Copyright 2002 St. Louis Post-Dispatch, Inc.  
St. Louis Post-Dispatch
June 14, 2002 Friday Five Star Lift Edition
SECTION: EDITORIAL; Pg. C18

LENGTH: 501 words

SERIES: DRUG COSTS; SECOND OF TWO EDITORIALS

HEADLINE: THE HIGH COST OF HYPE

BODY:
DRUG COSTS

THE latest arthritis drugs were hailed as breakthroughs when they appeared on pharmacy shelves three years ago.

The medications -- sold under the brand names Celebrex, Viox and Bextra -- were soon best sellers. Patients are always willing to spend a little more for the latest drugs.

But when it comes to relieving arthritis pain, the latest drugs aren't best. While they are two to three times more expensive than older drugs like ibuprofen and naproxen that are available as generics, the new drugs are no better at relieving pain, according to recent studies.

In theory, companies shouldn't be able to charge two or three times as much for products that are, at best, marginal improvements over the competition. A free market should prevent that.

But in practice, it happens every day. Over-the-counter drugs like Benadryl relieve allergy symptoms at least as well as newer blockbuster drugs like Allegra and Claritin. But the newer allergy drugs are much more expensive.

In coming weeks, the issue of prescription drug pricing will move to the forefront. Congress is expected to begin working on a Medicare prescription drug benefit. It will also hear testimony on bills to speed the introduction of less expensive generic medications.

Members of Congress will be seeking a simple solution to skyrocketing drug spending, which doubled between 1995 and 2000 and is expected to double again within the next few years. Instead, they will discover a complex market that often works in mysterious ways. Take the latest arthritis drugs.

The biggest advantage of these newer medications, which are called Cox-2 inhibitors, is that they are less likely to cause ulcers than the older drugs. For patients who are older or have had previous gastrointestinal problems, that's important. But as Post-Dispatch reporter Judy VandeWater discovered, the vast majority of those taking Cox-2 inhibitors don't fit that profile. Two trends explain why people buy expensive drugs they don't need. One is the rapid rise in prescription drug coverage. In 1990, private insurance accounted for about one-quarter of the nation's prescription drug expenditures. In 2000, it paid for about 44 percent. People with drug coverage tend to fill more prescriptions.

The other trend is drug marketing, which in recent years has become ubiquitous. That includes ads aimed at patients and more sophisticated efforts directed at doctors.

A report released last year by the National Center for Health Statistics found that 80 percent of newly released, heavily marketed drugs -- including Celebrex -- were on the list of best-selling medications. Just 10 percent of drugs that were not heavily advertised made the list.

America's elderly shouldn't have to go bankrupt paying for medicines they need. Neither should American taxpayers. But it will take more than congressional hearings and a prescription drug benefit to reign in runaway drug spending.

Right now, that's a prescription no one seems to have.

LOAD-DATE: June 15, 2002