Prescriptions come at high price

Communication between doctors and patients sorely needs improvement, especially when it comes to prescription drugs. According to Consumer Reports, 45 percent of U.S. adults regularly take at least one prescription drug and 18 percent take three or more ‘ which means consumers need to know how to get the best value for their health-care dollar.

Consumer Reports Best Buy Drugs, a public-education project that makes comparative drug information available free of charge at www.Consumer-Reports.org/health, recently evaluated drugs for 35 conditions. They included attention-deficit disorder, heart disease, high blood pressure, high cholesterol, insomnia, menopause, migraine and overactive bladder. Among the findings:

‘ GlaxoSmithKline spent $52 million between 2005 and 2006 advertising the diabetes drug Avandia and increased sales by 20 percent. But older diabetes drugs that cost much less are equally effective and probably safer.

‘ Alzheimer’s drugs that cost $150 to $200 a month are heavily promoted to doctors and are routinely prescribed, yet studies show they may help only 10 percent to 20 percent of patients.

‘ The four prescription drugs that treat heartburn, or GERD (gastroesophageal reflux disease), produce about the same benefit. But there’s a nonprescription drug that works just as well, and can save users hundreds of dollars a year.

CR Best Buy Drugs’ analysis of many classes of prescription drugs showed the following:

Older drugs often match newer ones. Skillful marketing by pharmaceutical companies aims to convince doctors and consumers that newer medicines are almost always better. But expert evaluations have concluded that in many cases older drugs available as less expensive generics are as good or even better than newer ones. And because most older drugs have been taken by millions of people for years, experts usually have a better idea of their long-term safety.

Drugs within a class aren’t always that different. Drug makers argue that every drug is unique and that people respond differently to each. Therefore, they contend, more drugs in each class gives doctors and consumers more choice and a better chance of successful treatment.

Tips to improve conversations about prescriptions with doctors:

‘ Consumers should keep a list of the drugs they’re taking and mention any adverse reactions.

‘ Ask about drug options ‘ and don’t be shy about asking doctors why they’re prescribing a given drug.

‘ Be wary of free samples, as they are often the newer brand-name drugs that might not be the best choice.

‘ Raise cost concerns, since doctors often don’t ask whether cost is an issue.

‘ Double-check dosing and ask whether a lower dose is an option.

‘ Never ignore side effects. Be assertive about uncomfortable symptoms.