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Experts See Financial Fallout Over Prilosec's New Status - Over-the-Counter Availability Could Change Insurance Coverage
Article
By Randy Dotinga
HealthDay Reporter
WEDNESDAY, June 25, 2003 (HealthDayNews)
One of the most popular heartburn prescription drugs in the world is headed to the shelves of a drugstore near you.
But it's not clear if the new over-the-counter status of Prilosec will burn a hole in consumers' wallets as they fight that burning sensation in their chests.
The good news is that the powerful purple pill will be easier to get, helping those who don't get enough relief from antacids and treatments like Tagamet.
The bad news? Insurance companies could stop paying for Prilosec and similar drugs, which some chronic heartburn patients must take every day.
"The insurance companies might abandon their patients who need this drug. That could be very problematic to many patients who can't afford it," says Dr. Peter J. Baiocco, associate chief of the gastroenterology section at Lenox Hill Hospital in New York City.
On Friday, the U.S. Food and Drug Administration announced it will allow Prilosec to be sold over-the-counter instead of by prescription. According to Procter & Gamble, which plans to begin selling Prilosec this fall, the medication was the best selling prescription drug in the world from 1996 to 2000.
Prilosec will join a long list of over-the-counter treatments for heartburn, the feeling of burning in the stomach area that may spread up the esophagus to the throat. "It tends to occur after meals, more so after eating spicy foods, drinking alcohol, having a heavy meal, or eating late at night and then going to bed," Baiocco says.
According to the American College of Gastroenterology, an estimated 60 million Americans, or about one in five, suffer from heartburn at least once a month. over-the-counter treatments for heartburn include antacids (Rolaids and Tums), which neutralize the acid in the stomach, and a class of drugs (Tagamet, Zantac, and Pepcid) that stops the body's cells from producing the acid.
Prilosec also prevents acid from forming, "but it does it in a much more powerful way," Baiocco says. Doctors prescribe the drug, known as a proton pump inhibitor, when heartburn strikes several times a week.
The various heartburn drugs typically have few side effects, he says, although some patients may develop headaches or diarrhea.
While Prilosec usually isn't harmful, patients who take it over-the-counter should be careful, says Dr. George Longstreth, a gastroenterologist with the Kaiser Permanente Medical Care Plan in San Diego. "Someone with a serious problem like gastric cancer might treat themselves for a while and even feel better and then delay the diagnosis."
But he adds that such a risky prospect would be unusual. It's more likely that patients would assume they have an acid problem when they actually have a condition that "isn't quite as ominous as cancer but still would call for a different treatment than the Prilosec."
Prilosec won't cost pennies a pill like aspirin and some other over-the-counter drugs. Procter & Gamble expects to sell the drug for less than $1 a pill, although that's a significant discount over the current prescription price of about $3 to $4.
But insurance companies are unlikely to pay for a drug that's available over-the-counter. Doctors already have to provide extra information to insurance companies when they want to prescribe Prilosec to a patient for more than a couple of months, Baiocco says.
Gastroenterologists say some patients do have to take Prilosec each day, typically one pill, to treat chronic heartburn. If insurance companies don't pay, that could add up to more than $300 a year.
The cost may prevent some heartburn sufferers from taking Prilosec, says Kaiser Permanente's Longstreth.
On the other hand, consumers with the worst cases of heartburn may be willing to pay for the pills. "If you're miserable, that doesn't sound like a lot of money," he says.
More information
To learn more about over-the-counter Prilosec, visit PrilosecOTC.com or check this statement from the Food and Drug Administration. The American College of Gastroenterology has a primer on drugs to treat heartburn.
Back to Nexium and Proton Pump Inhibitors Articles
References:
Peter J. Baiocco, M.D., associate chief, gastroenterology section, Lenox Hill Hospital, New York City
George Longstreth, M.D., gastroenterologist, Kaiser Permanente Medical Care Plan, San Diego
U.S. Food and Drug Administration, Procter & Gamble news releases
Copyright © 2003 ScoutNews, LLC. All rights reserved
June 25, 2003. This article can be accessed directly
www.healthscout.com/news/1/513852/main.html
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