Dr. Jarvik's Lipitor Endorsement

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If you've read The New York Times lately, you might have noticed a full-color, full-page ad that's been in the paper every day this week. It's for Lipitor, the cholesterol-lowering drug. The color picture is of Dr. Robert Jarvik, inventor of the artificial heart. Commentator Katie Watson is a medical ethicist. She says that the timing of the ad — and Dr. Jarvik's endorsement — are both significant. As far as she can figure, it's the first time that a doctor has been paid to endorse a prescription drug in an ad.

MICHELE NORRIS, host:

If you've read The New York Times this week, you might have noticed a full-page color ad. It's for Lipitor, the cholesterol-lowering drug. The picture is of Dr. Robert Jarvik, inventor of the artificial heart. Or maybe, you've seen Jarvik in the television commercials. Commentator Katie Watson is a medical ethicist. She says that the timing of the ads and Dr. Jarvik's endorsement are both significant.

KATIE WATSON reporting:

Celebrity patients, like Bob Dole and Mike Ditka, have peddled pharmaceuticals. But Dr. Robert Jarvik seems to be the first celebrity physician to endorse a prescription drug. In the print ad, the doctor says, I've studied the human heart for a lifetime. I trust Lipitor to help keep my heart healthy.

But he isn't in a white coat and he's not at the hospital. He's in a track suit, sitting at a luxurious lakeshore, dock behind him, sunny mountains on the horizon, inventor of the artificial heart turned vacation home neighbor. I'll have what he's having.

I asked my friend Martha, a prominent cardiologist in her own right, what she thought of the ad. He's a sellout, she shouted. What's called statin therapy is a proven way to lower cholesterol, she told me. But there's no research that's convinced her one brand is superior to another overall.

So here's one of her heroes hawking the world's most popular drug for the world's largest drug company, motivated by a paycheck. Martha said she stared at the ad for 15 minutes, feeling embarrassed and sad.

I had a sobering thought, this is my fault.

For more than 30 years, we bioethicists have championed patient's rights. We worked to replace the era of physician paternalism with patient autonomy. Instead of my physician calling all the shots, she tells me medical risks, benefits and recommendations. I factor in my values, priorities and circumstances. Then I decide what we'll do with my body.

But as soon as patients became people with choices, they also became targets for marketing. The pretense of patient education in drug advertising is absurd. If my doctor needs me to suggest Lipitor, the best thing I can do for my health is get a new doctor.

But Dr. Jarvik's ad is especially insidious, because here's a physician I recognize and respect recommending a drug to me. We're in the realm of advertising, which means his loyalty isn't with my health, it's with Pfizer's.

Michael Jordan's endorsement of basketball shoes may get our attention, but we also understand he's paid a lot of money to sell Air Jordan. Sadly, now that Lipitor's become Air Jarvik, we have to apply that type of critical thinking when Dr. Jarvik says, for me there is no substitute for Lipitor. Because actually, there is. And it's a generic.

Last Friday Merck's patent on a comparable cholesterol-lowering drug called Zocor lapsed. Its price is expected to drop up to 90 percent over the next year, from $3 a day to about $.30. Lipitor's more potent than Zocor, so patients who need the highest dose of statin therapy will have to stay on one of several name brands.

Perhaps that's what Dr. Jarvik meant when he said, for me there is no substitute. Maybe he needs a high dose. But many patients don't. And those who can substitute the new generic could save almost a thousand dollars a year. I agree with my friend Martha's feeling, that physicians have an ethical obligation to develop and promote treatments that are effective and affordable.

Martha's a cardiologist who doesn't take drug money. So if she were famous, the quote under a picture of her in a track suit would say, try exercise and healthy eating first and if your cholesterol's still too high, ask your doctor if a generic's right for you.

NORRIS: Katie Watson teaches bioethics at Northwestern University's Feinberg School of Medicine.

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