With annual sales of about $9 billion a year, Lipitor is said to be the best-selling drug in history and Pfizerits manufacturerwarns patients to tell their doctor if they experience any new pain or weakness. But according to a study by University of California at San Diego researchers, doctors dont listen to their patients.
Lipitor lip service?
Study: Docs ignoring patients’ side effect complaints
According to their report in the August edition of the journal Drug Safety, the researchers surveyed 650 adults who reported adverse side effects from Lipitor or other statins that were described as either muscle-, cognitive- or neuropathy-related. Patients said that they almost always initiated the discussion: 98% vs. 2% in the cognition survey; 96% vs. 4% in the neuropathy survey; and 86% vs. 14% in the muscle survey, according to the report. Patients also reported that about half the time their concerns were either ignored or dismissed.
Doctor suggested it was (my) imagination, wrote one respondent. Told me I just didnt like taking pills. Nothing wrong with me; its all in my head. She pooh-poohed me and said keep taking Lipitor.
Another wrote that the doctor just shrugged and then laughed.
The researchers wrote that those kinds of responses even came when there were symptoms with strong literature support for a drug connection, and even in patients for whom the symptom met presumptive literature-based criteria for probable or definite drug-adverse effect causality.
And the study underscores the outside influences doctors are subject to when caring for patients. Michael Ehlert, president of the American Medical Student Association, an organization that has been critical of pharmaceutical marketing techniques, said that there are two parts of the problem highlighted by the study: One, physicians only have 15 minutes with each patient, and two, doctors receive a lot of information about how good drugs are but not much on how dangerous they can be. Physicians are definitely focused on the positive side of drugs, he said. The bar charts and pretty pamphlets the drug-company representatives bring dont focus on negative side effects.
A well-known critic of drug marketing, however, noted that the study was somewhat flawed because it was impossible to know what the doctors really thought and why. I think there could be a lot of false positives, just as the current catch-as-catch-can system is associated with underreporting, wrote former New England Journal of Medicine Editor in Chief Marcia Angell in an e-mail.
Lead author Beatrice Golomb said the study suggests that physician surveillance for side effects from approved drugs is not enough and that patients need to be included in the process. Patient-targeted reports tend to be reliable and complement information from physicians, she said, explaining that patient reports are very different from those filed by doctors.
A spokeswoman from Pfizer declined to comment, but she said patients are alerted to five common and usually temporary side effects, and told to tell their doctors if they persist.
Send us a letter
Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.