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Everyone should take their pills and shut up and other stories . . .

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h650 (Published 13 February 2015) Cite this as: BMJ 2015;350:h650

Everyone should take their pills and shut up. That seems to be the basis of modelling studies that project the benefits of statins and blood pressure lowering drugs on ever greater swathes of the populace. To argue otherwise is to risk roars of indignation from eminent professors. But two important studies have shown that you can hand preventive pills to people but many won’t take them regularly, even for colossal levels of individual benefit. The first, which appeared last year (Circulation 2014;129:2539-46, doi:10.1161/CIRCULATIONAHA.113.007595), found that 5% of people on the streets of London would not take a pill if it gave them another five years of life. Now an American study (Circulation: Cardiovascular Quality and Outcomes 2015, doi:10.1161/CIRCOUTCOMES.114.001240) of 1000 randomly selected respondents shows that people would pay an average of $1445 (£948; €1265) to avoid taking one pill a day.

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