The group behind Consumer Reports (search) magazine announced Thursday it will begin comparing costs of popular medications to help the public choose the best bargains.
Experts, however, remind patients to use this information carefully and to talk to their doctor when considering changes in their medication.
Consumers Union (search) plans to roll out reports on up to a dozen popular drug classes, using scientific reviews and average retail prices to choose “best buys” in each class. Backers say the project is designed to help consumers, especially those without health insurance, substitute cheaper drugs for those that cost more but have similar safety and effectiveness.
“What if we can do the same thing for drugs that we do for cars and digital cameras,” says Joel Gurin, executive vice president of Consumers Union. “We’re doing this because the cost of drugs has become a national crisis in this country.”
Gurin’s group issued three reports Thursday on cholesterol-lowering statins (search), proton pump inhibitors (search) for heartburn and acid reflux, and nonsteroidal anti-inflammatory pain medications (search). All three are groups of drugs crowded with similar-acting but sometimes differently priced drugs.
Reports on antidepressant drugs and blood pressure-lowering medications are scheduled to follow soon on the project’s web site, www.crbestbuydrugs.org, he says.
The report on statins pegs generic lovastatin (search) as the best drug for patients who need moderate lowering of cholesterol, citing a lower average retail price than comparable drugs along with a similar safety and effectiveness profile. Some patients could save as much as $108 per month by using lovastatin instead of a higher priced drug, according to the report.
Lipitor was branded a “best buy” for patients who need more drastic cholesterol reduction or have heart disease or diabetes. While other statins sell for less than Lipitor’s $117 average monthly cost, that drug is the cheapest one proven to reduce the risk of heart attacks and sudden heart-related deaths, the report states.
Pharmaceutical companies have long guarded pricing information, though average retail prices like the ones reported by Consumers Union are readily available in pharmacies. Gail Shearer, the group’s director of health policy analysis, says she expects a mixed reaction from drugmakers, depending on whether their products are recommended in the reports.
“We’d like to see changes in the marketplace where companies have an incentive to price their effective drugs more affordably,” she says.
The recommendations use data from the Drug Effectiveness Review Project, a group based at the Oregon Health & Science University. State governments in Oregon, Idaho, and Washington have commissioned reports on a dozen drug classes based on available scientific evidence on safety and effectiveness.
Supporters say the effort could provide an evidence-based alternative to drug company-sponsored advertising that many complain pushes newer, high-cost drugs that often provide little benefit beyond cheaper options already on the market.
“We certainly feel that Consumers Union is filling a huge gap here,” says Georges Benjamin, MD, executive director of the American Public Health Association.
More Influence in the Exam Room
The reports tell consumers that the recommendations apply only to average patients and that only a physician can determine which drug is best for each individual. Shearer says the group wants the reports “to open up discussions” between patients and doctors about choosing lower-cost drugs.
“We really want people to print out the report and take it to their doctor,” she says.
But the group does not limit its recommendations to prescription drugs. “Best-buy” picks for both heartburn drugs and nonsteroidal pain medication are available over-the-counter, meaning that doctors won’t always have the ability to monitor choices consumers make.
“There is always a risk that people will just go self-medicate whether we mention them or not,” Gurin says of over-the-counter drugs.
Edward L. Langston, MD, a member of the American Medical Association Board of Trustees, says that drug recommendations based on price could be especially helpful for seniors without drug coverage who are financially at risk from high medication costs.
"All they see on TV for the most part are the direct-to-consumer advertising from the drug companies. I think it doesn't hurt to have another perspective here," he said. "The more information we have for patients to ask questions about, I think it's appropriate."
Consumer ratings for drugs are bound to increase a patient’s arsenal of information, and that could boost pressure on doctors to prescribe cheaper alternatives, says Kevin Ferentz, an associate professor of family medicine at the University of Maryland School of Medicine.
“And that’s fine. I don’t think any physician would have difficulty saying you should go by cost when efficacy is equivalent,” he tells WebMD.
The brand-name drug industry’s main trade group says Consumers Union has merely provided another source of information for patients and their doctors and that consumers should not rely on the reports to make medical judgments.
“They should not just look at a single web site and make decisions. It’s the opinion of one of many sources, and the operative words are ‘talk to your doctor,’” says Jeff Trewhitt, a spokesman for Pharmaceutical Research and Manufacturers of America (PhRMA).
By Todd Zwillich, reviewed by Charlotte E. Grayson, MD
SOURCES: Joel Gurin, executive vice president, Consumers Union. Gail Shearer, director of health policy, Consumers Union. Georges Benjamin, MD, executive director, American Public Health Association. Kevin Ferentz, MD, associate professor, University of Maryland School of Medicine. Jeff Trewhitt, spokesman, Pharmaceutical Research and Manufacturers of America.
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