Consumer Reports turns focus to prescription drugs
What Consumer Reports does for dishwashers, digital cameras, and automobiles, it now plans to do for prescription drugs.
Publishers of the nonprofit magazine yesterday launched an initiative to compare the effectiveness and cost of prescription drugs to help patients navigate in a world of skyrocketing costs, heavy advertising, and occasionally dangerous side effects.
The move is part of a broad trend toward putting more responsibility for healthcare in the hands of consumers. If successful, it will help bridge the gap between the information provided in dense medical journals and the 60-second television spots aired by drug makers.
The magazine released the first wave of reports yesterday on three classes of drugs: those treating high cholesterol, heartburn, and arthritis pain. About 20 classes of drugs will be studied , with results posted at CRBestBuyDrugs.org.
"It's a good antidote to the $3 billion worth of direct-to-consumer advertising that patients are barraged with," said Dr. Jerry Avorn, an adviser on the project who is a Harvard University professor of medicine, a physician at Brigham and Women's Hospital, and author of "Powerful Medicines: The Benefits, Risks and Costs of Prescription Drugs."
"The data on which it's based is not thought up by some Madison Avenue ad man," he said.
The reports include the familiar, user-friendly charts that shoppers have come to expect when they turn to Consumer Reports for price and quality information on, say, flat-screen TVs. Each report lists drug name, price, and dosage. For individual classes of drugs, such as those meant to lower cholesterol, the magazine rates how well each particular drug works.
The reports give "best buy" ratings to recommended drugs based on price and effectiveness, similar to the magazine's best buy recommendations on televisions, blenders, and other consumer products.
The magazine even offers consumer tips. For example, it says savvy shoppers who have to take 20 mg a day of the popular cholesterol drug Lipitor can save $58.50 a month by getting a prescription for a 40 mg dose instead and splitting the pills in half.
The magazine judged drugs' quality based on data from a multistate Drug Effectiveness Review Project, which is centered at the Oregon Health & Science University and is producing data for states that are developing preferred drug lists for their Medicaid programs. For price, Consumer Reports gathers information on the average retail prices in pharmacies, which tend to be much higher than mail-order prices. The magazine enlisted a panel of unpaid advisers to help develop its program and hired doctors to work as peer reviewers to examine the reports before they are published.
The drug industry reacted yesterday with caution to the Consumer Reports rankings.
"It is the opinion of only one source. The concern is that patients should not diagnose themselves and make a decision without working with their doctors," said Jeff Trewhitt, spokesman for the Pharmaceutical Research and Manufacturers of America in Washington, D.C. "It's important for healthcare professionals to choose medicines that meet the needs of their individual patients."
Although the different brands are generally interchangeable within each class of drugs, the reports includes sections for patients with "special considerations." For example, it says patients taking protease inhibitors to treat HIV should take only low doses of the anticholesterol medications called statins.
In the first round of reports, the magazine, which is published by Consumers Union, a nonprofit organization in Washington, rated statins. Generic statins came out on top for patients who need to lower cholesterol level by 40 percent or less. They work just as well as name brand statins that cost four times as much, according to the report. Taking generic statins can save a consumer $1,300 a year, the magazine said.
For patients who need to reduce their cholesterol more than that, the publishers recommended
For frequent heartburn drugs called proton pump inhibitors, Consumer Reports said the best buy is Prilosec OTC, which is sold in drugstores for about 79 cents a pill without a prescription. For arthritis pain, the magazine said the most cost-effective treatment is generic ibuprofen and generic salsalate, which cost $24 to $30 a month compared to the prescription drug Celebrex, for example, which costs $130 a month.
Each of the reports contains a discussion on safety and possible side effects. For statins, the possible side effects are muscle and liver damage. Patients taking heartburn medications must look out for headaches and diarrhea. For arthritis pain, consumers should be aware of the risks of stomach damage posed by ibuprofen and the potential for cardiovascular risks of drugs like Celebrex and Bextra. They are cousins of Vioxx, which
"It pulls together safety, effectiveness, and cost in a way that I don't think has been done for consumers before," said Joel Gurin, executive vice president of Consumers Union. "Access to prescription drugs and the price of prescription drugs has become a huge consumer issue. When we talk to consumers and do surveys, the price of drugs comes often comes up as number one."
Gurin said one of the goals is to encourage manufacturers to compete on price and bring down drug costs. Another is to improve the dialogue between patients and doctors.
Christopher Rowland can be reached at crowland@globe.com.
