindset that people find so detestable about the drug industry. The average person, myself included, do not “hate the drug companies.” What we hate is the drug industry’s arrogance.

Bill has a point… and besides as someone who works in the Ontario market- i can assure you neither LIpitor nor Crestor or any other branded drug appears on TV screens except for those with satellites tuned into American channels… Canada like the rest of the world is non DTC country in terms of television advertising and print is regulated to mainly medical trade publications.

Compliance is an issue for every drug in every therapeutic area but advertising has never been quantified as a positive or negative factor in any study mentioned here or by the drug industry at all.

Let’s not even start with whether in the broad population or only in specific high risk groups prolonged use of any statin as a deterrent is worth the cost to the individual in terms of side effects.

Bill, the lower economic barriers with $2-6 copays in the Ontario study, still left significant non compliance with fatal consequence. DTC is just a sidebar in the education deficiency story.

As to weighing the relative choices of treatments… doesn’t that belong in the privacy of the examining or consultation room, CMM?

2008 is the year of statin bashing. First Vytorin and Zetia, and now Lipitor. The only thing that will save the industry is Oprah announcing that she takes Crestor.
Robert Cykiert, M.D.
President,
WhatDoctorsThink.com

Wow, pills or bodybags, that’s an amazing extrapolation given that DTC is not mentioned anywhere in the study! Silly me, I forgot the “sidebar in the story” approach to clinical data that allows me to interject my own opinions into the study and remark off-handedly that they are a “sidebar,” thus lending them some sort of false sense of legitimacy.

Give us a break. If there was any data available to substantiate what was claimed about DTC and compliance, don’t you think that data would be in front of Congress’ collective faces daily, therby allowing the industry greater leeway when showing DTC?

Quit avoiding the question and either state that the comment on DTC and compliance is not supported by data and was just Pitts’ opinion, OR produce the data and prove that Pitts doesn’t just throw out comments that are not supported by fact in the hopes that no one will call him out. Which one is it?

Mr. Pitts is a brillant man, and I respect him for his intelligence. But there is hubris in thinking that either you have gotten so smart, or your audience has gotten so stupid, that you can just throw out supposition and have it accepted as gospel just because of the source.

It is a question of credibility. He has a side that he argues in favor of, and there is nothing wrong with that fact. But, in order to have your position be taken seriously, then you need to be able to say things that are backed up by fact. The agency that Mr. Pitts used to work for, (the FDA), as well as the industry that he advocates so fiercely for currently both require that objective data be used to prove points. Why does that not apply to statements made in a public forum to refute claims made in contrast to his positions?

That seems to me grossly one sided, particularly given his position. “Because I said so,” worked when we were all heard it from our fathers at five years of age, but it has no place in a public forum from a former FDA bigwig and founder of the Center for Medicine in the Public Interest. Particularly one as distinguished as the Wall St. Journal.

Well just think, maybe he can sell artificial hearts to those who don’t take their statin! Or will that be illegal too? I guess he can have a homeless person do it for him, cause he may not be licensed….

“Because of their arm’s-length relationship with patients, pharmaceutical manufacturers have been interested in whether drug advertising can improve therapy compliance. Contrary to many industry surveys, the author finds that the impact is small in economic terms, the effect spills over to other brands, and, in certain cases, the effect may decrease average compliance rates.”

DTC Advertising and Consumer Compliance.
Marta Wosinska, Assistant Professor, Harvard Business School
Journal of Marketing Research Vol. 42 Issue 3
August 2005

Just because some one went to law school does not make them a lawyer. And just because you went to medical school doesn’t make you a doctor. You actually have to PASS a state licensing exam!

Bill,
That sounds great.
I sell medical devices, which seem a heck of a lot more expensive than some pills.
So your saying it seems that the more spent on advertising, the fewer patients are compliant? Seems that every company ought to just stop advertising then. That makes sense.
Here is a non Harvard Business School equation (I didn’t qualify, went to Chapel Hill)…
Lets see, $50,000 surgery or $50 bucks a month for 1000 months ( thats 83 years for those of us not going to Harvard Business School ).

Jarvik DTA has always seemed to be a trivial issue. In concert with the cessation of the NIH ACCORD aggressive diabetic treatment arm and recent articles questioning the statin hypothesis because of the Zetia failure to show incremental benefit in ENHANCE, we have the makings of a perfect storm with terrible consequence.

I already hear of very high risk patients, who with superficial reading and knowledge, are making unilateral decisions, withdrawing critical therapy, based on sensationalized and biased reporting.

The EFFECT study has captured the potential consequences of these actions and should not be minimized or deemed irrelevant.

Stu, is it some sort of hidden medical fact that it is “either/or” between a 50K device and drug therapy? Are you advocating that ALL patients getting your 50K device have not taken any drug therapy? If not, then you threw out a blanket statement that does not apply to the whole, and only appeals to the sensationalist mentality.

DTC is directed toward starts, not compliance. Patients don’t pay 50K out of pocket for devices, but they do pay for the $50 a month for Lipitor. Generic Simvastatin works in many, many patients.

Lastly, I did not advocate anything, as I didn’t write the study. Maybe you should contact the author? Your points may have been stronger if you had been on the North side of I-40.

You presented the study to bolster your argument. Therefore you are advocating it.
I don’t know wether or not DTC increases or keeps patients compliant, I admit. But I do know that advertising is good at selling about anything including pet rocks. Your presentation of that study with the quote “in certain cases, the effect may decrease average compliance rates.” swims upstream in the face of a multi billion $ industry. It seems you are arguing than the entire media industry that has advertised pet rocks successfully, may inhibit patient compliance, poppy cock. If that keeps some that truly need the drug therapy compliant, than so be it. If it increases Pharma profits, great, hope they use it in more research to help cure more problems. If they are falsely advertising, marketing knowing harmful meds, than fry’em.
Now back to the article, I have no beef with the advertising that kicked off this blog. It is certainly more worth while than be saturated with Viva Viagra ads and see the akward face on my daughters when they hear how one should see a Dr (licensed) if experiencing a 4 hour erection. No one cares if Dr J was rowing except Merck. Dr Jarvik is more than qualified to tell someone to see their Dr about their high cholesterol.
The $50k for the surgery or the $50 for the drugs is a bad analogy, but I venture to GUESS that those on the $50/mo drug are less likely to be in need of the $50k procedure. Most will not pay the $50k directly, but the system does get its $$ from most. Of course if you like BHO or HRC you can imagine that it will be FREE.
If I have misconstrued your position, than silly me.
Good night.

If Pfizer had paid David Letterman to do a commercial encouraging people to take care of their cardiovascular health would that too be unethical? (David had a heart attack years ago.) It seems to me that you can hire anyone you want to pitch a product regardless of expertise. If Tiger Woods endorses Buick does he have to be a certified mechanic? Does Tony Snow have to be an MD to encourage preventative steps to avoid cancer? Is this really an issue for Congress? This is one of the dumbest big-government issues I’ve seen in a long time. I’d prefer Congress to work on border security and social security. Leave public ads alone unless there is fraud. Then there is this branch of government called the executive that’s supposed to prosecute these things, too.

Dear Pills or Body Bags, you copied and pasted much of a journalist’s rendition about RELATIVE risks and adherence to a 7 drug group of pills from the inner sanctum of the Red Light District of cardiology’s interventional medicine, theheart.org, and where access to the non anointed [and patients] is blocked by password requirement. The EFFECT [drug compliance] study is not on Medline yet, it is not placebo controlled [and where we know Lipitor has shown beyond any doubt NOT to reduce body bags] and there is no indication as to actual deaths postponed in those most faithful to trips to the pharmacy. The absence of ABSOLUTE mortality data is telling. Moreover, statin drug usage or compliance studies are fatally flawed because almost invariably baseline cholesterol and other important health data are unavailable.
.
The RELATIVE risk of being killed by a Jarvik heart was great but fortunately the ABSOLUTE risk of anyone being killed by one was minuscule. So, run for the hills when anonymous people support pills or procedures by fear mongering and relative numbers as opposed to using placebo controlled data and ‘Numbers Needed to Treat’.

http://pharmagossip.blogspot.com/2008/02/freelance.html

As one door closes…..

What is a DTV please?—Is that some kind of a drug user’s DVD player?

Dear VeteranRep, ‘border security’ is MORE important than the use of prescription drugs? Let me remind you of the JAMA study http://jama.ama-assn.org/cgi/content/full/279/15/1200 that, each year, ~106,000 Americans are killed and 2.2 million seriously injured by the ‘proper’ in-hospital use of drugs. Maybe the borders around, and the drugs in, hospitals ARE issues Congress should worry about first to make people safer. Numerically, in health and in money, there is no comparison. Direct to consumer ads don’t help the awful toll from the over and improper use of prescription drugs. You mentioned ’social security’ .. Drug costs don’t figure here too? My conflict: I cross the U.S. border several times per week and believe it an extremely safe place compared with drugs or hospitals.

great advice EDDIE, don’t take your pills, don’t go to to hospitals. You are a great spokesman for enhancing health insurance industry profits. Talk to Jarvik and he can advise you on how to negotiate a nice contract.

All rejoice the end to Jarvik!! Hoorah!!! Hoorah!!!

What the hell does Dingell know about anything? He oughta keep his nose of out of the affairs of private citizens and private companies. I don’t care what the commercial “appears” to be. You can’t get Lipitor without a prescription from a real doctor anyway. Its not like Jarvik is handing out scripts for Lipitor to anyone with a self addressed stamped envelope.

Just to clarify, the US Congress is spending tax dollars to investigate the validity of a tele commercial? Try using that expensive brain of yours, Congressman Dingell, for something of real value

James has it right. Eddie, it’s not that medication errors are unimportant, it’s an issue of “What is Congress’ job?” They don’t need to run DTC advertising or the medical field in general. Congress recognizes no limits on its reach and power. Border security and social security ARE the purview of Congress through legislation and budget and therefore that is where their collective noses ought to be stuck until they solve the big issues that will bankrupt our country. They ought not to go home until they actually solve a problem, but they prefer the the lights of the press on cotton candy issues like Jarvik and Pfizer. James is right about Dingell and all the others. They don’t know anything about running any industry, but they spend their time on it instead of running the government which actually IS their job.

I repeat - ask Jarvik about Lipitor or “ask any mermaid you happen to see, What’s the best tuna? Chicken of the Sea!” It is the same thing.

Why does Congress have to spend MY money to look into Lipitor commercials, which anyone with an IQ above his BUN knows are puffery? Did some Congresscritter not get his/her/its campaign $?

{For the non medical types - upper limit of normal BUN is 20…)

John Dingell is, himself, not qualified to make such judgements about anything medical unless he, unbeknowndst, has a medical degree of his own. Dr. Jarvik has the credentials to make such judgements whether a practicing clinical physician or not. More meddling by an unqualified Democrat. God save us!

Stephen Hammock, PA-C.

The world of stupid is upon us. John Dingell isn’t qualified to say anything about the medical field. He did not even research Mr. Jarvik. Look at crap we as Americans put into officer. What a shame a commerical has our boob tube whinners calling the Kettle Black.

Dear VeteranRep, I thought 1. Congress is there to protect The People and 2. that the issue at hand (and where we agree) is this campaign where people were mislead by a man insinuating “as a doctor and a dad” that Lipitor is effective in saving lives in a fatal disease. Pfizer knows it does not, anyone having read the placebo controlled data knows it does not, yet, in part because of Jarvik prostituting himself as a spokesperson, many not having read the studies are likely to believe that they can ‘trust their hearts to Lipitor’. For many reasons, this is likely to harm people, i.e. Congress’ role.

The person absent from this important blog is Dr. Jarvik defending the campaign, the man not returning calls or email. He is no football coach [Ditka, Reeves] flogging ED or cholesterol drugs, he presents himself as a top specialist in the field.

Unless all ads present total balance, the Congress or other regulators have roles to intervene. We both know, drugs can kill and sometimes cure. It’s the preventing of harm first that is the role of ‘fair balance’. To make things simple, why not kill all such ‘as your doctor if Rx is right for you’ ads and pharma can go back to developing drugs that actually DO save lives in fatal diseases. I believe Pfizer did the right thing in finally pulling this sorry campaign. The WHO has called another Lipitor campaign ‘unethical’ in The Lancet, so Pfizer is a slow learner, but in this case, bravo!

While many of you are piling on the congressman for spearheading the campaign to relieve Dr. Jarvik of his “endorsement”, you are ignoring the power of the medium of television. Someone touched on it above about how advertising can get people to buy pet rocks. TV advertising is the most powerful and persuasive form of promotion you can use. If people weren’t so prone to buy crap, we wouldn’t have QVC, HSN, and 30 minute infomercials starring Ron Popeil. People BUY stuff for little or no reason. Using an alleged doctor to say Lipitor will prevent heart attacks prompted MILLIONS of people to ask their doctor for Lipitor. There are so many doctors out there who don’t spend the time to examine their patients thoroughly and just want to run them in and run them out with as few problems and snags as possible. So to shut up a nagging patient, just prescribe Lipitor for them and move on.

THAT’s the danger Congress saw in Jarvik’s misleading Lipitor ads.