Many of the breakthrough drugs of the 1980-1990′s are now available
as generics, and pharmacy competition has led to great bargains for
patients needing these drugs.
The 1980’s and 1990’s were a golden age in the development of great
new drugs to treat many common and uncommon diseases. Prior to that
time it was very difficult to treat depression, hypertension,
diabetes, and congestive
heart failure. It was nearly impossible to treat high cholesterol.
Breakthrough drugs like the SSRI
inhibitors and calcium
channel blockers for hypertension, metformin
for diabetes, and several drugs in combination for congestive heart
failure came to market, and have revolutionized the care of many of
these chronic diseases. Now the great news it that many of these drugs
are available as generics, and competition between retail pharmacies has
led to incredibly cheap medication. Here is my top ten list of great
- ACE inhibitors. I tend to use lisinopril, but
several others are also available. These meds are effective at
controlling high blood pressure, but have also been shown to prevent
heart attacks in patients post MI, to prolong life and reduce
hospitalizations in congestive heart failure, to prevent diabetes
related kidney failure, and is usually extremely well tolerated. A
small percent of patients get a cough, and even smaller percent are
allergic to these medications.
- Statins This class of LDL cholesterol lowering drugs has made effective treatment of high cholesterol practical and simple. Several have gone generic including simvastatin, lovastatin, and pravastatin. Although simvastatin (Zocor) is not on the chain pharmacy $4. drug lists, it is quite inexpensive ($10.90/ 100 40mg doses at Costco) and is effective enough for most patients to achieve goal LDL cholesterol levels. Many studies have shown statins to be effective at lowering rates of various cardiovascular diseases.
effectively treated with an SSRI can be treated with a generic one now
as Prozac (fluoxitine), Zoloft (sertraline), Paxil (paroxitine), Celexa
(Citralopram) and others are available as $4./ month at the chain
the standard first line medication for type 2 diabetes, is a $4./ month
medication, and is now being used for pre-diabetes to prevent
progression to diabetes, for polycystic ovarian disease, infertility,
and other off label uses. It is usually well tolerated, but cannot be
used in patients with low kidney function.
these nice allergy medications to market as OTC meds (no prescription
needed) This is great except most are now not covered by insurance drug
benefits. Still they are a huge improvement over the old sedating meds
that led to accidents and poor school and work performance.
but still effective ranitidine and the newer proton pump
inhibitors (PPI’s) like omeprazole (Prilosec OTC and by Rx) and
others used to be incredibly expensive, but are now quite affordable.
They have essentially eliminated surgical peptic ulcer disease, and help
the suffering of innumerable heartburn sufferers. There is lots of new
data linking long term use of PPIs to osteopenia and C. difficiele
infections, so they are ideally used for limited periods of time, but
they have made chronic peptic ulcer disease a thing of the past.
corticosteroids are now available as generics to treat eczema,
psoriasis, and other skin conditions. Triamcinolone cream (Kenalog) and
others are inexpensive and effective.
(sumatriptan) lost its patent in the last year, and has become more
affordable. Others will follow soon. These have been miracle
medications as abortive treatment when used early in the course of
major bipolar disorder has been revolutionized by the development of
the newer antipsychotics, and the cost has become reasonable with
risperidol and others now available as generics.
become incredibly common, treatment costs were exorbitant until
acyclovir lost its patent. Now it is much less expensive, and the
disease that keeps on giving is at least not also unaffordable to treat.
Many of these medications cost $100-600. / month as branded
medications, but most are now either on the $4./ month discount pharmacy
lists, or otherwise quite affordable. Ask your doctor about generic
alternatives to any expensive medications you are taking. Don’t be
fooled by the myth that because insurance pays well, the cost is low.
Prescription medication costs make up about
10% of the US health care dollar spent. You can make a difference.
Ed Pullen, MD, is a board certified family physician practicing in Puyallup, WA. Dr. Pullen shares his viewpoints on medical news and policy from a primary care physician’s perspective at his blog, DrPullen.com.