How to Talk to Your Doctor

Asking about medications

To secure the approval of the Food and Drug Administration for a new drug, its manufacturer need prove only that it works better than a sugar pill, not that it's better than other remedies. So most of the "new" drugs that the FDA approves--75 percent in 2005--are me-too versions of existing remedies rather than genuine breakthroughs. Drugmakers must convince consumers and physicians that their new pink pill is better than the older green one.

As a result, it's important to discuss your medication options with your doctor. In a recent Consumer Reports Survey, almost one-third of the doctors failed to discuss side effects of prescribed drugs, and two-thirds never brought up costs of treatments and tests, patients said.

And it can save you money by asking if there is a generic version of a particular drug. Consumers are already voting with their dollars for generics, which now make up more than 60 percent of U.S. prescriptions dispensed. Half the doctors we surveyed said their patients frequently ask for them. But research suggests that the U.S. could save more than $8 billion with increased use of generics. If you're offered a newer drug, ask whether it has been proven better or safer than its predecessors. Twenty-five percent of doctors in our survey said they frequently observed adverse effects from newer drugs.


Ignore drug ads

There's another party in the examination room with you and your doctor: the pharmaceutical industry, which spends billions of dollars a year trying to get you to pester your doctor for expensive new brand-name drugs--and wining and dining doctors so that they'll prescribe them.

Almost all the doctors we surveyed said they make at least some time to meet with pharmaceutical company representatives who arrive bearing free samples, gifts, and sales pitches for their drugs.

But it's not just the doctors that pharmaceutical companies are trying to sway. Seventy-eight percent of doctors said patients asked them at least occasionally to prescribe drugs they had seen advertised on television, a request that 67 percent of the doctors surveyed said they sometimes honor. It's critical to ask questions and learn as much as you can about a drug, because it's unlikely that you've gotten enough information from a snappy television advertisement.

Patients most frequently ask about drugs for acid reflux, impotence, allergies, and insomnia--mainstays of the television ad lineups. Very few of the patients we surveyed--7 percent--admitted to asking for advertised drugs for their most bothersome health condition over the previous 12 months.

Older drugs can be just as effective, have a longer safety record, and often cost less. The new drug might not be on your health plan's list of approved medications; 60 percent of the doctors we surveyed complained about such restrictions.


Explore Your Alternatives

Alternative medicine is starting to emerge from the long, bitter battles between believers and debunkers, often waged in the virtual absence of scientific evidence. Treatments such as acupuncture, massage, guided imagery, relaxation training, therapeutic touch, tai chi, and yoga are now used in clinics and hospitals alongside conventional treatments. Indeed, such methods are now often called "complementary" or "integrative" medicine. Asking your doctor about alternative treatments is something that should be considered.

Mainstream medical schools offer courses in alternative methods. Most important, alternative therapies are being tested in well-designed clinical trials, and reliable evidence about safety and efficacy is starting to emerge.


Americans pay the most for drugs

Eighty percent of people we surveyed said the pharmaceutical price gap between the U.S. and the rest of the world is unacceptable. Here's the average retail price for a month's supply of popular brand-name drugs in the U.S. and in six other countries.

COUNTRIES	Actos (diabetes) 15 mg, 30 pills	Lipitor (cholesterol) 10 mg, 30 pills	Fosamax (osteoporosis) 70mg, 4 pills	Nexium (heartburn) 20 mg, 30 pills	Singulair (asthma) 10 mg, 30 pills
U.S.	$86.13	$68.37	$64.16	$92.04	$83.40
Australia	41.10	24.27	32.98	22.23	57.21
Canada	62.22	48.45	35.07	60.69	63.21
France	31.38	19.53	34.11	30.63	43.02
Germany	38.52	29.73	37.35	19.26	58.08
Japan	21.48	30.57	23.61*	NA	59.97
United Kingdom	45.72	34.17	40.31	35.04	51.09

*35-mg dose. Source: IMS MIDAS