Flomax for prostate woes?

The claim

If you're breathing and have a TV, you've seen the ads. In one, smiling middle-aged men bike and kayak as a voice says, "In one week, Flomax may relieve male urinary symptoms due to BPH, also called an enlarged prostate." In 2008 maker Boehringer Ingelheim spent $116 million advertising Flomax (tamsulosin) to consumers, according to data from Nielsen Media Research. The ads worked: Flomax was among the 20 most commonly prescribed drugs in 2008 and racked up sales of more than $1.2 billion.

The check

We reviewed evidence from more than 60 studies of drugs used to treat an enlarged prostate. (Results are available free in our Best Buy Drugs report at ConsumerReportsHealth.org).

Bottom line

Most men needn't go with the Flomax: They'd do just as well with a generic drug, Doxazosin. Flomax is actually considered a "me too" drug, very similar to some that are already on the market. (And stay tuned: As of October, generic Flomax was scheduled to be available in March 2010.) The jaw-dropper: Flomax can cost up to $246 per month if you pay the retail price; Doxazosin, $10 or less. And Flomax is available in just one dosage strength, 0.4 milligrams. So if a man needs to increase the dose to 0.8 mg, as some do, he'll need to take two pills, doubling the cost. Competing drugs come in varying strengths, with little or no extra charge for a stronger pill.