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Papers by John Wakefield
Annals of Internal Medicine, 2010
Health Affairs, 2007
In discussing advances in preventing and treating cardiovascular disease (Jan/Feb 07), Myron Weis... more In discussing advances in preventing and treating cardiovascular disease (Jan/Feb 07), Myron Weisfeldt and Susan Zieman write that "combining several generic drugs…would be particularly useful in underserved populations with limited resources." Indeed, the stark similarities in the pattern of cardiovascular disease (CVD) in developing countries-and among racial and ethnic minorities in the United States-remind us of the sobering realities of a health care system defined by populations of separate fates. Even in the face of evidence suggesting that preventive drug therapy can avoid thousands of needless deaths, the U.S. health care system fails to provide optimal preventive care for everyone, which is compounded by a disproportionate effect on the poor and minorities. Kaiser Permanente strives to place all of its members over age fifty-five who have diabetes or documented CVD on a fixed-dose "bundle" of three pills: aspirin, lovastatin, and lisinopril (A-L-L). More than 73,000 new prescriptions for statins and angiotensin-converting enzyme (ACE) inhibitors have been written since the program started in 2003. Using the prediction of a 15 percent recurrence rate by Thomas Gaziano in the same issue of Health Affairs and the Steno-2 study (diabetes) savings of about 50 percent from a similar bundle of medications, we predict that members on this protocol will suffer 5,400 fewer heart attacks,
Annals of Internal Medicine, 2010
Health Affairs, 2007
In discussing advances in preventing and treating cardiovascular disease (Jan/Feb 07), Myron Weis... more In discussing advances in preventing and treating cardiovascular disease (Jan/Feb 07), Myron Weisfeldt and Susan Zieman write that "combining several generic drugs…would be particularly useful in underserved populations with limited resources." Indeed, the stark similarities in the pattern of cardiovascular disease (CVD) in developing countries-and among racial and ethnic minorities in the United States-remind us of the sobering realities of a health care system defined by populations of separate fates. Even in the face of evidence suggesting that preventive drug therapy can avoid thousands of needless deaths, the U.S. health care system fails to provide optimal preventive care for everyone, which is compounded by a disproportionate effect on the poor and minorities. Kaiser Permanente strives to place all of its members over age fifty-five who have diabetes or documented CVD on a fixed-dose "bundle" of three pills: aspirin, lovastatin, and lisinopril (A-L-L). More than 73,000 new prescriptions for statins and angiotensin-converting enzyme (ACE) inhibitors have been written since the program started in 2003. Using the prediction of a 15 percent recurrence rate by Thomas Gaziano in the same issue of Health Affairs and the Steno-2 study (diabetes) savings of about 50 percent from a similar bundle of medications, we predict that members on this protocol will suffer 5,400 fewer heart attacks,