Posted on 03/02/2024 2:44:32 AM PST by dennisw
It’s based on - now as in the 1950’s when the first effective treatments were prescribed - results of insurance company actuarial tables.
People with “hypertension” die from renal failure, cardiovascular issues like stroke and heart attacks at MUCH higher rates than those with lower pressures.
Yes, the lower the better, generally.
It’s not about the money, this is about preventable morbidity and mortality.
However…
Curiously, the first treatments were known centuries ago, and reserpine marketed as Serpasil at one time - extracted from Snake Root (Rauwolfia serpentina) is STILL prescribed during pregnancy, is dirt-cheap and has a favorable side-effect profile. HCTZ is SO cheap, it’s STILL possible to lower BP for pennies on the dollar compared to some meds.
As a Family Practitioner, I’ve often been AMAZED at patients telling me they can’t afford their blood pressure medicine during conversations like this:
What are you taking for your BP?
What my CARDIOLOGIST prescribed. Something VERY new, unproven, highly touted at CME meetings and heavily advertised.
At $400 a month, no, not too many people could.
Did he/she try prescribing HCTZ, ACE inhibitors (ACEi and ARBs are still first choice per NIH studies), at a cost of, oh, ten to one hundred dollars a YEAR?
No, he only wanted me to have the BEST! I can’t stop taking it, he says I’ll have a stroke.
Yeah, it’s what’s called “the hard-sell” and it scares the bejabbers outta the little oid ladies and younger anxiety disordered patients alike; it’s what the pharmaceutical detailer pushed on him that week.
And he signed up for a study with a clever acronym. might even get his name on a paper or two, present at a conference.
what are your thoughts on Eliquis? It is very expensive. Is it necessary for occasional Afib?
He he he...winnowing the chaff.
That’s nice that Oregon has RECRIMINALIZED drugs. Now, they will no doubt go back to the EXPENSIVE revolving jail door system that didn’t work either.
What works is PAIN and lots of it. Plus, it drastically reduces jails, prisons and guards. Singapore and Saudi Arabia have proved this beyond all doubt.
Personally, professionally, I THINK the Eliquis mfrs have paid to have the studies done, all but the post-production/marketing reviews.
Right now it’s the hottest thing since digoxin - which turned out to be virtually useless, no matter HOW many tens of thousands of patients had taken it for cumulative millennia worth of correlative data it eventually fell by the wayside.
I’ve skimmed through the literature and I agree its use EARLY on in several hypercoagulable states/conditions it’s saving lives (that reduction in morbidity/mortality I mentioned earlier). It’s obscenely expensive for most people, around $400/month. One of my friends who had an MI and a couple of stents was on it for about six months and WITH insurance, he was still paying $287/month out of pocket. Cardiologist finally relented, understanding his economics, his life expectancy as a 67 year old kidney transplant patient (going on 23 years with his sister’s “spare” kidney), he’s now on coumadin; go figure.
Now defund the police again.
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