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April 17, 1991

Reducing High Blood Cholesterol Levels With Drugs

Author Affiliations

Parke-Davis Division of Warner-Lambert Co Morris Plains, NJ

Parke-Davis Division of Warner-Lambert Co Morris Plains, NJ

JAMA. 1991;265(15):1949-1950. doi:10.1001/jama.1991.03460150053013

To the Editor.—  The recent article by Schulman et al1 considers the cost-effectiveness of the use of several lipid-altering agents for the treatment of hypercholesterolemia, with the ultimate goal of reducing the risk for the development of coronary heart disease. Acknowledging that we, as the manufacturer of one of the pharmacologic agents (gemfibrozil) mentioned in this article, have a vested interest in the published results by Schulman et al, we nonetheless believe that certain issues in this study need to be addressed.The authors assumed that all of the lipid-regulating agents (ie, cholestyramine resin, colestipol hydrochloride, gemfibrozil, lovastatin, niacin, and probucol) used in their analyses have been proved to be effective in reducing the risk of coronary heart disease. We believe this assumption cannot be presently supported from the published literature. Only cholestyramine resin2 and gemfibrozil3,4 have undergone long-term primary prevention trials that demonstrated their safety and