WASHINGTON The nonprofit Consumers Union has issued the first in a series of evidence-based, patient-friendly reports listing what it calls the most cost-effective drugs, organization officials announced at a press conference.
The initial guides cover nonsteroidal anti-inflammatory agents (NSAIDs), statins, and proton pump inhibitors (PPIs).
The publisher of Consumer Reports said it hopes that patientsespecially those with little or no drug benefit coveragewill use these reports to make informed choices in conjunction with their physicians.
The reports are designed to cut through the clutter of drug company advertising and scattered Internet searches. But drug makers won't be allowed to use the "Best Buy Drugs" designation in marketing or ads: Consumers Union prohibits manufacturers from commercializing any of its recommendations.
The guides should be familiar to anyone who has used Consumer Reports' ratings to buy a car, appliance, or bicycle. But unlike the group's analyses on other consumer goods, the Best Buy Drugs reports are free of charge.
"In each category, based on all the evidence, we've identified Best Buy Drugsthe drugs that are likely to be the best, most affordable choices for most people," said Joel Gurin, executive vice president of Consumers Union.
The Best Buy Drugs are not selected based on Consumers Union's own tests, however, but rather on systematic reviews conducted by the Drug Effectiveness Review Project (DERP), and on further peer review from medical experts like Mark Helfand, M.D., director of the Oregon evidence-based practice center at Oregon Health and Science University, Portland, which initiated DERP in 2003.
DERP follows the literature review and analysis methods pioneered by the Cochrane Collaboration. That lends the Consumers Union's reports credibility, said Peter Toth, M.D., director of cardiovascular disease prevention at Sterling Rock Falls Clinic in Sterling, Ill.
"I believe patients will find it to be a valuable resource when trying to balance cost with clinical efficacy," Dr. Toth commented.
Funded by 12 states, DERP has completed reports on 12 therapeutic categories. Consumers Union is making the first three available on a new Web site (www.CRBestBuyDrugs.org
The organization has said that it will add three more categories over the next few monthsselective serotonin reuptake inhibitors, β-blockers, and ACE inhibitorsand will continue to do so on a monthly basis. Each report, which is also available in print form, offers a chart comparing the average monthly price for every drugbrand-name, generic, and over-the-counteravailable in the class, at each dosage.
Price data are purchased from NDCHealth, a company that processes pharmacy transactions, and those data reflect national retail averages. Consumers may be able to find even better prices by shopping around, said Gail Shearer, director of health policy analysis for Consumers Union.
In the statin category, the report recommends generic lovastatin as its Best Buy Drug for reducing low-density lipoprotein (LDL) by less than 40%. Lovastatin costs an average $28 per month for 10 mg and $40 for 20 mg, according to Consumers Union. Lipitor (atorvastatin), at an average $117 per month, is the Best Buy Drug for LDL reduction of more than 40%.
Although Crestor (rosuvastatin) offers better LDL reduction for the price, it is not recommended because it has not been proved to reduce heart attacks or death, and safety studies are still being conducted, the report said.
Consumers Union rates the over-the-counter version of Prilosec (omeprazole) as the Best Buy Drug among the proton pump inhibitors.
The 20 mg/day dosage of Prilosec costs $24 a monthone-fifth the cost of the next least-expensive drug in the class. And, it "is just as likely to relieve symptoms for most people with GERD [gastroesophageal reflux disease]," the report said. But the report also counsels people with drug coverage to talk with their physician about which medication has the lowest out-of-pocket cost under the patient's plan.
Dr. Toth said that if patients use an over-the-counter drug to treat GERD, they might skip seeing a physiciana potentially troubling issue.
"In the case of PPIs, there is concern because among a significant percentage of patients who suffer from chronic GERD, you do have to make sure that they're not developing Barrett's esophagus and that they don't have something more significant than simple reflux," Dr. Toth noted.
Consumers Union reviewers were initially worried about self-medication, but added a caveat to increase the dose or see a physician if symptoms did not improve, said Steve Findlay, a health care analyst with Consumers Union.
Reviewers were more concerned about highlighting over-the-counter medications in the NSAID category because of those drugs' potential to cause ulcers with chronic use, he said. The Best Buy Drugs in that category were generic ibuprofen at an average cost of $24$30 per month, depending on dosage, and generic aspirin at a cost of $24$32 a month. By taking these older, generic medicines, patients could save up to $2,160 a year, Consumers Union said.