the cholesterol-lowering drug Lipitor is up more than 11 percent over last year. According to Thomson Reuters MarketScan, a day’s supply went from $3.17 in 2009 to $3.53 in 2010.
Lipitor is not alone. the anti-clotting drug Plavix rose in price by more than 13 percent, so a month’s supply runs about $195. the psychiatric drug Seroquel jumped 16.5 percent over last year. and the price of the leukemia drug Gleevec went up more than 20 percent, to more than $4,800 for a bit less than a month’s supply.
Why are drug prices climbing so quickly? Big brand-name manufacturers point to the high cost of research and development for new medications. the trouble with this argument is that many companies have been cutting back on their R&D budgets. They also have very little to show for their investment during the past decade. Breakthroughs for Alzheimer’s disease, Parkinson’s or other hard-to-treat conditions have been few and far between.
Many analysts blame the dramatic price increases on coming generic competition. both Lipitor and Plavix will soon lose their exclusive patents. that means insurance companies are likely to encourage patients to take atorvastatin instead of Lipitor and clopidogrel instead of Plavix.
Insurance companies have created penalties for patients who want brand-name medications. many health-insurance plans use tiers to discourage brand-name use. Generic versions, when available, are usually tier 1 with low copays of $10 to $15. Brand-name drugs not on the formulary might not be covered at all or require a copay more than $100.
Take the popular sleeping pill Ambien, for example. it is now available as generic zolpidem. If you had to pay out of pocket for the brand, the cost could be as high as $190 for a month’s supply. the generic is often $10 to $20.
If generic drugs were always identical to the brand-name products, as the Food and Drug Administration maintains, this would be only good news for consumers. There are questions, however. Experts estimate that 80 percent of active ingredients now come from countries like India, China, Brazil and Mexico. There is very little oversight of manufacturing plants.
Many readers of this column have reported problems with zolpidem, as this story demonstrates: “Ambien worked great for me. I fell asleep within 30 minutes and stayed asleep for eight hours. I was excited about generic zolpidem when it became available. Money in my pocket. the first generic I tried did not work at all. No sleep. a different generic zolpidem resulted in only four hours of sleep, and it took me more than an hour to fall asleep.”
People who would like to learn about saving money on brand-name drugs from online pharmacies might find useful information at PharmacyChecker.com. we also have prepared a Guide to Saving Money on Medicine. To request a copy, send $3 in check or money order with a long (No. 10), stamped (61 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. CA-99, P.O. Box 52027, Durham, NC 27717-2027. it also can be downloaded for $2 from our website: peoplespharmacy.com.
Question: my 60-year-old girlfriend had sudden severe lower-back pain and leg pain and swelling. she was diagnosed with sciatica by a doctor in the emergency room and sent home with Valium and Percocet.
One week later, the pain and swelling were so intense that she could not get out of bed. I called the ambulance to take her to the emergency room. she was diagnosed with blood clots in both legs and immediately had an emergency thrombolysis, in which the clot buster tPA is injected into the clot through a catheter.
She is still hospitalized.
Answer: Blood clots in veins are indeed potentially lethal and frequently misdiagnosed. Hundreds of thousands of Americans are affected by this condition each year. a blood clot traveling to the lung can cause a pulmonary embolism that can kill people.
Tissue plasminogen activator (tPA) can help break up a blood clot but must be used carefully since it can cause uncontrolled bleeding.
Q: after having increasingly itchy and swollen eyelids for more than a year, I tried the dandruff shampoo solution mentioned in your column. it worked, and I have had no problems at all in more than two months. I am so relieved and grateful. No more blepharitis.
A: Blepharitis is the technical term for eyelid inflammation. There are many potential causes of symptoms such as redness, itching and swelling of the eyelid, so it requires diagnosis by an eye-care specialist.
Some doctors recommend applying dandruff shampoo (T/Gel) to the eyelids while showering. such shampoos knock out yeast that lives on the skin and causes seborrheic dermatitis. be very careful to keep shampoo out of eyes.
If eyelid inflammation is because of bacterial overgrowth, a commercial eyelid cleanser such as SteriLid might be helpful. we have heard that mineral oil applied carefully with a cotton swab to the edge of the lower eyelid also may aid in controlling some forms of blepharitis.
Q: I’ve been on simvastatin for about six months, and I have developed excruciating hip and upper-leg pain. I get very tired in the middle of the afternoon and sometimes go to bed by 8 p.m.
I also am troubled with constipation, then the runs. I feel like I’m 100 years old though I am 69. could simvastatin be causing all this trouble?
A: Statins such as atorvastatin (Lipitor), lovastatin, pravastatin, rosuvastatin (Crestor) and simvastatin can cause fatigue, digestive distress and muscle or joint pain. the discomfort can affect almost any part of the body, including neck, back, legs or hips.
Muscle weakness also can affect the eyes. a recent report in the American Journal of Medicine describes a man who had to stop driving because of red, irritated eyes and double vision caused by atorvastatin. the authors found 256 cases of statin-induced eye problems in medical reports.
We are sending you our Guide to Cholesterol Control and Heart Health, with pros and cons of statins and many alternatives for lowering blood lipids. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (61 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. C-8, P.O. Box 52027, Durham, NC 27717-2027. it also can be downloaded for $2 from our website: peoplespharmacy.com.
Q: I suffered from psoriasis on my hands and elbows for more than 22 years. I accidentally discovered a solution for this miserable malady.
I had an unusual craving for black licorice and asked the owner of our local nutrition center how to eliminate this craving. she suggested taking an herbal form of licorice. This immediately solved my craving.
To my surprise, I realized I had gotten an added bonus. my psoriasis disappeared. the licorice worked better than the steroid creams my doctor prescribed for so many years.
A: Licorice (Glycyrrhiza glabra) is part of a traditional Chinese herbal mixture that is considered effective for psoriasis. we don’t suggest taking it orally, though, since licorice can lead to low libido, fluid retention and high blood pressure. Herbal experts such as James Duke, Ph.D., have recommended applying licorice extract topically to psoriasis lesions for relief.
Q: you recently answered a question from a person with high blood pressure and cholesterol who wanted to know about natural management. I’m in that boat as well.
With my family history, I’ll probably be on meds someday, but I’d like to delay that as long as possible. my doctor has recommended daily exercise, 3 grams of fish oil, red yeast rice and a magnesium supplement for high cholesterol. I also watch my intake of sugar and alcohol.
For high blood pressure, I watch my salt intake (no processed foods) and drink water laced with lemon as a constant mild diuretic. I’ve lowered my cholesterol from 275 to 206 and dropped my blood pressure from borderline high to normal with this approach.
A: Everything your doctor has suggested makes sense to us. Exercise is a powerful tool in losing weight and controlling blood pressure. Fish oil and red yeast rice are proven approaches for cholesterol control. the lemon-laced water is a new idea for us, but it seems like a safe option, and if your blood pressure is controlled, you must be doing something right.
Q: I have read in your column about using Certo in white grape juice for arthritis relief. does it have to be white grape juice, or would purple grape juice or pomegranate juice work just as well?
A: many readers have had similar questions. Most people who use Certo in grape juice use purple or red grape juice rather than white grape juice. One reader who tried pomegranate juice with Certo found it helpful: “I’ve read about grape juice and Certo for easing joint pain, but I don’t like grape juice. I tried pomegranate juice with Certo instead.
“After just a couple of days, the results are amazing. I can comfortably make a tight fist now, which means I can throw punches in aikido class again without jamming an arthritic knuckle.”
For more details about Certo in juice or other natural remedies for joint pain, we are sending you our Guide to Alternatives for Arthritis. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (61 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. AA-2, P.O. Box 52027, Durham, NC 27717-2027. it also can be downloaded for $2 from our website: peoplespharmacy.com.
Reach the Graedons via their website, PeoplesPharmacy.com.