Dietary supplement breaks drugmaker's heart

When will they ever learn? There is an adage that says always start with the truth because you will eventually end up there. Such is the case with the recent findings presented at the American Heart Association annual scientific meeting. In case you missed it, the niacin based drug Niaspan outperformed not one, but two, leading cholesterol-lowering drugs: Merck's Zetia, and sister drug Vytorin. Apparently Zetia and Vytorin do little to reduce LDL cholesterol and even less to flush out artery build up.

Apparently this is not new news. A study dating back to 2006, released in January 2008, showed that Vytorin had little positive affect when compared to patients taking Zocor. Within weeks of the study a class action suit was filed alleging that Merck and Shering-Plough were well aware of the discrepancy, but made no move to tell consumers.

In fact, Vytorin launched a rather successful advertising campaign. In 2006, the company shelled out $136 million on Vytorin advertising, according to Nielsen Monitor-Plus. I can only imagine the possibilities if niacin, or any other supplement, were worthy of such a large purse of money for advertising.

It is estimated that the combined sales of both drugs will reach $4 billion this year. Sales for B-vitamins overall reached $1.1 billion in 2008, according to a recent Nutrition Business Journal vitamin and supplement report.

But this study sheds new light on just how much patients are paying for a better chance at reduced cholesterol. Is the dietary supplement industry short changing itself? Here is the math: Zetia $3.23 per day, 2g Niaspan $7.48 per day and Niacin slow release supplement .44 per day (for this example, SloNiacin Polygel Controlled Release 750mg, 2 per day, $22 for 100 capsules).

If dollars and cents alone were a measure of common sense, the $4.04 difference between Niaspan and SloNiacin makes one wonder how much money Abbott Labs is making on the backs, or hearts, of the consumer…$4.04 per day difference rounds out to $1474 per year.

It isn't entirely clear yet whether this study will push physicians toward recommending supplements to their patients. Lead author of the study, Allen Taylor, a cardiologist at Washington Hospital Center in the District of Columbia said "Niacin led to a reversal of artery build up." And Taylor's admission led many cardiologists around the globe to admit (publically) that perhaps they should consider recommending niacin as a second line of defense after initial statin treatments. Score one for the supplement team.

But, the other shoe fell with this little paragraph at the end of the Wall Street Journal story on the subject: "Over the counter niacin is available, but the heart association, citing inconsistent quality and other issues in those products, recommends patients use prescription versions" (Wall Street Journal, Nov. 17, 2009, pg D3). Score one for the drug team.

Consistency and Quality. These two words hang over the supplement industry like dense fog. Will it ever burn off?