TV Ads Expand the Market for Statins, At the Expense of the Public's Health

We have previously written about the overprescribing of statins, especially to people for whom the benefits are questionable because of their low risk of heart disease. (See, for instance, “Statins for Primary Prevention: Risks Without Benefits” from the June 2013 issue of Worst Pills, Best Pills News.)

There may be several factors behind this phenomenon. For instance, one study documented that doctors’ knowledge about appropriate statin prescribing, especially for patients with lower cardiac risk, was dangerously lacking.

A new study involving 106,685 people measured the interplay among exposure to direct-to-consumer advertising (DTCA) for statins, medical diagnosis of high cholesterol, estimated risk for cardiac events and prescription of statins. This study essentially attempted to examine how successful those patients “motivated” by TV ads to get statins might be in convincing their often inadequately informed doctors to inappropriately prescribe these drugs.

According to the authors, increased exposure to DTCA statin ads was associated with a 16-to-20 percent increase in being diagnosed as having high cholesterol and a 16-to-22 percent increase in being prescribed a statin. Almost all of this increase occurred in people deemed to be at low risk for future cardiac events. Conversely, for those who were at higher risk of cardiac events, the increased DTCA exposure was not associated with an increase in prescriptions.

The billions of dollars spent on DTCA of statins in the U.S. during the seven years covered by the study (2001-2007) certainly seem to have had an impact, the overall result of which is probably negative for the public’s health. Those in favor of DTCA are quick to point out that this “education” about health risks leads to more doctor visits, testing and “appropriate” treatment. This study certainly confirms earlier evidence that DTCA increases the demand for drugs such as statins. Yet the increased prescribing did not occur among people at high cardiac risk, who stand to potentially benefit from testing and treatment. Instead, increased prescribing was largely limited to those at low risk of heart disease, for whom the risks of statins — more of which are being documented each year — very likely outweigh the highly questionable benefits.