Rising Drug Costs: The Nexium Rip-Off Part II

Last week I told the story of Nexium, the redundant but very expensive replacement for Prilosec. There isn't a lot more to tell about that drug, except that it encapsulates (a little pharmaceutical humor there) everything that's wrong with drug development and marketing in the United States health care system.

Any need for Nexium could be filled by the out-of-patent and much cheaper Prilosec. There are other drugs for acid reflux like H2 blockers, which are also inexpensive, out-of-patent, and effective. There is no excuse for doctors writing prescriptions for Nexium in large numbers. Nor should consumers take this kind of hit in the wallet for a new drug which is not really new and does not offer substantially better performance.

Why are we spending so much more on expensive drugs that aren't usually more effective for people than much cheaper generics? Because doctors prescribe them, and the insurance companies, government assistance programs, and individual patients who pay the bills don't protest often enough. It is hard to blame drug companies for trying to maximize their profits by selling the same thing at a higher price, if their customers are dumb enough to pay for it.

In a November 14 New York Times article, Eduardo Porter writes, "The Food and Drug Administration has classified only about 20 percent of the drugs developed over the last 10 years as qualitative breakthroughs. Even though they spend more on research, pharmaceutical companies are finding fewer new drugs. In a report this year, the F.D.A. said that the way drugs are developed 'is becoming increasingly challenging, inefficient and costly.'"

Translated, that means 80 percent of the new drugs coming on the market are not breakthroughs. They are marginally better, if at all. Some are probably a step backward, as the Vioxx fiasco illustrates.

What is the solution to excessive drug cost? Mainly, the government, insurance companies, and individual patients have to get very hard-nosed about what is being prescribed. When a patient has a condition that can be treated with drugs, generally the generics should be tried first, gradually working up to the more expensive patented medicines if necessary.

Of course, it wouldn't hurt if people focused more on disease prevention so they wouldn't need so many drugs. That is the other part of the crisis in drug costs. More people are taking more drugs than ever before. Even without inflation in drug prices, our costs would be rising simply due to increased use.

With the aging of the population, drug use will be on the rise. Guaranteed. And costs will continue to go up until society sensibly starts putting its collective foot down, throwing their pills out the window, and screaming, "I'm mad as hell, and I'm not going to take these blanking pills any more."

Defying death, I continue to ingest vitamin E

This morning, as I have done for years, I took a 400IU capsule of vitamin E. This is in addition to the 400IU contained in my full dose of daily multivitamin-mineral tablets. My total daily consumption then, is 800 IU. Both of these, by the way, are natural-source vitamin E, not synthetic.

"The results of at least five large observational studies suggest that increased vitamin E consumption is associated with decreased risk of [heart attack] or death from heart disease in both men and women." So states the Linus Pauling institute. Since heart disease is a major killer in the United States, well... you can do the math. Read what vitamin E can and can't do for you here.

Additional information on the study showing increased risk of death in users of vitamin E supplements: The recent meta-study mentioned in yesterday's entry "reported that adults who took supplements of 400 IU/day or more were 6% more likely to die from any cause than those who did not take vitamin E supplements. However, further breakdown of the risk by vitamin E dose and adjustment for other vitamin and mineral supplements revealed that the increased risk of death was statistically significant only at a dose of 2,000 IU/day..." (Linus Pauling Institute, at the link above.)

Vitamin E almost certainly works best in partnership with a wide spectrum of other vitamins and minerals. And the best way to ensure you're getting those is to eat many many servings of fruits and vegetables, organically grown if you can get them, and as fresh as possible. In addition, a good multivitamin-mineral supplement will provide not only vitamin E, but the vitamin and mineral partners each nutrient needs to work efficiently.

Will Vitamin E be the death of you?

A recent "meta-study" which pooled the results of many other vitamin E studies claims that people taking the highest doses of vitamin E had a 10% greater risk of death. Before we go soft at the knees and throw out our vitamin E supplements and multivitamins, let's review some other studies about vitamin E.

Pearson & Shaw's classic book Life Extension reports several facts:

• Fruit flies' average life span was extended by 8-15% by feeding a diet containing 0.25% vitamin E.

• Vitamin E is able to reduce the rate of spontaneous deaths from cancer in Irish Wolfhounds from virtually 100% to zero.
  

• Animals given injections of cancer cells live longer when given large vitamin E doses.

The authors write, "Large doses of vitamin E have been shown to increase resistance to cancer, bacterial and viral infections, stroke, arthritis, heart attack, and even smog."

When there are hundreds of studies showing benefits of vitamin E supplementation, and one study showing harm, perhaps it would be prudent for news media to report that fact for the sake of context when reporting the results of this new meta-study. Why should you have to learn that from a blog? Apparently, since reporters won't do their jobs, bloggers have to.

Obesity linked to leukemia risk

News flash today: The risk for acute myelogenous leukemia (AML) more than doubles in the obese elderly. The prognosis for this cancer is relatively poor. Another reason to get eating under control and keep it under control.

My best friend and his wife have had excellent weight loss and maintenance results with a low-carb diet, suppressing appetite by taking essential fatty acid capsules before a meal. They also supplement with a muliple vitamin-mineral tablet and take an herbal brew based on the anti-cancer Essiac formula, called Guardian Spirit Tea made by Frontier Herbs.

Circling sharks: the Nexium rip-off, Part I

Normally I don't expect to find health information in the New Yorker magazine, but in October Malcolm Gladwell wrote about High Prices of medicines in the column 'A Critic at Large'.

Once upon a time, there was heartburn. People tried antacids to neutralize the acid, then drugs to block the production of stomach acid. Finally, in a land named the AstroZenica corporation, they created a molecule they named Prilosec. They made $26 billion from Prilosec in one five-year period. And among the people of Prilosec, there was much rejoicing, that they had been able to extract so much money from so many heartburn-suffering people. But all was not well in AstraZenicaland. The evil patent-expiration monster threatened to take away all their income in 2001, when their exclusive right to profit from the design of this molecule would be null and void.

In 2001, profits from Prilosec would begin to drop off, and the profit chart would look like the trailing edge of a shark fin. So the lawyers, scientists, and marketing men got together to form a strategy to continue making huge profits, called the Shark Fin Project. And how lucky they were. As it turns out, Prilosec is a two-handed molecule. It comes in two forms, each of which is a mirror image of the other. If you take away one of the hands, the new truncated Prilosec becomes elegible for a new patent! And visions of dollar signs danced in their heads.

And so they did. They cut the molecule in half. They applied for a new patent. They gave the drug a new name. They did a study showing that for one particular condition that occurs in people with excess acid, where the stomach juices gurgle up from below and burn the esophagus, the new amputated Prilosec, called Nexium, worked 3% better than Prilosec. That this difference is insignificant in practical terms did not deter the advertising men and the drug promotion arm of AstraZenica. They put $500 million in their pockets and went out to sell this "new" drug, which was the same molecule as the old drug reduced by half, to doctors and patients for $120 per month's supply.

And so AstraZenica lived happily, if not ever after, at least for the mean time.

This little parable encapsulates much that is wrong with the drug industry -- selling the same old thing with a new name and a new patent, a little modification perhaps, touted as better but really not much better if at all. Since it is a new drug, it will have a high price, to pay for "research and development."

But in a rational world, very few people would buy this drug, because very few would find it more effective than the alternative, the good old Prilosec, which can now be purchased without a prescription at a cost of $20 per month. We obviously do not live in a rational world, and the fault lies not in the AstraZenicas, but ourselves. More about that next time...

Everything you know is wrong

Deception is everywhere in conventional medicine and in alternative medicine. It's a minefield out there.

My focus here will be life extension and treatment of disease in the true Hippocratic mode ("I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice."). This approach will involve discussion of diet, nutritional supplements, and non-toxic alternative therapies more than it does the use of controlled doses of refined toxins (pharmaceutical drugs). By so doing, I hope to keep us from "harm and injustice". Since physicians have generally failed in this oath, someone has to take up the slack. It's a dirty job, but someone has to do it.

I am more interested in finding techniques that work than I am in understanding how they work. Understanding is a fine thing, but honestly, we don't understand how gravity works, and we may not understand for some time to come. (Warps in space-time? gravitons? I don't know. Neither does anyone, except God.) This lack of knowledge does not hamper the useful application of gravity. (Some scientists have even demonstrated an antigravity effect, with the use of spinning discs of certain materials. No one knows why that works, either.)

I'm looking forward to searching health news to bring readers tips to help them look better, feel better, slow the aging process, suffer fewer illnesses, and cope better with illnesses already extant. Plus, I have a few opinions of my own to throw in from time to time. Only a few. Haha.

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