The recent withdrawal of Vioxx, a popular painkiller used for treatment of arthritis, has created a flurry of attention focused on the use and safety of prescription drugs. In September, Merck & Co. voluntarily removed Vioxx from the market because it was found to increase risk of heart attack.
An estimated 20 million people have taken Vioxx since the drug was launched in 1999. The number of injured patients is estimated to be from 30,000 to 100,000, resulting in what will most likely be one of the biggest litigation issues in the pharmaceutical industry. Concerns have also been raised about Celebrex, another medication in the same class of Cox-2 inhibitor drugs.
What has followed is a barrage of media coverage and public concern about the cost, safety and effect of prescription drugs. Is all of this activity a backlash against the pharmaceutical industry, or is there a growing trend by Americans to consider less costly, less risky and safer options to drugs?
Prescription drugs continue to be the fastest-growing area of health cost in America. Drug purchases in 2004 topped $216 billion. This was an increase of 11.5 percent from the previous year. Data from one large Milwaukee health plan shows that if you are an employer with 2,000 employees and dependents, you can expect that 1,700 people will use their prescription benefit an average of 11 times.
The United States leads the world in the development of new drugs, and yet America ranks 29th in life expectancy. While these drugs have a valued impact on quality of health, millions of Americans see pills as a solution for everything from weight gain to sadness. We have become a quick-fix society. Most of us have an expectation that when we see our physician with a health concern, we will leave with a diagnosis and a pill to solve the problem.
Despite the fortune spent on medicine in the United States, very little money is spent to treat the causes of chronic diseases before major illnesses develop. The Center for Disease Control reports that 54 percent of heart disease, 37 percent of cancer, 50 percent of cerebrovascular disease (strokes) and 49 percent of arteriosclerosis (hardening of the arteries) is preventable through lifestyle modification.
The increased incidence of disease resulting from unhealthy lifestyles, including obesity, poor nutrition and lack of physical fitness, coupled with the $2.5 billion spent annually on consumer advertising, prompt the demand for more drugs.
However, people increasingly are saying no to pills and seeking other options.
Patty Heying, a registered nurse and independent contractor, did exactly that with great results. Following a diagnosis of hypertension and high cholesterol, the 42-year-old Heying declined her physician's recommendation for prescription medication until she could try natural options first. Through diet, increased exercise, natural supplements, stress management and use of therapeutic grade essential oils, she successfully reduced her blood pressure and cholesterol.
Within eight months, in a follow-up visit to her physician, her blood pressure returned to normal and her cholesterol fell from 278 to 202. She has continued to keep her blood pressure and cholesterol within normal range.
However, Heying would tell you that avoiding prescription drugs isn't as simple as making a decision to stop taking them. When she recently applied to a local health plan for individual insurance, she was denied coverage for not seeking follow-up treatment for her hypertension and elevated cholesterol. When she received a letter of rejection, she called the health plan underwriting department and was told that the use of prescription medication would have indicated appropriate follow-up treatment.
The irony of our health insurance system is that it rewards people for taking drugs but limits payment for nutrition counseling and health club memberships. Even if you are conscientious about the overuse of prescription medication, you will get little encouragement from the health care system. Patient compliance is too often defined as being obedient about getting your prescription filled.
Has the system given up on the health care consumer's ability for self care? It is a well-established medical fact that diet and exercise are significant factors in reducing coronary artery disease, but unfortunately, many doctors still do not spend significant time on prevention. Yet, can you blame physicians for reaching their limit with human nature? Most people will ask for and expect the easiest, quickest solution. Generally, that is a pill.
What does the removal of Vioxx and concerns about the drug category mean for the millions who suffer from arthritic pain? What options do patients and physicians have? Patients who are currently taking Vioxx should contact their health care providers to discuss discontinuing use of the drug and possible alternative treatments, such as weight control, exercise, massage, dietary supplements, relaxation techniques and acupuncture.
For arthritis sufferers, such alternative treatments can provide relief for many patients. For instance, some studies show that the omega-3 fats in fish oil, flax seed and walnuts may have an anti-inflammatory and analgesic effect on arthritic pain. Another supplement that is popular for ease of arthritis and muscle/joint pain is glycosamine-chondroitin. It is currently the focus of a large study by the National Institutes of Health. Since dietary supplements are another form of medication, they should be used with caution.
Connie Roethel, R.N., M.S.H., is president of Complementary Health & Healing Partners (CHHP), a corporate wellness and health promotion services company with offices in Mequon. She can be reached at (262) 241-9947.
February 18, 2005, Small Business Times, Milwaukee, WI
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