Hell hath no fury....

Apparently the Catalyst shows from a month or so ago have had an effect and it was one the statinators, who felt they didn’t get equal time, did not like. And I’m sure their life support system, Big Pharma, didn’t enjoy it either.
A few hours ago, a popular Australian online news source published an article claiming that the Catalyst show could end up causing 3000 heart attacks. How did they arrive at this specific number?
The Heart Foundation has made the estimate after a survey it conducted found a third of those taking cholesterol lowering statin medications stopped them or reduced them in the wake of the Catalyst program on ABC.
When extrapolated to the entire population of 2.1 million Australians who take statins the survey found 55,000 people completely stopped taking their pills after the program.
We don’t know the number of subjects the Heart Foundation of Australia (HFA) sampled to arrive at their countrywide estimates, but they extrapolate them not only to estimate the number of people who stopped their statins, but also to the 130,000 who changed their medications by stopping then restarting or reducing their dosage and to the 120,000 people who discussed their statin with their doctor. One presumes a few of those went off the pills as well.
Dr. Norman Swan, the Australian Broadcasting Corporation’s  own medical expert, has publicly announced that “people will die” as the result of the Catalyst show.
The NHF survey estimates that 2-3,000 people will have heart attacks over the next five years if all the patients who discontinued their statins as a result of the show continue to stay off the drugs.
Since each heart attack costs the Australian nationalized health service somewhere in the range of $6,000-$12,000, the total cost could end up being around $33 million. A pretty big chunk, indeed, to be extracting from the publicly financed health system. If it proves out that way.
I did a little calculating on my own and came up with some other interesting figures. Using their figures of just the 55,000 people they estimate will completely quit their statins (we’ll ignore the other couple of hundred thousand, some of whom may have quit the drug and others of whom may have decreased their dosage), we can calculate the savings to the Australian nationalized health system.
Statins are pretty expensive drugs that can, depending upon the kind and dosage taken, cost upwards of $100 per month. But let’s assume the Australian health system can buy at a deep discount and get their statins for a mere $10 per month and calculate the savings from 55,000 people quiting the drugs.
55,000 X 12 months X 5 years X $10 per month = $33 million.
So, it’s a wash at those prices as far as the Australian health system outlay goes.
But according to what I’ve read, Lipitor (atorvastatin), even though it is off patent, still costs Australia’s health service $51.24 per month. Let’s rerun our calculations using that number.
55,000 X 12 months X 5 years X $51.24 = $169,092,000.
So, if the Australian health service were looking at this strictly from a cost savings basis, it would see a savings of $136 million if 55,000 people quit their medicine and 3000 of them have heart attacks.
And that doesn’t include the new cases of diabetes, which the NHF conveniently forgets. The true figure isn’t in yet, but it looks like somewhere in the range of 2 percent of patients who go on Lipitor are going to develop diabetes. (In the US, the lawsuits are already flying. Google: Lipitor lawsuit diabetes, and you’ll see what I mean.)
Let’s look at the stats on that.
55,000 patients who stopped statins X 2 percent who would develop diabetes = 1,100 cases of diabetes the Australian health service won’t have to pay to treat. Assuming the lifetime cost of dealing with diabetes is $8,000 per year (that’s about what it is in the US), that would mean the health service would be saving another $8.8 million per year.
But wait. These people are going to live longer than a year.
Let’s assume they live another 15 years. Not an unreasonable assumption. Then the total cost would be $8.8 million times 15 years or another $132 million, about four times the cost of the number of heart attacks the NHF estimated would occur should 55,000 people decide to quit their statins. We don’t even want to think about the numbers should these people live 20 or 30 more years.
So, if these 55,000 people stay on their statins, the Australian health service is going to be out $301 million ($169 million for the statins plus $132 million for diabetes care).
If the 55,000 people go off the statin as per the NHF estimate, then they estimate 2,000 − 3,000 will have heart attacks in the next five years. Which they say will cost the taxpayers $33 million. But where to they get their numbers?
Is their 2,000 to 3,000 number accurate?
Let’s dig a little deeper.
The NHF estimates that 55,000 people quit their statins. They also figure that one in four of these people had already had a heart attack, which means that 13,750 of the people who quit had had a heart attack and 41,250 had not had a heart attack.
Let’s look first at those who hadn’t had a heart attack.
According to the published data on treatment with statins, 1.6 percent of these 41,250 people will have a heart attack who otherwise wouldn’t had they taken the statin. That calculates to 660 people.
Of the other 13,750 who had previously suffered a heart attack, the data show that 2.6 percent or 358 people would have another heart attack who otherwise would not have had one, had they not quit their statins.
So, according to the data, if 55,000 people really did quit their statins, over the next five years 1,018 of them will have heart attacks who would not have had one had they continued their statins.
What this means is that the Australian health service is paying $169 million dollars to prevent 1,018 heart attacks. Which calculates to $166,011 for each heart attack prevented. Do you think that is a rational preventative health policy? I don’t.
Especially in view of the fact that approximately 10 percent of the 55,000 people will suffer some adverse effects of the statins and two percent of them will develop diabetes.
Forget the other adverse effects, the short term memory loss, the muscle aches and weakness, the liver damage, the rhabdomyolysis, the kidney failure, and all the rest. Just the two percent who get diabetes will end up costing (as per our calculations above) $132 million more. So if you factor that in, the health service is paying almost $300,000 per each heart attack prevented.
But wait, you may be asking. What about the 2,000-3,000 heart attacks the NHF predicted if 55,000 people go off their statins? That’s a lot more than the 1,018 we just calculated. Where did the NHF get its numbers?
Well, Big Pharma doesn’t like to admit it, but people have heart attacks all the time even while taking statins. Taking a statin is no guarantee you won’t have a heart attack, although many people erroneously think it is.
The 2,000-3,000 number includes the number who will have heart attacks despite being on statins, which is kind of disingenuous way to present the statistics.
So why are all these people so hot to discredit this TV show, which simply told people there was another perspective to the statin story? And maybe to discuss it with their doctor.
Remember that number we calculated? The one that showed how much the Australia health service would save if those 55,000 people quit taking their statins? The $169 million?
The Australian health service will save that much. But there is another side to the equation. If the Australian health service saves $169 million, that means someone else doesn’t receive $169 million. Figure out who that is, and you’ll see the rationale for all the consternation.
Cherchez l’argent.

If you’re new to this blog and are wondering what all the fuss is about, here is the link to my post on the Catalyst show on statins.  You can watch the entire show on this link.
And here is the link to part one of the two part Catalyst series on diet and drugs.  The first show is on the notion that maybe cholesterol isn’t really the risk most people think it is.

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