According to a new report by Consumer Reports Best Buy Drugs, the generic drug doxazosin is as safe and effective as the widely advertised drug Flomax for treating the symptoms of enlarged prostate, and could save consumers nearly $3,000 a year. Flomax was one of the 20 most commonly prescribed drugs in 2008.
Why doesn’t the public know that a cheaper, equally effective and safe drug to treat the symptoms of enlarged prostate exists? In 2008, the manufacturer of Flomax, Boehringer Ingelheim, spent $115 million to advertise to consumers. Like other, older generic drugs, doxazosin, is not supported by a big advertising budget.
Consumer Reports Best Buy Drugs recently analyzed a systematic review of more than 60 medical studies on drugs to treat the symptoms of enlarged prostate and identified doxazosin as its “Best Buy” because it’s the most cost effective option. In this case, as is true with many other drug classes or drugs to treat a specific condition, the older, generic drug fared as well as the new brand drug and is considerably less expensive.
“Flomax is the new ’it’ drug and that’s a testament to the marketing muscle of Madison Avenue. It’s a great example of how costly drugs are driving up health costs when there are other drugs that are equally safe and effective, such as the $10 a month generic doxazosin,” says Dr. John Santa, director of the Consumer Reports Health Ratings Center. “This drug has been on the market for decades and its safety and efficacy profile is well established,” says Santa.
Consumer Reports Best Buy Drugs, which rates more than 200 prescription drugs to treat more than 20 common conditions, is part of a larger initiative by the newly launched Consumer Reports Health Ratings Center to provide consumers with health Ratings based on independent and unbiased review of the best scientific evidence available, also known as Comparative Effectiveness Research. Consumer Reports Best Buy Drugs reports are available for free at http://www.consumerreportsenespanol.org.
Research from Consumer Reports shows that when prescribing medication, physicians do not routinely consider the cost of a drug. But, when patients can afford their medications, Consumer Reports’ research also finds they are more likely to take their drugs as their doctor prescribed. Dr. Santa urges physicians to pay attention to a drug’s cost, since part of a doctor’s oath is to be a fiduciary for the patient. “This means that doctors should consider the financial interests of their patients. It is unfortunate that many doctors and some patients have forgotten that obligation,” says Santa.
The Story of Flomax: One Advertising Dollar At a Time
Half of all men over age 50, or about 20 million men in the U.S., have an enlarged prostate, as a normal part of aging, though not all experience bothersome symptoms. Says Santa, “A few years ago, drug manufactures saw a huge potential market and went for it. Since then we’ve seen advertising for this drug skyrocket, and as a result, Flomax is now overprescribed.”
In 2008, more than $1.2 billion dollars were spent by consumers and their insurance companies on Flomax alone, an increase of 23 percent over 2007; ranking it #27 on the top 100 list of branded drug by retail dollars. Not coincidentally, in 2008, Boehringer Ingelheim, the manufacturer of Flomax, spent more than $115 million to advertise Flomax directly to consumers, ranking it #7 in the top 10 of most commonly advertised drugs last year. The result: Flomax was among the top 20 most commonly prescribed drugs in 2008 with 11 million prescriptions written.
“Flomax is just the latest in a series of drugs promoted as blockbusters that, in fact, create more sticker shock than anything else,” says Santa. “The advertising appeal to middle aged men capitalizes on something all men want to avoid -- standing in a restroom line at a sporting event. But consumers who are savvy enough to see through these marketing strategies might find themselves with enough money to attend more sporting events rather than buying brand drugs.”
Try Lifestyle Changes First; Then Drugs
Almost all men -- if they reach a certain age -- will develop an enlarged prostate, also known as Benign Prostatic Hypertrophy, or BPH. The statistics are not precise, but about half of men of any age who have BPH will have symptoms that require attention and treatment that may involve taking one of the drugs evaluated in the report.
“This means that millions of men over the age of 50 are regularly taking drugs or using other treatment options to ease the symptoms of BPH,” says Santa.
Consumer Reports Best Buy Drugs recommends trying lifestyle changes first, which can often provide relief. Those changes include going to the bathroom when you first feel the urge, reducing or eliminating intake of alcohol and caffeine, and limiting fluid intake before bedtime. If these don’t bring relief, the next step is usually to consider medication.