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Medicine Chest: How to Take Drugs

Both Sides:
Prescription drugs improve the quality and duration of our lives. But drug reactions account for 15% of all hospital admissions, and kill 100,000 Americans each year. And drug inflation runs over 20%/year, making drugs almost unaffordable.

What to do:
Learn enough to decide with your doctor. . .

  1. Whether you really need medication
  2. Which of the expensive new drugs are safe and can help you
  3. Which older, less expensive, FDA-guaranteed, generic equivalents can save you money.

Overuse:
Penicillin is still around and it is as effective as Cipro against anthrax. But penicillin (45 cents/day) isn't worth advertising, while Cipro ($3.66/day) certainly is. Antibiotics are prescribed three times too often for strep throat; more than half of all unnecessary antibiotics are the expensive drugs intended for the ICU (not penicillin).

Underuse:
Despite the most potent medications ever, the death rate for asthma is increasing because of underprescribing. Congestive heart failure is more deadly than many cancers, but one-third of patients leave the hospital without the drugs of choice!

Why?
In 1997, the FDA accelerated the drug approval process, leading to a flood of drugs similar to those already available. It also relaxed restrictions on drug advertising, leading to unprecedented marketing to physicians ($11.8 billion in 2001) and to patients ($2.47 billion last year).

Your Doctor?
She can't know about all new drugs, and she gets more advertising than new education. She may give you a free sample which leads to an expensive refill, or may prescribe only drugs with which she is long familiar. In the first case, you get the new, expensive, relatively untested drug. In the second case, you might be deprived of a drug, which though expensive, could be the drug of choice for your condition.

What Can You Do?
To get the most out of medication while protecting yourself against serious side effects:

  • Take OTC medication only with your doctor's consent.
  • Take prescription medication only whenever necessary and appropriate.
  • Ask your doctor to prescribe older medications whenever appropriate.
  • Ask your doctor to prescribe generic (the oldest) medications whenever appropriate.

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Medicine Chest: How to Take Drugs

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