Wednesday, September 05, 2012

The Rise and Fall of the Silly Season

August has long been known as the silly season in terms of newspapers publishing low-key or humorous stories to fill the otherwise empty news columns. This year, possibly owing to global warming, the season started early, with the publication of articles at the end of July trumpeting research promoting the Polypill.

The Polypill was first postulated in 2003, so the story is not exactly new.  The pill contains three drugs to lower blood pressure and a statin to lower cholesterol (amlodipine, losartan, hydrochlorothiazide and simvastatin for those who are interested). The concept is to make the Polypill available without prescription, at a cost of 50p per day, encourage everyone to buy it and thus halve the number of people who die of cardiovascular disease.

Now, that sounds like a meritorious aim; a magical pill to halve 200,000 deaths per year in the UK. So where are the flaws in this argument? Well, to start with, to gain that saving effect everyone, I repeat, everyone in the UK would have to take the Polypill; all 56.1 million of us according to the 2001 census. That is 56.1 million annual monthly sales to save 0.1 million lives. Making the assumption that some sensible person out there has patented this latest version of the Polypill, then that is a lot of profit for the pharmaceutical industry.

Then, of course, there are the side effects of the medication. Anyone who has been prescribed some of the constituent medicines will know that side effects are common. I grant you that most are minor, but nonetheless, many are inconvenient and sometimes very troublesome. Swollen ankles, gastric upset, urinary frequency, impotence, muscle pain and weakness, rashes, confusion and memory loss are just a few of the unwanted features. It is therefore bad enough trying to comply when your doctor believes that you need to consider such therapy; does anyone truly think that those who have not identified themselves as unwell or at risk will put up with such effects? I suspect not.

And what about lifestyle? Where does the enthusiasm for five portions of fruit and veg per day, low fat and low calorie foods, reduced meat consumption, reduced alcohol consumption, stopping smoking, exercises at least three times per week, and reducing weight to sub-obesity levels fit in? All of them are no longer necessary, or so it would seem. Forget the healthy lifestyle and simply pop a pill every day to compensate. A late 16th Century proverb declared that ‘the age of miracles is past’. Apparently, the declaration was premature.

In 1995, Ivan Illich published a book called Limits to Medicine. It was subtitled ‘Medical Nemesis: The Expropriation of Health’. In his book, Illich declared that ‘the medical establishment has become a major threat to health’. He was concerned that ‘the disabling impact of professional control over medicine has reached the proportions of an epidemic’. He was prescient to say the least. With the advent of the Polypill, we all become patients at the stroke of a medicine licence.

Not convinced that my cynical approach is the correct one? Then let me ask you a question. Would you subscribe to the idea of underpinning every house in the country in order to stop a few subsiding? I suspect not, and with that I rest my case.

Hopefully, autumn will come and the silliness will be forgotten for another few years. Meanwhile, I am off for a good walk in the fresh air, followed by a healthy fish dinner and, just perhaps, a small glass of red wine.
 (First published in the Scunthorpe Telegraph, Thursday, 2nd August 2012)

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