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Over the years, aspirin has been found useful for many problems other than headache relief. Moving front and center as a drug category with many potential uses are the statins. Although not all approved uses, statins are being tried to prevent heart attacks and strokes. They are also being evaluated in Alzheimer's disease, macular degeneration, glaucoma, multiple sclerosis, rheumatoid arthritis, osteoporosis, and cancer because of their lipid-lowering effects or anti-inflammatory effects. These drugs demonstrate that the longer-term benefits of new drugs cannot be easily recognized as they are being developed. Because of the perceived high cost of drugs, politicians, consumer activists, and well-meaning individuals are trying all kinds of maneuvers to alter the income of brand name drug companies by reducing the cost of new drugs. I recognize that paying anything for a product you do not want to take is difficult. For some individuals this cost can be a major drain on a limited income. We need to learn, however, to balance the cost of discovery (which in this country is primarily supported by patients as they purchase drugs, and some say that drug research in the world is supported by the American consumer) and what it costs the patient. Without the money to develop the statins, some medical problems moght not have treatments. Thus, it behooves us as pharmacists to not only appreciate, but also communicate the value of medicines.
The latest national cholesterol guidelines recommend more aggressive cholesterol-lowering. This means that we are going to see an increased use of statin medications, including combination therapy, to reach these lower cholesterol goals. This category of drugs is already one of the most expensive drug categories for most health plans, and we can expect even more use of them. Until we find the right balance between discovery and patient cost, pharmacists can expect more pressure to reduce drug costs. Some of this pressure will focus on the pharmacist fee, even though we feel this is undeserved. The perceived value of drugs like the statins is one reason for this focus on drug costs. The multitiered pricing currently used by the pharmaceutical industry is another. How prepared are you to support the legislative process to protect pharmacy fees? These decisions are primarily made at the state level, and your state pharmacy organization is the group standing up for pharmacy. All pharmacists benefit from their work, but only some pay their dues. I hope you are a dues-paying member and not expecting others to support your professional obligation.