Cheaper drugs don't always drive out brands

We've heard a lot about insurers and other payers pushing patients to use generics rather than brand-name meds, and how that pressure hampers Big Pharma. But there's a flip side to that coin. Sometimes, getting patients and doctors to switch is well nigh impossible.

Take a federally funded study pitting old blood pressure meds--the diuretics--against newer, more expensive drugs such as beta blockers. Published in the Journal of the American Medical Association in 2002, the study clearly showed that patients with high blood pressure and other heart risks did better on the older, cheaper drugs. And the researchers mounted an all-out effort to promote those findings.

But, according to the New York Times, that research created only a tiny ripple in the drug market. Diuretic use increased initially, but then it leveled off. Researchers said drugmakers fought back against their publicity efforts, trying to discredit the study. Plus, pharma continued to roll out new meds, which weren't available for the comparative effectiveness study, robbing diuretics of their head-to-head advantage.

So, if Congress actually goes through with setting up a comparative effectiveness bureau of some kind, will that really end up reining in healthcare costs? We'll have to wait and see. But if this study is any indication, the WSJ Health Blog notes, skepticism could be in order. Particularly if that bureau produces FYI-type data, rather than info that government payers, such as Medicare and Medicaid, are required to act upon.

- read the Health Blog post
- see the article in the NYT

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