Rx: Read This

Comparison Shop for Pills? A New Tool Lets You. But Experts Say Don't Buy on Price Alone

Most people wouldn't consider a major purchase without first comparing price and reliability of the products in question. But that task has been next to impossible for consumers of prescription drugs. This has been particularly painful for the 45 million Americans who are uninsured at some point during the year and the 25 million who are insured but have modest or no drug coverage.

But now the standard bearer of comparison shopping -- Consumer Reports, published by the nonprofit Consumers Union -- has launched a free service that reports on the safety, effectiveness and cost of drugs. In each category of medication, Consumer Reports even flags "best buys" -- the drugs it considers to offer the safest and most effective therapy for the money.

This means, for instance, that people who need a cholesterol-lowering statin drug can go to www.crbestbuydrugs.org and scan the options. Charts and text explain how much cholesterol reduction to expect from each drug, whether it has been proven to cut the risk of heart attack or death, the average monthly cost and safety concerns.

Consumer Reports did not test each drug, as they might toasters or vacuum cleaners. The ratings are based on independent analyses of published clinical trials conducted by the Drug Effectiveness Review Project, a venture funded by 12 states that's based at Oregon Health & Science University.

The statin report, along with reports on proton pump inhibitors (for acid reflux, heartburn and ulcers) and on nonsteroidal anti-inflammatory drugs (for arthritis and pain) now appear online. Consumers Union plans to add one new class of drugs per month over the next year. Some partner groups, including Families USA, U.S. Public Interest Research Group and the AFL-CIO hope to distribute print versions of the data. Due next: Reports on selective serotonin reuptake inhibitor (SSRI) antidepressants (such as Prozac and Paxil) and two categories of heart drugs, ACE inhibitors and beta blockers.

The Consumers Union Best Buy program is part of a burgeoning industry aimed at empowering drug purchasers to make better-informed and more-cost-effective choices. A number of Web sites, including www.pdrhealth.com, www.safemedication.com, www.webmd.com and www.intellihealth.com, offer information on drug dosing, side effects, contraindications and Food and Drug Administration (FDA) actions. And it's possible to track down a drug's approximate retail cost by calling local pharmacies or checking prices on www.drugstore.com or other online pharmacies. Early next year, AARP will launch a Web site listing drug effectiveness data and some price information, said Van Ellet, AARP senior legislative representative. For now, the Consumers Union's Web site appears to be unique in offering cost, safety and effectiveness information in one place. The price data reflect national averages compiled by NDCHealth, a subscription-only service, and should be used only as a rough guide, said Gail Shearer, director of health policy analysis for Consumers Union. "It is important for people to understand that some shopping around could really benefit them," she said.

The group thinks that by shining a spotlight on cost and effectiveness, drug makers will be pressured to cut prices, especially on less-effective medications, said Shearer.

The site explicitly warns people not to self-treat or change their medications without consulting their doctors. The group regards its reports as something "that consumers can take to their doctors to talk with them about their drug treatment choices," said Joe Gurin, executive vice president of Consumers Union.

The drug industry and some physicians said the reports emphasize cost over individual needs and that steering consumers in some cases to over-the-counter (OTC) medicines could result in dangerous self-treatment.

For instance, Consumers Union flags the OTC drug Prilosec as its "best buy" for acid reflux and heartburn, saying it works just as well as the top-selling brand, Nexium (esomeprazole), ubiquitously marketed as the "Purple Pill." The site reports that OTC Prilosec costs $24 a month, compared to about $170 a month for Nexium.