Brave New World of Prescriptions

It's becoming rare to sit through an entire television program without seeing at least one commercial advertisement that's trying to convince you to get a prescription for some new medicine. The Associated Press reports that drug companies last year spent more than $4 billion on such advertising.

The Centers for Disease Control and Prevention has announced that some medicines prescribed for urinary tract infections can cause birth defects. According to the National Birth Defects Prevention Study, funded by the CDC, women who had taken sulfa drugs or nitrofurantoins reported more birth defects than those who took traditional antibiotics.

Those drugs have been on the market for decades, and thousands of women have taken them — usually with no ill effects. Sulfa drugs, such as Bactrim and Thiosulfil Forte, already have been linked to anencephaly, a generally fatal birth defect.

Because drugs are placed on the market with little or no experimentation on humans, some side effects don't come to light until years after they are introduced. The Food and Drug Administration approves or rejects new offerings based on animal research, or known information on similar compounds.

So while drug makers and inspectors take as many precautions as possible, some approved drugs later are found to cause problems — as in the famous cases of thalidomide and Vioxx. Fortunately, such cases are rare.

Despite the novelty of new drugs, many people choose the old tried-and-true options that can be just as effective at a much lower cost.

One of the factors driving the constant flow of new medications, as well as their cost, is the shortened patent life the government allows on drugs. Once the patents expire, or someone successfully sues to have the formula released in the name of public benefit, competing companies quickly start producing copies under both generic and name brands.

In order to help pay for the research that produced the original drug, the manufacturer frequently makes slight alterations, gives it a new name and secures a new patent.

Sometimes the new version remedies any problems found in the original formula, but often the difference is negligible. So even people familiar with a certain drug are best advised to check for new cautions or recalls regarding any medication before using it.

At the same time, consumer groups note that many of the new drugs that are advertised aren't any safer or more effective than what's been on the market for years. Consumer Reports has published a magazine, "Best Drugs for Less," that compares drugs by price and function.

Doctors and pharmacists, as well as some good research on the Internet and other sources, can help people decide what medicines are best for what ails them at any given time. In these times of rising health care costs, patients should do at least some rudimentary research into the medicines commonly used to treat their conditions.

The growing cost of health care is spurring more and more people to self-diagnose and buy medicines off the Internet or across the southern border, where often they can be bought without a prescription, and at a fraction of the cost.

People who do so should understand that while they might save some money, there often aren't any guarantees that you'll get what you think you're paying for. Folks with chronic conditions often take the same medications for years, but one of the costs factored into the price is the security of knowing exactly what you're putting into your body.

The newest medicines are attractive, especially to folks who have struggled with older drugs that help, but sometimes not enough. Newer seems better, but the new medicines can come with unexpected side effects. Check out what your doctor wants you to take, and be sure to tell him or her if you have any trouble with the new drugs. The patient is the first to know if there are any problems.

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