Cheap Drugs

Aaron Carroll writes today that we’re addicted to new drugs even though older drugs are often just as good or better than the new ones. The problem is that we don’t usually know this for sure since comparative studies are rare. However, a few years ago one was done for blood pressure medications:

There were so many drugs to choose from for this trial (at different costs) that the National Heart, Lung, and Blood Institute (NHLBI) primarily organized and supported a randomized, controlled trial to examine which was best. This study was enormous; it took place in 623 centers in the United States, Canada, Puerto Rico, and the U.S. Virgin Islands between 1994 and 1998, and included over 33,000 participants. Patients received one of four drugs:

  • Amlodipine, a calcium channel blocker
  • Doxazosin, an alpha-adrenergic blocker
  • Lisinopril, an angiotensin-converting enzyme inhibitor
  • Chlorthalidone, a diuretic

The last of these, the diuretic, was the oldest of the drugs, and by far the cheapest. However, at the end of the study, the results were clear. This old, cheap diuretic was significantly better at preventing at least one of the major types of cardiovascular disease when compared to the other, newer drugs. Since the diuretic was also significantly less expensive, it should be the drug of choice in initial treatment of high blood pressure. However, it usually is not.

I’m glad to hear it! My blood pressure has been slowly rising for the past few years, and last year my doctor decided I should start taking something for it. At first she recommended a beta blocker, but as we talked about it she said something that made me a little nervous (I don’t remember quite what). “You know,” I said, “I actually have a strong preference for the oldest, cheapest, best studied drugs around.” She looked slightly surprised, but said that was perfectly reasonable and immediately prescribed a diuretic. I’ve been taking it ever since. (And, yes, I try to watch my sodium intake too.)

The whole post is worth reading. Sometimes new drugs are great, but I’m willing to bet that we waste upwards of a quarter to a third of the money we spend on pharmaceuticals because both doctors and patients have been brainwashed to always want the latest and greatest. But me? I like drugs that have been really well studied and are known to have infrequent and well understood interaction effects. In fact, new drugs actually make me kind of nervous. I am an insurance company’s dream patient.

DOES IT FEEL LIKE POLITICS IS AT A BREAKING POINT?

Headshot of Editor in Chief of Mother Jones, Clara Jeffery

It sure feels that way to me, and here at Mother Jones, we’ve been thinking a lot about what journalism needs to do differently, and how we can have the biggest impact.

We kept coming back to one word: corruption. Democracy and the rule of law being undermined by those with wealth and power for their own gain. So we're launching an ambitious Mother Jones Corruption Project to do deep, time-intensive reporting on systemic corruption, and asking the MoJo community to help crowdfund it.

We aim to hire, build a team, and give them the time and space needed to understand how we got here and how we might get out. We want to dig into the forces and decisions that have allowed massive conflicts of interest, influence peddling, and win-at-all-costs politics to flourish.

It's unlike anything we've done, and we have seed funding to get started, but we're looking to raise $500,000 from readers by July when we'll be making key budgeting decisions—and the more resources we have by then, the deeper we can dig. If our plan sounds good to you, please help kickstart it with a tax-deductible donation today.

Thanks for reading—whether or not you can pitch in today, or ever, I'm glad you're with us.

Signed by Clara Jeffery

Clara Jeffery, Editor-in-Chief

We Recommend

Latest

Sign up for our newsletters

Subscribe and we'll send Mother Jones straight to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate

Share your feedback: We’re planning to launch a new version of the comments section. Help us test it.