Older drugs aren't just cheaper, they're better, study says

Generic drugs already have cost on their side when competing with pricey brands. But according to a new study in Health Affairs, older meds may actually be more effective, too. The newest drugs on the market beat placebo by slimmer margins than their predecessors did in clinical trials, the study found, indicating that doctors have more reason to choose older drugs.

The researchers looked at 315 placebo-controlled trials published in four top medical journals from 1966 to 2010. The trials tested drugs for a wide range of illnesses, Reuters reports. In the earliest trials, drugs were 4.5 times as effective as placebo, on average. By last decade, the new drugs beat placebo by just 36%.

These are averages, of course. Single drugs that made big strides would be offset by handfuls of not-as-revolutionary drugs. As Reuters points out, there have been major advances in cancer treatment, such as Genentech's breast cancer drug Herceptin and the Novartis ($NVS) blood-cancer drug Gleevec. Plus, look at antiviral leaps made by HIV fighters and, more recently, hepatitis C drugs.

Scientists also pointed out that patient populations in current trials may be harder to treat than those who volunteered back in the 1970s. Today's trial participants, in many cases, volunteer because current treatments aren't working. Plus, newer studies are larger and may be more rigorous.

Still, at least one expert who wasn't part of the study figures that the conclusions merit attention. "Their results are pretty compelling," Dr Aaron Kesselheim of Harvard Medical School told the news service. "It does appear that things are headed in the same direction, with newer drugs having relatively less efficacy."

The study's lead author, Dr. Mark Olfson of Columbia University, told Reuters that some doctors are already turning to older drugs out of frustration with newer brand-name treatments. "[S]omething real is going on here," Olfson said. "Physicians keep saying that many of the new things just aren't working as well."

In recent years, pharma has drawn criticism for turning out a series of "me-too" drugs, which offer small advances over existing therapies, rather than big, innovative steps. Drugmakers' attempts at larger leaps forward have often run aground. But last year, the FDA approved 39 new drugs, the most in 16 years, including some truly new targeted drugs. The question now is whether that recent surge extends the trend that this new study identified or takes the trend line in a new direction.

- read the Reuters news

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