Children on Statin Drugs

The July 8th Science Times had an article on children as young as eight being put on cholesterol lowering drugs called statins in hope that it would prevent heart attacks in the future.  The recommendations come from a panel at the American Academy of Pediatrics. Children with LDL cholesterol of 190 mg/dl or with a significant family history would be candidates for such a drug.  Doctors are divided on the issue and I tend to agree with the doctors who are against this practice.  

Side effects are muscle pain and cognitive problems.  There is no data that suggests it will prevent a heart attack or prolong life.  it would be a terrible shame to have children taking a medication that most could have done without if only they ate less McDonald's and exercised more.

Parents are often influenced by doctors advice.  If a child fits the criteria, drug companies advertise these drugs as life prolonging if not life saving, and a doctor advises so, parents will be likely to consent to the treatment.  Until a child reaches their age of majority (18 in most states) they cannot make their own medical decisions.  Since there is no long term studies that prove it will work, not what would happen to a person of statins for more than 50 years of their life, it would seen wreckless to force such a treatment on a child.  Children do have informed consent, parents make healthcare decisions.  Should we allow children who are not able to consent, be put on potentially dangerous medication that has no real multi year study to suggest it might actually work?

NY Times Cancer Drug

Yesterday I read an article titled "Costly Cancer Drug Offers Hope, but Also a Dilemma".  This is about a cancer drug called Avastin. It is FDA approved for advanced lung and colon cancer but is being prescribed for many different types of cancers without evidence of it actually working to prolong life or kill the cancer. The article quotes that the drug price from the maker (Genentech) ranges from, $4,000 to $9,000 a month, based on the patient’s weight and the type of cancer.
What was even more astounding to me was that it is not an unusual practice that doctors and hospitals can buy the drug and then sell it to patients or their insurance company at a mark up! I wonder where the financial incentive ends and the patient care begins? My former roommate and best friend, Billy has had colon cancer for 4 years now. I have not asked him, YET, if he is on this drug. Billy is willing to try anything that will make him well. If his oncologist were to suggest it, Billy’s insurance would pay for it (he is well insured). It is approved for colon cancer so is there REAL benefit to this or perhaps a strong placebo effect he can pay 50,000 a year for, or should I say WE ALL pay for through insurance premiums. If it would make him or others well, I would surely pay my share for it but I am appalled that it can be purchased and resold with a mark up. I am not saying by ANY stretch that money spent to save lives is money wasted but lets look at the numbers. In one case about its effectiveness against lung cancer the study’s Avastin patients lived no longer than those who got the chemotherapy plus placebo. The drug slowed the median time until progression of tumors but the difference was less than a month. This hardly seems like good money spent. If a tumor does not get larger, but the patient still dies, is that really a benefit? There is a case noted where a patient with brain cancer had a remarkable improvement and the physician has prescribed it to many other of her patients. This is an “off label” use or a use not defined by the FDA. Since this drug is always given in combination with chemotherapy, I guess it would be hard to decide whether or not it truly makes a difference. People will rightfully do anything to rid themselves of such a horrible disease and therefore would not go into a trial where this drug is used alone to reveal true if any benefits. Could it be the case that cancer is too profitable to cure? Sigh.......