Wednesday, July 23, 2008

You Can't Keep a Drug Maker Down

We're down on Merck. Have been for some time. Merck manufactures lots of drugs. Some are vaccines, which are mostly unnecessary and bad for you. Others can lower blood serum cholesterol, which in theory is a good thing for those with a high level of that ingredient, because statistics show that people with cardiovascular disease die earlier if they have high blood serum levels of cholesterol, than those who don't.

Why then are we "down on Merck?" Merck manufactures a brand drug called Zocor, which is a member of the family called "statins" (I take a generic form of one of them, Mevacor, which is lovastatin) which act on the liver in such a way as to limit the production of cholesterol, which in the blood stream can theoretically deposit as "plaque" on the sides of arteries and narrow the opening of these vessels for the flow of blood and thereby cause heart attacks and strokes. I use the term "theoretically," because there is no cause-effect proven action between serum cholesterol in the blood and cholesterol from ruptures in plaque causing heart attacks and strokes. The connection seems obvious and likely, but other factors in the "statins" may also inhibit cardiovascular catastrophes: statins reduce a form of inflammation in the system on which medical research is still tilling the ground. But this reduction of "inflammation" may be more related to the statistical lowering of early death rates due to heart attacks and strokes in patients taking statins, than the actual measurable lowering of cholesterol level on the blood. Or it may be a more complex combination of factors.

One reason there may be more factors than just cholesterol involved, is that the combination drug sold by Merck and Schering-Plough -- Vytorin -- which has Merck's statin drug Zocor along with Schering-Plough's "Zetia," has not shown any indication of additional lowering of death rates despite the measurable factor of lowered cholesterol in the blood. The "Zetia" factor in Vytorin blocks the uptake of cholesterol from the gut when food is eaten. "Zocor," or "simvastatin," the generic name, lowers cholesterol levels in the blood and has been proven statistically to lower early death rates, however it acts in the system. Zetia alone, or in the combination drug with Zocor, "Vytorin," has not shown the same results even though it lowers serum cholesterol.

In fact, a new study show that Vytorin is not better than Zocor, or simvastatin alone, and may even cause cancer, although that new study is quite controversial. What is definite is that the generic version of Zocor, simvastatin, costs a fraction of the brand drug Vytorin, and Merck and Schering-Plough stand to lose a literal financial fortune if patients buy simvastatin and don't buy one of the brands Vytorin, or Zocor, or Zetia.

Even more fascinating is the reason the tests were done in the first place, that have pointed to a cancer issue: Merck and Schering-Plough wanted to show in clinical tests that Vytorin is a wonder drug that could have a positive effect on aortic stenosis, which is a huge cause of heart operations, in which the aortic valve inside the heart is replaced because the valve has shrunk which inhibits its ability to allow blood to move from the heart to the body. Aortic stenosis can cause sudden death in patients, mostly elderly in which the disease is more common, because the heart muscle is overworked and can become damaged.

So in looking for a reason to promote this unnecessary combination brand drug, Vytorin, executives of Merck and Schering-Plough may have inadvertently pushed their companies' stock shares into figurative cardiac arrest.

Couldn't happen to a more honorable bunch of guys. Just kidding! Meanwhile, just because the Dr. went to school longer than you doesn't mean you can't do your own homework and bone up on your medical needs. You might save your own life, or, at least, your money.

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