Should I Stop Taking Zetia?

After Merck & Co. and Schering-Plough Corp. admitted that Vytorin -- a combination of Zetia and Zocor (simvastatin) -- worked no better than an older, generic medication to reduce plaques in arteries, Dr. Steven Nissen, head of cardiology at the Cleveland Clinic in Ohio, immediately called for a "moratorium" on the use of Vytorin and Zetia, according to a story on Bloomberg.com (see coverage here).

My question is this: Should I stop taking Zetia, which was prescribed to me by my cardiologist, who--although I respect his judgment--is no head of cardiology at a renowned medical center?

The problem is that I haven't heard from MY CARDIOLOGIST or MY FAMILY DOCTOR about whether or not I should continue to take Zetia. I guess I should call them.

But why is it that the my Volkswagen service center calls me soon after buying a new car, whereas I have never received a call from any doctor about service for my body?

I know that Nissen is not my doctor and is not giving individual medical advice to all those patients like me out there who are on Zetia or Vytorin and whose doctors are mum on the subject. Whether or not I should continue my medication depends upon my personal medical history that only me and my doctor can evaluate.

But where is my doctor? Why isn't he more pro-active? Why hasn't he contacted me a long time ago and either re-assured me about Zetia or told me to hold off until the ENHANCE study data were reported? Why didn't he tell me about the study a long time ago and what it might mean for ME personally? I know you will say that he should have and I should find a doctor who is more proactive. Hey, it may be possible to find one. But who has the time for all that due diligence and switching medical records around!

There's all kinds of cardiologists these days advising me what to do. There's Dr. Jarvik, for example. He's telling me that Lipitor is good for my cholesterol. Oh! Wait a minute! He's not REALLY a cardiologist. In fact, he doesn't even have a license to practice medicine at all (see Jarvik -- Lipitor spokesperson -- "outed" as an unlicensed physician!).

Then there's Dr. Nissen, who IS a practicing cardiologist. He's quoted all the time in the media. I respect his opinion although I know he's every pharmaceutical executive's worst nightmare.

I am sure there will be many more cardiologists weighing in with their opinions in media stories to come. But MY doctor probably won't be one of them.

Of course, I will be calling my cardiologist today and asking him about all this. I will report back to you when I hear something from him.

P.S. Don't worry about me. While my cholesterol is a bit high, I have recently passed my high-tech stress test, which cost my insurance company about $13,000 (thanks be to God that my wife has a real job with good benefits. My laid-off neighbor with 2 small children, however, is not so lucky.)

P.P.S. Since this blog is really all about pharmaceutical marketing, I should say something about how the ENHANCE trial failure may affect the advertising of Zetia and Vytorin.

Obviously, these brands are probably maintaining a low profile these days. I don't remember seeing the usual ads on TV last night. Perhaps the ads are being revamped in light of the ENHANCE trial news and will soon re-appear addressing the issues raised by the study's failure. But why weren't these damage-control ads rolled out IMMEDIATELY? Maybe it's best to say nothing to the public -- No way! Merck and Schering-Plough should have PSAs explaining their take on the situation and NOT just depend on issuing a press release!

What about the product web sites? Perhaps they have some information. I checked both www.zetia.com and www.vytorin.com -- both the patient and doctor sites -- and found NOTHING about the recent news. I looked in patient education areas where doctors are supposed to find information to hand out to their patients, I looked in the FAQ areas, the "Questions to Ask Your Doctor" areas, the "Studies" areas -- NO WHERE COULD I FIND A WORD ABOUT THIS!

That's a shame in my book. Shame on you Merck! Shame on you Schering-Plough! Shame on you MY DOCTOR!

Then they wonder why patients go to other sources on the Internet and other patients they do not even know on the Internet to find information they need about their medications!