People’s pharmacy: How can people decide if a drug is worth the risks?
Every time we take a shower, we are reminded of what happens when you ignore instructions. Several years ago, we purchased a new shower door and hired a handyman to install it.
This was not his area of expertise, but he didn’t bother to read the instructions carefully. He hung the door backward. As a result, every time we slide the door open, it squeaks like crazy and does not create a perfect seal.
Do-it-yourself projects often end badly when we don’t read the instructions first. So why do we assume we can take medications without reviewing information about them?
When you pick up your prescription from the pharmacy, what do you do with the little leaflet included in the bag? Many people throw it out without a glance. Some may stuff it in a drawer for future reference. We suspect that only a few read it.
Those who do read the insert may find it overwhelming and give up after a few sentences. Others may assume the warnings have nothing to do with them.
One reader of this column wrote: “Why does the FDA approve drugs that have very serious side effects that could make your condition much worse? When I see drug commercials on TV with a long list of scary side effects, I wouldn’t want to take something like that. Perhaps the complications only happen occasionally, but I believe that many doctors and pharmacists may not take these side effects seriously.”
This comment reveals the problem with most drug information. TV commercials that list adverse reactions like serious infections, fatal blood clots, cancers, heart attacks, strokes or death don’t tell you how frequently these problems may occur.
We are rarely told how often “common side effects” like muscle pain, weakness, cough or stomachache are likely to occur with our medicine. That’s true for television commercials as well as patient leaflets. Even the Food and Drug Administration’s official prescribing information rarely provides accurate data on benefits as well as risks.
Take statins, for example. At least 50 million Americans swallow a statin-type cholesterol-lowering drug daily. Atorvastatin is the most frequently prescribed drug in America. Many people take it to prevent an initial heart attack.
There’s no question that statins lower LDL. The question is whether that will result in a longer, healthier life for people without diagnosed heart disease.
A comprehensive review found that people taking statins get on average 12 extra days of life thanks to the medicine (Journal of General Internal Medicine, August 2019). The analysis showed that people with heart disease get an average postponement of death by 17 days, while those without heart disease get 10 additional days.
They may experience side effects such as muscle pain. A renowned cardiologist, Dr. Steve Nissen of the Cleveland Clinic, wrote in the New England Journal of Medicine (March 4, 2023): “… 7% to 29% of patients report adverse musculoskeletal effects that prevent them from using statins …” Such a range makes it harder for patients to decide if the benefits outweigh the risks for statins.
People deserve clear information that will help them decide if the advantages of a new medicine are greater than the possible harms. Patient medication information needs to be clear and concise so that people can use it to make decisions.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, Fla., 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”