Concerns over Consumer Reports article on Best Buy Drugs
Posted Feb 21 2011 12:00am
In the March issue of Consumer Reports is a report "Best Buy Drugs- many common generics beat brand names." Statistics on direct-to-consumer advertising and information surrounding the requirements of generic makers of brand medications are discussed. For several conditions, brand medications are compared to generic alternatives- sometimes the generic equivalent and sometimes to different medications altogether. Some things about the article raised an eyebrow and some others really concerned me.
What first caught my eye was the statement made in the article "to earn a Best Buy designation, a drug must be at least as effective and safe as other medications in its class and less expensive." When I looked at the "Best Buy" (Are we talking medications or appliances?) medication and compare them to the brand name, I noticed immediately that, at least for the senior population, the "best buy" wasn't always a best buy when it comes to side effects. In fact, several best buy medications are on the Beer's List of potentially inappropriate medications for the elderly.
Regarding medication effectiveness, most examples used could be equally efficacious, but not in all cases. Special note was made of the lovastatin vs. Lipitor, because lovastatin was the first statin and also the weakest. You could take a higher dose of lovastatin, but so goes the risk of adverse reactions.
Fluoxetine was a best buy for depression, but is generally not recommended in the elderly due to its extremely long half-life. Metformin is recommended for diabetes and is definitely the drug of choice in the most patients. Patients over 80 or those with poor kidney function should not take metformin however. Ibuprofen is recommended over Celebrex due to side-effect profile and risk factors, but ibuprofen has side-effects and risks of its own and can be very severe in some patients.
Consumer Reports puts out some great information year after year. This article, too, provide some good information, but did not include some important considerations for special patient populations like seniors. To be fair, most of this information is available by clicking through medication names and then through side-effects and warnings, but how many reader go through that much trouble? Buying a big screen TV and buying medications are not the same. Judging a medication from an article is no substitute for the individualized consultation provided by your pharmacist and other members of your health care team.