PRESCRIPTION POKER
Volume 1: The Heart
66 percent of Americans take prescription drugs, and drug spending tops $600 billion per year. But how many patients actually benefit from the drugs they take?
Prescription Poker: Playing the Odds with Medications unpacks this question through a detailed analysis of commonly prescribed heart (and other) medications and their often-low success rates.
Through a deep dive into pharmaceutical-sponsored trials, R. L. Aplin, MD, demonstrates how numerous patients will receive little to no benefit for every one patient who reaps the medication’s intended result. This number needed to treat, or NNT, is the “absolute” reduction in risk—and a well-kept secret thanks in part to big pharma’s influence in health care. Prescription Poker reveals the likelihood of medication success and brings to life the way doctors and other providers are influenced to write the next “lifesaving” prescription. With that in mind, this book is a consumer-advocate must-read for patients and their families, many of whom struggle to afford their medications, and for those who wonder if the side effects of the drugs they’re on are worth enduring.
“There are lies, damned lies, and statistics.”
—Mark Twain
Favorite Patient . . .
I was on call one-night several years ago. A lady from a local town had a heart attack. She was helicoptered to our hospital at 2 AM, and I met her in what’s referred to as the “cath lab,” a specialized room for performing coronary angiograms and opening closed arteries going to the heart, which was her situation.
She had a cardiac arrest after getting on the table, meaning that if our heart attack program didn’t exist and she was at home or elsewhere, she would have likely died. We shocked her heart once, and she was back among the living.
She was a very thin lady who smelled heavily of cigarette smoke. I opened her artery with a balloon and stented it. While we waited to take some final contrast dye videos, I suggested that she perhaps quit smoking. She abruptly sat up on the table and shouted “f… you."
She went home within 36 hours of her arrival, pain-free and doing well.
I saw her in clinic follow-up a few months later. She was doing great and smelled even better!!
Becoming a doctor . . .
I wasn’t one with a little kid’s doctor sets. Nope. I knew I was destined for Major League Baseball even though I had an anemic batting average, and I got hit by pitch 7 times in my senior year in HS. By the way, I got to play because there were only 10 kids out for baseball in tiny Deer River, Minnesota. So I didn’t start, but I would get in….sometimes…if someone got hurt.
I graduated from college with a degree in business. My brother was a very accomplished businessman. He told me I wasn’t gonna do very well in business. He told me to go to medical school, so I did. After my initial training, my wife told me to become a cardiologist, so I did. Clearly, until I wrote this book, I didn’t do a lot of thinking myself, apparently!!