Getting a new car or camera model is often equated to pills as well…that the newer version is an improvement over the old. But experience has taught doctors that this is not necessarily true..especially when it comes to medications.
While drug pharmas may go to town extolling the virtues of their new drug releases (which they claim to have undergone extensive research and FDA-approved), it is easy for doctors and the public to be swayed by these promises and switch to the new. Some doctors know this can sometimes backfire. For instance, newer meds have a shorter track record of usage, sometimes not enough for side-effects to appear which escaped scrutiny during the drug trial period. After prolonged use, previously-undetected side-effects can surface which may even lead to eventual withdrawal of the drug from the market.
A case in point: at the ongoing American Heart Association (AHA) meeting in Orlando, Florida, November 2011, it was revealed that a popular anti-cholesterol medication Crestor was not significantly better than the older more popular Lipitor that it intended to replace, in terms of reversing cholesterol blockages in arteries.
For the makers of Crestor, AstraZeneca, this is a double-blow: it had sponsored the clinical trial to demonstrate its superiority over its rival(the SATURN trial). Now that this failed to materialise, it is going to find it tougher to market its drug once its rival loses its patent rights this month.(This means bona fide pharmas can produce non-branded versions, aka generic types, which are considerably cheaper.)
This is of course good news to consumers who now can buy generic Lipitor, at a fraction of the price before, knowing full well that they will not lose benefits extolled by the newer ones. My take-home message though, is that none of the pills are going to work well if one does not incorporate it with change in life-style habits..
- Astra’s Crestor Is Comparable to Lipitor in Study (online.wsj.com)
My curiosity was raised recently when a news report claimed that one of the top 5 medicines in the world has recently been found to be not that effective.
First of all, the top five are:
1. Lipitor – the wonder drug for lowering blood cholesterol. USD 13 billion sales annually.
2. Plavix – the blood-thinner that works by preventing blood platelets from sticking together. USD 6 billion annually.
3. Seretide – aka Advair, is a combination steroid-betaagonist( to relax the air passages in the lungs) that is inhaled by asthma patients. USD 6 billion.
4. Nexium – the wonder drug for the treatment of stomach ulcers and gastritis. USD 5 billion .
5. Norvasc – the top-selling medication for blood pressure. USD 4.8 billion.
Its interesting to see that many side-effects have been reported worldwide when using the above drugs, which brings one to the maxim – all drugs have side-effects and using it is a balance between its benefits and its risks. Some of these side-effects are quite harmless, like feet swelling up with Norvasc, but others can be potentially life-threatening.
Such is the case with one of the above – Plavix aka clopidogrel – which has recently been issued a “black box” warning by the FDA here. A boxed warning is the FDA’s toughest warning and appears prominently at the top of a drug’s label to warn users of a serious warning. In the case of Plavix, 2-14% of users will not respond to its benefits (the anti-clotting action) and therefore will be at risk of a blood clot forming in the arteries of their heart or brain despite taking the medication. The inefficacy is determined genetically and its possible for potential users to have themselves screened in the near future to see whether they should take the medication or not.
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