There's a Pill for That

THE DRUGS WE SEE ADVERTISED MOST ARE OFTEN THE MOST PRICEY

Pharmaceutical ad campaigns often support the newest and most expensive drugs - and these drugs are not always better than the old ones. The heartburn medicine Nexium, for example, was the most advertised drug in 2005, with $224 million spent on consumer ads. It's a very similar drug to Prilosec, with similar rates of efficacy - but because it's newer, it's still protected by patent law, meaning that no other company can sell a generic competitor for 20 years. With no competition, these patent-protected pills are generally more expensive - Nexium costs about $160 for 30 days, compared with about $30 for 42 days for Prilosec. Perri points to Singulair, which is approved for both asthma and allergies, as another example: At $115 for 30 pills, it's much more expensive than other allergy treatments.

THE BOTTOM LINE: Don't press your doctor to give you the newest drug. Instead, ask which treatment will give you - with your particular medical history - the best results.

ADVERTISED DRUGS ARE USUALLY NEW TO THE MARKET - AND MAY PRESENT RISKS THAT AREN'T YET KNOWN

New drugs can have unexpected side effects that aren't caught in their clinical trails. The arthritis drug Vioxx made a huge splash when it was introduced in 1999, in part because of heavy advertising. But drug trials indicated that older remedies such as naproxen (an anti-inflammatory) combined with a proton pump inhibitor like Nexium or Prilosec (to reduce acid production that can damage the stomach lining) were equally effective for most patients. Vioxx turned out to pose serious heart-health risks, but it took five years for those risks to become fully evident, and in the meantime, millions of people took the drug, exposing themselves to heightened danger of heart attack or stroke.

"When a drug is approved by the FDA, it's usually based on short-term studies," says Richard Kravitz, M.D., a professor of medicine of the University of California at Davis. "The advice I received in medical school was: Don't be the last on your block to start using a treatment, but don't be the first either." In part because of the Vioxx scare, the pharmaceutical industry has made some changes. In 2005, Pfizer pledged not to advertise new drugs for the first six months they're on the market, to allow more time for unknown or longer-term side effects to emerge; Bristol-Myers Squibb committed to wait a year.

THE BOTTOM LINE: Ask your doctor if a drug's side effects are well understood and if there are time-tested alternatives that have been proved to work as well.