Unneeded ‘Wonder Drugs’

Re “Big Pharma’s Dirty Little Secret,” Commentary, Dec. 26: Rather than worrying about how to pay for all these expensive new drugs from big pharma, it is time society asked how much of this is necessary or even useful. There are a few real “wonder drugs” that save lives and maintain health, but most new brand-name drugs are very expensive replacements for perfectly adequate generic (off-patent) drugs that could be used just as well (and sometimes better) to treat self-limited or patient-induced conditions.

The Cox-2 inhibitors (Vioxx, Bextra, Celebrex) that have recently captured our attention are a case in point. By definition, they cannot be more effective in reducing pain than simple aspirin, a very effective and very inexpensive drug. Cox-2 inhibitors act on only one of the two pathways affected by aspirin, so they are useful in reducing stomach problems caused by aspirin. Cox-2 inhibitors have been wildly over-prescribed because advertising has created the perception that they are “super aspirin” with narcotic-like effects on pain.

The development of new medical treatments is now dominated by how much people and societies are willing (or obligated) to pay for them, not by cost-benefit or even net health gain. As long as we are willing to be seduced by the mirage of miracle cures for minor discomforts, our perceived needs will be met happily but expensively by big pharma.

Gerald E. Loeb MD

Professor of Biomedical

Engineering, USC

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In his Op-Ed, Peter Rost restates two “secrets” that everyone should be aware of by now. Namely, that we do not have the best healthcare system in the world and that the pharmaceutical industry charges the highest prices to U.S. consumers. I’m delighted that Rost, a vice president of marketing at Pfizer, states that he joined the industry to save lives. He assures us that re-importation of drugs is safe (it’s still illegal) but offers no other solution.

When it was discovered that the U.S. would have a shortage of flu vaccine doses this year, the president announced that he would seek to import some vaccine doses from Canada. Earlier, the administration would not condone drug reimportation from Canada because it had not yet determined whether drugs from Canada were safe.

The real answer is universal healthcare coverage, which would not only provide care for all, but also negotiate a level playing field for drug and hospital costs.

Melvin H.

Kirschner MD

Van Nuys