Health: Preservation or Prescription - The Twilight of Vioxx
Regardless of how much scientific knowledge we might think we have about the use of prescription drug medications, the use of them remains largely an exercise in trial and error. The recent voluntary and worldwide withdrawl of Vioxx by Merck & Co. was the result of a long-term study that revealed patients using Vioxx are twice as likely to experience a heart attack or stroke. If a single prescription medication can have these kinds of consequences over time, it leaves one to wonder what multiple prescription drug interactions might have in store for us. Noticeably absent in many discussions about prescription medications is the vital and essential role of preventative health...
Disease Preventation is Only Part of the PictureAccording to a WebMD article, approximately 2 million people worldwide were taking Vioxx. The risk in the potential for heart attack or stroke increased from 7.5 per 1,000 on placebo to 15 per 1,000 on Vioxx. Statistically, this puts 30,000 people at significant risk.
To Merck's credit, they have undertaken a voluntary withdrawl of Vioxx. The market has responded according with a 26.78% drop in the value of Merck stock.
I found this comment in WebMD of particular interest:
All things being equal, Lavie would rather see his patients take naproxen or ibuprofen. So would Sam Lim, MD, chief of rheumatology at Grady Health Systems and assistant professor of rheumatology at Emory University, Atlanta.
"Cox-2 inhibitors have never been shown to be more effective than traditional NSAIDs for arthritis pain -- and they have no really significant safety advantage," Lim says. "I would recommend stopping Cox-2 inhibitors because we have equally effective drugs that are not conclusively worse: the traditional NSAIDs. If there is concern about gastrointestinal safety, patients can use protective drugs like proton-pump inhibitors to lower their risk even more."
Even so, Lim will prescribe Celebrex or Bextra to patients who want the drugs, provided they are aware of the theoretical risk.
If a single prescription medication can reveal startling consequences such as these, then it leave us to wonder what multiple precription medication interactions might have in store. If a single medication is an exercise in trial and error, then multiple medications may be more akin to a game of Russian Roulette.
A study called Multivitamins and Public Health: Exploring the Evidence released by The Lewin Group indicates that health care spending might be reduced by 1.6 billion through the use of daily nutritionals. Jeffrey Blumberg, professor at the Friedman School of Nutrition Science and Policy at Tufts University stated:
As our country (i.e. - the United States) faces an ever-growing crisis in health care, it is important to recognize the role that dietary supplements can play in reducing our burden of disease and the costs to manage it."