What Will You Swallow?
How Drug Companies Get You to Buy More
Expensive Drugs Than You May Need
A desire to take medicine is, perhaps, the great feature which distinguishes man
from animals. —Sir William Osler, 18911
Pharmaceutical companies will soon rule the world if we keep letting them believe
we are a happy, functional society so long as all the women are on Prozac, all chil-
dren on Ritalin, and all men on Viagra. —Author unknown2
ON A RECENT Saturday morning, I (Rick) got a page at home from Ethel, an elderly patient. Because of a new rash, she'd consulted a colleague in our university clinic the previous afternoon. Her diagnosis was shingles, a painful eruption caused by a virus, and the clinic doctor had given her a prescription for the antiviral drug famciclovir. But Ethel had been to her local pharmacy and had discovered that it would cost $170 for a seven-day supply. Being a low-income Medicare patient with no insurance coverage for drugs, she couldn't afford the medicine, and she wondered if a less expensive drug could be prescribed. I changed her prescription to an older and less expensive drug, acyclovir. After several phone calls, I found a pharmacy where Ethel could fill her prescription for just $25.
In changing the prescription, I considered that famciclovir and acyclovir have roughly similar effectiveness, although famciclovir can be taken three times a day, rather than the five times a day needed for acyclovir. Experts suggest there is little to recommend one drug over the