Do Calcium Supplements Cause Heart Attacks?

Calcium is good for us, right? Milk products are great sources of calcium, and we’re told to emphasize milk products in our diets. Don’t (or can’t) eat enough dairy? Calcium supplements are very popular, especially among women seeking to minimize their risk of osteoporosis. Osteoporosis prevention and treatment guidelines recommend calcium and vitamin D as an important measure in preserving bone density and reducing the risk of fractures. For those who don’t like dairy products, even products like orange juice and Vitamin Water are fortified with calcium. The general perception seemed to be that calcium consumption was a good thing – the more, the better. Until recently.

In a pattern similar to that I described with folic acid, there’s new safety signals from trials with calcium supplements that are raising concerns. Two studies published in the past two years suggest that calcium supplements are associated with an significantly increased risk of heart attacks. Could the risks of calcium supplements outweigh any benefits they offer?

What does a new drug cost?

Despite the variety of health systems across hundreds of different countries, one feature is near-universal: We all depend on private industry to commercialize and market drug products. And because drugs are such an integral part of our health care system, that industry is generally heavily regulated. Yet despite this regulation, little is publicly known about drug development costs. But aggregate research and development (R&D) data are available, and the pharmaceutical industry spends billions per year.

A huge challenge facing consumers, insurers, and governments worldwide are the acquisition costs of drugs. On this point, the pharmaceutical industry makes a consistent argument: This is a risky business, and it costs a lot to bring a new drug to market. According to PhRMA, the U.S. pharmaceutical industry’s advocacy group, it cost $1.3 billion (in 2005 dollars) to bring a new drug to market. The industry argues that high acquisition costs are necessary to support the multi-year R&D investment, and considerable risks, in to meet the regulatory requirements demanded for new drugs.

But what goes into this $1.3 billion figure? To understand the cost of a new drug, we need to consider both the cost of drugs that were marketed, but also factor in the costs of the failures – those discontinued during development. While most pharmaceutical companies are publicly held, no company produces detailed breakdowns of “per marketed drug” R&D costs, or the specific amounts spent on drugs that were later abandoned. Yet there have been attempts to estimate these values. The most detailed and perhaps controversial paper is a 2003 paper from DiMasi et al, entitled, The Price of Innovation: New Estimates of Drug Development Costs.[PDF] DiMasi’s estimates has been subject to considerable criticism, most recently in a paper by Light and Warburton, entitled Demythologizing the high costs of pharmaceutical research. They claim the median R&D cost is a fraction of DiMasi’s estimate: Just $43.4 million. “Big Pharma lies about R&D to justify illicit profits” shouted Natural News. Who’s right?

Storm – the movie

The beat poem by Tim Minchin, describing a dinner party conversation with an alternative medicine advocate, is now an animated movie. If you’ve never heard Storm, you’re in for a treat:

Help Save Cathy

Acute myeloid leukemia (AML) is the most common rapidly-progressing leukemia in adults. In AML, the bone marrow makes abnormal white blood cells, red blood cells, and platelets. The consequence is anemia, bleeding risks, and an inability to fight infections. Chemotherapy is the usual initial approach. When it cannot bring a remission, the best treatment option may be a stem cell transplant. In order to successfully donate stem cells, there must be a compatible match of cell antigens between the donor and the recipient. Family members may or may not be good recipients – successful donors can be be completely unrelated. Ethnic similarities may mean better matches, too.

A pharmacist colleague of mine in Toronto has AML – and I’m asking for your help. Catherine Anagnostopoulos, a 44 year old mother of three,  is in urgent need of stem cell transplant. To date, no successful donor has been identified. Cathy is of Greek origin, but anyone is encouraged to register in their national stem cell and bone marrow registry – stem cells cross borders all the time.

After answering a short health questionnaire, you will be sent a kit by mail. Rub a swab on the inside of your cheek, drop it in the mail, and you’re registered. If you are a match for any needy recipient, you’ll be contacted. The actual transplant procedure, in many cases, is similar to donating blood. In Canada, visit the One Match Stem Cell and Marrow Network. In the USA, visit Be The Match. (Please post any other known registries in the comments).

If you’re in Toronto, there are three community swabbing events scheduled in the next few weeks:

• Wednesday, April 13th 2011, 2:00pm to 8:00pm, Leaside Blood Donor Clinic and Swabbing Event, Northlea Elementary & Middle School, 305 Rumsey Rd, Toronto, Ontario, (North Gymnasium)
• Wednesday, April 20th 2011, 3:00pm to 7:00pm, Presteign Heights Elementary School, 2570 St. Clair Ave. East, Toronto, Ontario M4B 1M3
• Sunday, May 1st 2011, 12:00 pm to 6:00pm, St. John’s Greek Orthodox Church, 1385 Warden Avenue, Toronto, Ontario, (Youth Centre Gymnasium)

For more information on Cathy, see Help Save Cathy. Please help Cathy via Facebook, and Twitter. And please pass the message on. Cathy and many other people need the gift of life that you alone may be able to give.