On 2008-03-07 22:32:20 +0000, "The Medway Handyman"
said:

Andy Hall wrote:
On 2008-03-07 00:11:17 +0000, "The Medway Handyman"
said:


His rather limp reply was that they wouldn't do me any harm. Apart
from wasting NHS resource of course.

Generic statins are cheap so this is a non issue. The funding path
between our pockets and the point of delivery of healthcare is the
actual waste of resource, which is why the NHS as currently arranged
should receive major surgery.

It certainly isn't a non issue. Prescribing something of doubtful
value & justifying it because they are 'cheap' is a terrible waste
of limited resource. If they are cheap & prescribed by the million
its still lots of money.

In comparison to the potential cost of long term care of those
disabled by cardiovascular events, it's very cheap.

Not if it doesn't work it isn't.

Which is the precise point.

In terms of a worthwhile means of measurement, which can only be from a
large sample of people with varied demographics over a long time (e.g.
a generation or more) there is not definitive evidence one way or
another in terms of outcome in quality adjusted life years.

It is known that statin drugs reduce undesirable blood lipids in
certain groups of patients. To that extent, they do as billed.

We also know that there is some correlation between poor lipid profiles
and poor outcome from cardiovascular events.

What we don't know is whether poor lipid profiles are causal for poor
CV outcomes and we also don't know whether statins, using a broad study
base over a long period affect outcome.

However, it's a very long stretch to say that statins don't work at
this point. The most pessimistic honest view is that they may work.

To that point, a small sample taken from what happens in one bit of the
ambulance service is not useful in any way at all as corroborating
evidence one way or another.

The only valid way to compare outcome is to test across a wide
population for an extended period, which is what is happening. If we
adopted the principle of don't use a new treatment because it might not
work, we would be in the middle ages.