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Monday, April 7, 2008

Vytorin (Ezetimibe/simvastatin) Doesn’t Work; You Wouldn’t Know

posted by on April 7 at 14:36 PM

In the past few months, I bet you’ve seen at least one ad like this:
Vytorin500.jpg

When I first saw these ads, I was impressed.

Most direct-to-consumer drug advertising is loathsome, filled with moronic non sequiturs—what does kayaking have to do with a nucleoside analog used to treat herpes—or simply build up anxiety about a problem, offering no explanation as to how the drug helps.

These ads, for a combination pill meant to treat high cholesterol, are actually quite clever in explaining how the drug should work—a combination of blocking cholesterol production by your liver (a gift of your parent’s genes) and blocking the absorption of cholesterol you eat.

Memorable, clear, informative; too bad the drug doesn’t work.

The results of our study showed that the addition of ezetimibe to the highest recommended dose of simvastatin did not reduce the intima–media thickness of the carotid-artery wall in this cohort of patients with familial hypercholesterolemia, despite significant incremental reductions in levels of both LDL cholesterol and C-reactive protein. The primary outcome, the change in the mean intima–media thickness, did not differ significantly between the two study groups, nor did the secondary outcome measures.

In plain English, this combo pill was no better at stopping the arteries from getting clogged with cholesterol. In fact, the older statin drugs—available as much cheaper generics now—do a better job on what you, as a patient, would care about.


The vast majority of people exposed to these ads probably don’t know this, and will never know that the drugs didn’t work, that you’re better off with a vastly cheaper drug, that the companies making Vytorin sat on the negative results in this study while racking up billions of dollars in sales. My suspicion is that many people will continue to ‘ask your doctor about Vytorin,’ as the ad suggests. And this is why even exemplary direct-to-consumer drug advertising is so damn irritating.

RSS icon Comments

1

Having HSV-1 I always hoped and prayed that I would get HSV-2. I mean, V*ltrex shows me that a vacation comes with HSV-2!

On a more serious note;

The Va*trex ads are the biggest bit of scaremongering I've ever seen. "I don't want to give it to my partner..." (which loosely translates into "You will transfer it to your partner if you don't take V*ltrex") If you're married how the fuck should that matter (Herpes isn't the end of the world)? Is everyone in those goddamn ads just dating for now? are they all fucking out of wedlock? It's absurd.

asterisks for spam blockage

Posted by Bellevue Ave | April 7, 2008 2:49 PM
2

The sad thing is how many people take these ...

Generally, if an ad says "ask your doctor about ProductName" ... don't.

Posted by Will in Seattle | April 7, 2008 3:11 PM
3

Read http://thelastpsychiatrist.com/2008/04/vytorin.html for one opinion of why this latest study is kind of a clusterfuck from the getgo. The main takeway is that V*torin is better than Z*cor alone when it comes to LDL levels, total cholesterol levels, and something called CRP.

Anyways, it sounds like a fairly thorough bit of incompetence and questionable judgment from everyone, including the manufacturer (who acted unethically in trying to suppress the results), the study organizers (who studied something twice removed from the actual goal), and the press (who's a sucker for a dramatic headline like "V*torin doesn't work" when the truth is more nuanced).

Posted by also | April 7, 2008 3:14 PM
4

Is there an example of direct-to-consumer drug advertising that is actually helpful?

Posted by Chris in Tampa | April 7, 2008 3:21 PM
5

Looking at the image, I thought it was some sort of combined cholesterol-reducing (the piece of pie, on the right) and anti-anxiety (your annoying granny, on the left) medication...

Posted by cdc | April 7, 2008 3:37 PM
6

I just watched Michael Clayton two days ago. Creepy.

Posted by Greg | April 7, 2008 3:55 PM
7

All of these "ask your doctor about..." ads crack me up. I mean, if your doctor even has the remotest glimmer of a clue, he should be on top of this shit and you shouldn't NEED to ask, right?

Posted by Fifty-Two-Eighty | April 7, 2008 3:56 PM
8

The bigger issue is the marketing of this drug to physicians, who are the ones that write the prescription. This was a drug heavily pitched by drug reps, who never had the data on outcomes to support it.

Posted by RJ | April 7, 2008 3:56 PM
9

@4 - yes. Aspirin. One of the better - and cheaper - meds that actually does a lot of good.

Posted by Will in Seattle | April 7, 2008 4:18 PM
10

@7, that always confused me too, especially coming from ads where they never even hint at what the drug is supposed to treat. Do I just go to the doctor with a list of every drug my TV told me I should ask him out, and go down the line?

Posted by tsm | April 7, 2008 4:56 PM
11

You shouldn't bother asking your doctor about Vytorin, because your insurance company isn't going to pay for it. You see, Insurance Companies realize the average t.v watching, pill popper is a total nincompoop who demands whatever the hell it is Big Pharm is advertising on t.v even though they don't know what it is and don't need it. Your insurance company, cheap bastards that they are, will only approve coverage for generics ($5.00 co-pay) and expect you to cough up the extra couple of hundred dollars a month for your brand name, as-seen-on-t.v medication.

Posted by yucca flower | April 7, 2008 5:22 PM
12

Exactly, 11!

Vytorin is $3-$4 a day and it is nowhere near as effective as generic statins costing a tiny fraction.

As cute as the commercial are (who doesn't like being compared to baked ham or a platter of fried chicken?), it's one of the things I'm hoping for with a Democratic administration - removing prescription drug advertising from TV and magazines (it was once banned). Prescription drugs aren't really a free market commodity in the sense that I chose this drug over that drug. That decision is made by my doctor, my pharmacist, and my health care provider.

Posted by Bauhaus | April 7, 2008 6:55 PM
13

@11,

Well, they should do that, and the government should do that if or when we get single payer health care. Unless you have documentation that the generic doesn't work or doesn't work well enough, you shouldn't be able to use the name brand.

Posted by keshmeshi | April 7, 2008 8:13 PM
14

This was actually a pretty big story in the mainstream press in January when Merck and Plough-Schering released preliminary results under Congressional pressure. So, I'd hope you're not right about the ignorance of "the vast majority" w/r/t Vytorin and Zetia.

Posted by josh | April 7, 2008 9:03 PM
15

You know what else is irritating? Giant Canadian media conglomerate CanWest Mediaworks wants a piece of that profit pie so bad they're shamelessly charging that our restriction on d-t-c drug advertising is a violation of the Canadian Charter of Rights and Freedoms. Yes, they're framing it as a human-rights issue, claiming they are being denied the right to freedom of speech. This despite the fact that they are only restricted from advertising for the drugs, not from including them in editorial content.

If they win, I guess we'll be getting extra-large servings of this crap every day, too. Can't wait.

Posted by Irena | April 7, 2008 9:24 PM
16

@josh.

You're right, and I thought about mentioning that very point in my original post. But more in the sense that *even with* mainstream media coverage, vastly more people were/are exposed to the ads than any sort of honest reporting on the subject.

Hmm. After this round of layoffs, does the Seattle Times have any science reporters?

Posted by Jonathan Golob | April 7, 2008 10:40 PM
17

The USAToday has had two page ads for this crap several times in the last week. Business section, natch. Doesn't their advertising department bother to read the paper?

Posted by G in INdiana | April 8, 2008 4:44 AM
18

Of course the MDs practically parrot the commercials. In my practice as a cardiac nurse, many of my patients have said "Dr. ___
told me that Vytorin works best for me."
As if this costly combo med is tailored to their lipid problem.

Posted by suz | April 8, 2008 5:47 AM

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