The Gist Thomas Goetz: "Medicine works by helping some people a lot and most people not at all."
Jan 27, 2026
Thomas Goetz, award-winning science journalist and host of Drug Story, unpacks the history from FDR to cholesterol science and the rise of statins. He explores cold math like number needed to treat, Lipitor’s population impact, and how medical guidance and pharma incentives reshaped EpiPen use and allergy advice. The conversation highlights how good intentions and industry dynamics alter public health at scale.
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FDR Sparked Modern Heart Research
- FDR's death spurred creation of sustained heart-disease research like the Framingham study.
- That long-term data uncovered cholesterol as a major risk factor for heart attacks and strokes.
NNT Reveals Drug Population Impact
- Number Needed To Treat (NNT) shows how many people must take a drug for one person to benefit.
- Thomas Goetz explains Lipitor's NNT is about 100, so most treated people see no life-changing benefit.
Statins Lower Cholesterol But Help Few
- Statins reliably lower LDL cholesterol but only prevent one heart attack per ~100 treated.
- Many patients therefore endure side effects without gaining the avoided-event benefit.