No Wonder You Had a Heart Attack, You Drug Abuser

Study shows drugs such as Vioxx and Celebrex were widely over-used long before recent problems, write G. Caleb Alexander of the Chicago bioethics group (and colleagues; the lead author is Carolanne Dai) in this week's Annals of Internal Medicine.

The COX-2 inhibitors are no more effective in relieving pain than aspirin, ibuprofen, or any of the traditional non-steroidal anti-inflammatory drugs (NSAIDs), but they ... cause fewer of the gastrointestinal side effects that often trouble long-term high-dose NSAID users. In exchange for reduced GI risk, however, they cost 10 to 15 times as much as the drugs they replaced ... bringing in billions of dollars of annual revenue. These drugs were also heavily promoted to physicians and to the general public. In 2000 alone, Vioxx was the most aggressively promoted drug on the market, including $161 million of direct-to-consumer advertising.

So, predictably,

Over time, growth in COX-2 inhibitor use was most likely to come from those users least likely to benefit from these drugs.