Over the years, aspirin has been found useful formany problems other than headache relief. Movingfront and center as a drug category with manypotential uses are the statins. Although not all approveduses, statins are being tried to prevent heart attacks andstrokes. They are also being evaluated in Alzheimer's disease,macular degeneration, glaucoma, multiple sclerosis, rheumatoidarthritis, osteoporosis, and cancer because of theirlipid-lowering effects or anti-inflammatory effects. Thesedrugs demonstrate that the longer-term benefits of newdrugs cannot be easily recognized as they are being developed.Because of the perceived high cost of drugs, politicians,consumer activists, and well-meaning individuals aretrying all kinds of maneuvers to alter the income of brandname drug companies by reducing the cost of new drugs. Irecognize that paying anything for a product you do notwant to take is difficult. For some individuals this cost canbe a major drain on a limited income. We need to learn,however, to balance the cost of discovery (which in thiscountry is primarily supported by patients as they purchasedrugs, and some say that drug research in the world is supportedby the American consumer) and what it costs thepatient. Without the money to develop the statins, somemedical problems moght not have treatments. Thus, itbehooves us as pharmacists to not only appreciate, but alsocommunicate the value of medicines.
The latest national cholesterol guidelines recommendmore aggressive cholesterol-lowering. This means that weare going to see an increased use of statin medications,including combination therapy, to reach these lower cholesterolgoals. This category of drugs is already one of themost expensive drug categories for most health plans, andwe can expect even more use of them. Until we find theright balance between discovery and patient cost, pharmacistscan expect more pressure to reduce drug costs. Some ofthis pressure will focus on the pharmacist fee, even thoughwe feel this is undeserved. The perceived value of drugs likethe statins is one reason for this focus on drug costs. Themultitiered pricing currently used by the pharmaceuticalindustry is another. How prepared are you to support thelegislative process to protect pharmacy fees? These decisionsare primarily made at the state level, and your state pharmacyorganization is the group standing up for pharmacy.All pharmacists benefit from their work, but only some paytheir dues. I hope you are a dues-paying member and notexpecting others to support your professional obligation.