Warning: I'm on a soapbox here, spurred by the contents of a weekly healthnews alert:
Background: While I am all for increased consumer (new term for what used to be called "a patient") awareness, without increased _education_ about various conditions, 'awareness' tends to promote fear and a rush for the latest "fixitol" drug -- which may be no better than older drugs in the same class or even older drugs from other classes. Not to mention the fact that _prevention_ of the condition might be non-drug related things like proper nutrition, exercise, smoking cessation etc. Which of course takes commitment on the part of the 'consumer,' and might profit diet and exercise gurus instead of Merck, Roche or other drug manufacturers. Anyone who's watched TV in the US in the past couple of months should be able to answer "what's that purple pill for?" (Nexium, for regular heartburn/gastric distress) Now while it does an admirable job of controlling stomach acid secretion, is it any better *in a clinically relevant* sense than its older siblings? No. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12872509&dopt=Abstract Generic omeprazole (Prilosec) at this site is $76 for a 28-day supply; the brand name variety is $116. http://www.medicapharma.com/Antacids/antacids.html?source=look A 30-day supply of Nexium is $202 at this site http://www.valueprescribe.com/nexium/?AffiliateID=2003049723 or over twice the generic omeprazole -- which hasn't been shown to be inferior to the 'newbie.' [Note that there _are_ cases where a brand name matters - frex generic digoxin seems to be much harder to keep at stable levels than Lanoxin, in my and many cardiologists' experience; _bioavailability_ can vary dramatically in different delivery vehicles (frex pill ingredient composition which may include "inert carriers", pill structure etc.).] Now developing a new drug is _costly_, and most chemicals tested fail somewhere along the line from invention or discovery to 'safe and effective medication;' a pharmaceutical company must make a profit to be able to develop new drugs and pay the bills etc. But drugs in many categories are *not* new, and might even be a metabolite or similar derivative of the 'old' drug, or simply in a different delivery vehicle (chewable, frex). The development cost of such a drug is far less than a de novo one. This Frontline program has a great deal of information for those interested in the costs of medication: http://www.pbs.org/wgbh/pages/frontline/shows/other/etc/synopsis.html Marketing ploys in direct-to-consumer ads include tactics that have *no* clinical relevance, such as "Our statin (cholesterol-lowering drug) does at 20mg per dose what Brand X does at 80mg!" If the price, side-effects and clinical outcomes are similar, that is *completely* irrelevant. Another: "Brand Y isn't approved for this particular application" -- but the final pathway for the condition is identical -histamine blockage, frex, so testing an antihistamine for its control of dog allergies vs. cat allergies is moot. What brought this up today is the recent release/approval of Levitra, new competitor for Viagra: http://www.msnbc.com/news/954753.asp "...There have been no published studies directly comparing the pills to determine advantages of each. But the potency, speed and duration of each drug are hotly disputed..." In the same newsletter are articles on how those who exercise have lower risk of impotence, how bad lifestyle choices increase the risk of heart disease, and how angioplasty (a procedure to open up coronary arteries without massive surgery - unless complications require emergent intervention) is better than 'clot-buster' drugs for those having a heart attack, at least in one Danish study: http://www.msnbc.com/news/953944.asp http://www.msnbc.com/news/954499.asp http://www.msnbc.com/news/955040.asp I've previously read about most of the above information in various medical updates I get, but having them all show in the same issue of one 'healthblurbs' subscription just seemed...infuriating. "...and all for the want of a horseshoe nail!" Debbi who is crabby with a headcold today, and so highly intolerant of deliberate ignorance :P __________________________________ Do you Yahoo!? Yahoo! SiteBuilder - Free, easy-to-use web site design software http://sitebuilder.yahoo.com _______________________________________________ http://www.mccmedia.com/mailman/listinfo/brin-l
