New Drugs Are Not Always Better Drugs

Every prescription drug offers potential benefits. It comes with possible risks, too.

Those risks often get lost amid the marketing, hype and hope of the latest and "greatest" new medication. Patients see an ad for a new drug, figure it's right for them and ask a doctor to prescribe it.

That's a reaction to a marketing campaign, not an informed decision based on weighing individual risks against benefits, says Kasey Thompson, Pharm.D., spokesperson for the American Society of Health-System Pharmacists.

Whether you're enrolled in a consumer-directed health plan such as a medical savings account or you have more traditional health insurance, it's important to learn all you can about medications and other aspects of your health care.

The Lessons of Vioxx

The value of knowing the risks became clear in 2004 when the painkiller Vioxx left the market. Vioxx had been sold in the United States since 1999, but new research showed an increased risk for heart attack and stroke in patients who took it for more than 18 months. In 2005, sales of another drug in the same class, Bextra, ended after the U.S. Food and Drug Administration (FDA) questioned its cardiovascular safety and cited rare but sometimes fatal skin reactions. The FDA let Celebrex, the third painkiller in this class, stay on the market, but asked its maker to add warnings about potential heart risks. If you take Celebrex, the FDA suggests you talk with your doctor.

Those problems led to questions about the FDA process for approving and monitoring drugs. But that doesn't mean our drugs aren't safe. "We have the safest drug distribution system in the world," says Edward Langston, M.D., a family doctor, pharmacist and member of the American Medical Association Board of Trustees. Still, he urges prudence, as he did long before the Vioxx problem.

"I'm always cautious when new drugs come out, particularly if there are other acceptable drugs in the same class," he says. "Every time we write a prescription, it's a balance between benefit and risk. I think patients only hear for the most part about the benefits, particularly with the direct-to-consumer advertising."

Before you demand the newest treatment, says Dr. Langston, learn all you can about a drug. Discuss with your doctor the drug's benefits and risks based on your age, gender, condition and other medicines you take. The longer a drug is on the market and the more people use it, the more we learn about it.

Knowing the benefits and risks is vital, says internist Sandra Kweder, M.D., spokesperson from the Office of New Drugs in the FDA's Center for Drug Evaluation and Research. Before you take any new-to-market drug, ask yourself and your doctor whether that drug's new feature is important to you. Vioxx, for example, didn't treat pain much better than other non-steroidal pain relievers, she says. But it did cut down on stomach bleeding.

We often have "a general perception that new is better. That's not always true," says Dr. Kweder. When you buy a car, you study it from all angles. "The same should be true for a medicine. ... Educating oneself about the medicine, what it is good for and what it isn't good for, and who it may not be good for is one of the most important things that a consumer can do."

Ask These Questions

Ask questions about a medication. Too few patients do, says Dr. Kweder. She and her agency suggest you ask:

• What are the brand and generic (non-brand) names of the medicine?

• What's the active ingredient?

• Could I use a generic form?

• What is the medicine for and what will it do for me?

• Will this medicine take the place of any other medicine I have been using?

• How is it different from what I already take?

• When should I start to feel better?

• When should I report back to my health care team?

• Should I avoid any drinks, foods, substances or activities while I use this drug?

• What are the known and suspected risks of this medicine compared with other drugs that do the same thing?

• Can I use this medicine safely with other drugs and treatments I use? This includes prescription and over-the-counter medicines, vitamins, herbs, other supplements and other treatments.