Doctors Often Pick Costlier Drugs

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Study:

Doctors Often Pick Costlier Drugs

April 21, 2004

CHICAGO (AP) -- Doctors often prescribe

newer, more expensive drugs for high blood pressure instead of the ones

recommended under medical guidelines, and the practice is costing the nation

more than $1 billion a year, researchers say.

The researchers did not examine why,

exactly, doctors go with the costlier drugs, but they speculated that

aggressive drug-company advertising may be one reason.

The study of Pennsylvania's drug-assistance program looked at more than 133,000

patients who filled more than 2 million prescriptions for hypertension

medicine in 2001. The prescriptions cost the state $48.5 million.

About 40 percent of the time, patients were

prescribed different drugs than those called for under medical guidelines,

according to the study in Wednesday's Journal of the American Medical

Association.

Getting doctors to prescribe the preferred

treatments would have saved the state $11.6 million in 2001, the study found.

The researchers, Drs. A. Fischer and

Jerry Avorn of Harvard's Brigham and Women's

Hospital, said that nationally, the savings could amount to $1.2 billion a

year on high blood pressure medicine alone.

The study found that calcium channel

blockers accounted for the most spending, about $17 million, with an average

cost of $33.39 a prescription. The least expensive drugs, diuretics called thiazides, cost $5.33 a prescription.

The Joint National Committee on Prevention,

Detection, Evaluation and Treatment of High Blood Pressure recommends that thiazides be used as the first-line treatment in cases of

hypertension without other complications.

As for the role of pharmaceutical industry

advertising, Fischer said, " I think it's a really important area for

further study. There's advertising both to consumers and physicians. "

Dr. Hoangmai Pham,

senior health researcher at the Center for Studying Health System Change,

said advertising is only part of the story. She said patients often believe

the best care is the costliest and push for more expensive treatments.

Also, " a lot of times physicians

inherit patients and people are loath to switch regimens, especially if they

seem to be working. This paper provides one more reason why you might stop

and reconsider, " she said.

Pham, who was not involved in the study,

said she believes similar savings could be found throughout the health care

system without compromising patient care.

" It's only one of many circumstances in

which better quality doesn't cost more and can actually cost less, " she

said.

Copyright 2004 The

Associated Press. All rights reserved.

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