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At WorstPills.org, they “list the drugs we and our consultants think you should not use. For each of these, we recommend safer alternatives.” This excellent website is worth the small yearly fee. Their simple rule is to wait seven years after drugs go on the market before using them. Lack of efficacy and harmful side effects are usually apparent by then. They describe the “seven deadly sins” of medication use. You can often spot them, even if your physician does not. The following are from their superb article, “Misprescribing and Overprescribing of Drugs.” ✪ Treating side effects of one drug with more drugs. ✪ Prescribing drugs when life-style changes are more effective. ✪ Using drugs that do not work. Virus treatment with antibiotics is an example. ✪ Use of new drugs rather than the simplest and cheapest. ✪ Prescribing multiple drugs that interact with each other. ✪ Multiple drugs are used rather than just one. ✪ Prescribing doses that are too high. If you decide that you need medications, price-shop them. Several websites show the cheapest costs for each insurance plan. You can often find drugs for even less than your copay. See: ✪ HealthWarehouse.com ✪ GoodRx.com ✪ BlinkHealth.com ✪ WeRx.org ✪ Costco and Sam’s Club ✪ Independent and grocery store pharmacies ✪ Shopping outside the US (see below) Watch your retail pharmacy closely to avoid being overcharged. They are not like a grocery store. Price shopping for food is natural, you understand it, and in some stores, prices are nearly wholesale anyway. Since you rarely go to the pharmacy, price comparison is more difficult. You know much less about drugs than the pharmacist, and they will gouge you if you are not careful. For example, the mupirocin antibiotic ointment (oil-based, Bactroban brand), went off patent and now costs $10 a tube. The company later patented a cream (water-based) and priced it at $80. Know the difference, or they will sell you the expensive type. The ointment is better for most things, anyway. Generic vs patented drugs: The flip-side of price shopping is that you may be handed cheaper generics. In theory they are identical, but the quality control on foreign-manufactured generics is inferior to the brand names, and this may translate into problems for you. Since you often get a different generic every time you re-order, you may find some are weaker or problematic in other ways. I have observed this when prescribing calcium channel blocker blood pressure medications. The patented ones seem to work better with fewer side effects. Another example: I prescribed a generic beta blocker drug called metoprolol, which was supposed to work for 24 hours. But after only 12 hours, the patient’s heart rate would go up, and the patient would go into an abnormal heart rhythm called atrial fibrillation. This meant the drug was shorter acting than the manufacturers claimed. I even tried having the patient cut the pill in half and take it every 12 hours, but this worked poorly also. Here is how drug names work: the industry usually creates both a confusing chemical name and also a catchy trade name to use when harassing doctors and patients. Celebrex, for example, has a chemical name of celecoxib—try pronouncing that one. Medical journals traditionally use the chemical name. I have used whatever seems more readable here.
Yoho MD, Robert. Butchered by “Healthcare”: What to Do About Doctors, Big Pharma, and Corrupt Government Ruining Your Health and Medical Care (pp. 133-135). Inverness Press. Kindle Edition.