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Editorials

Statins and The BMJ

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5038 (Published 07 August 2014) Cite this as: BMJ 2014;349:g5038

Re: Statins and The BMJ

As a medical journalist who has been following the statin debate for some years, I'm concerned about the committee's recommendation that the ongoing statin debate "be conducted primarily in medical journals rather than in the lay media".

Quite apart from the issue of how on earth would you enforce such a restriction, it it seems to reflect precisely the sort of thinking that has allowed this situation to arise in the first place. Statins have been around for 20 years and for most of that time there has been a solid medical consensus that these drugs are safe, save lives and should be given to an ever increasing number of people.

There have of course been a few brave dissenting medical voices but opposing the might of NICE, the MHRA, and a range of prestigious Heart charities is not professionally rewarding. In fact the response of Sir Rory Collins to criticism - to take to the press and to accuse his critics of killing people - illustrates just what the costs can be.

It might of course be an example of the kind of public debate the committee wants to avoid but is it really better if that kind of hostility were vented in private? "Don't fund that chap Abramson, very unsound, no grasp of statistics at all." Having it in the press allows people a much better sense of what is going on.

That combined with the open letter to NICE objecting to the proposal to expand statin prescribing that put the issue of the front page. Without the public being able to see both sides of the argument in this way I would argue that many of the issues that have subsequently come have might well have remained comfortably behind closed doors.

Earlier this year I exchanged emails with Dr Godlee in connection with evidence that I had obtained showing that the CTT did not allow any independent researchers access to its data and that it did not hold data on side-effects while researching an article for the Daily Mail (http://dailym.ai/1oukfV5)

Dr Godlee agreed that it was unsatisfactory that the data was not accessible but observed that it was not actually breaking the law.

The findings of the committee have certainly highlighted these two issues but surely they need a lot more public discussion rather than less. The proposal to have the CTT data examined by the likes of Abramson is obviously welcome (not so sure about Collins who has already produced his analysis) but the results will need a lot of public explaining.

The recent round of public discussion of statins involving hidden data, vested interests, and critiques of how benefits and side effect are calculated let a lot of light in on a topic that has remained largely hidden. That is especially important with a new generation of more powerful and far more expensive cholesterol lowering drugs coming down the pipe line.

If all discussion about them were kept behind doors it's likely that once again a more nuanced picture wouldn't t become public for another twenty years. This is one proposal to be be firmly resisted.

Competing interests: No competing interests

13 August 2014
Jerome Burne
journalist
London