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Aaron Carroll writes today that we’re addicted to new drugs even though older drugs are often just as good or better than the new ones. The problem is that we don’t usually know this for sure since comparative studies are rare. However, a few years ago one was done for blood pressure medications:

There were so many drugs to choose from for this trial (at different costs) that the National Heart, Lung, and Blood Institute (NHLBI) primarily organized and supported a randomized, controlled trial to examine which was best. This study was enormous; it took place in 623 centers in the United States, Canada, Puerto Rico, and the U.S. Virgin Islands between 1994 and 1998, and included over 33,000 participants. Patients received one of four drugs:

  • Amlodipine, a calcium channel blocker
  • Doxazosin, an alpha-adrenergic blocker
  • Lisinopril, an angiotensin-converting enzyme inhibitor
  • Chlorthalidone, a diuretic

The last of these, the diuretic, was the oldest of the drugs, and by far the cheapest. However, at the end of the study, the results were clear. This old, cheap diuretic was significantly better at preventing at least one of the major types of cardiovascular disease when compared to the other, newer drugs. Since the diuretic was also significantly less expensive, it should be the drug of choice in initial treatment of high blood pressure. However, it usually is not.

I’m glad to hear it! My blood pressure has been slowly rising for the past few years, and last year my doctor decided I should start taking something for it. At first she recommended a beta blocker, but as we talked about it she said something that made me a little nervous (I don’t remember quite what). “You know,” I said, “I actually have a strong preference for the oldest, cheapest, best studied drugs around.” She looked slightly surprised, but said that was perfectly reasonable and immediately prescribed a diuretic. I’ve been taking it ever since. (And, yes, I try to watch my sodium intake too.)

The whole post is worth reading. Sometimes new drugs are great, but I’m willing to bet that we waste upwards of a quarter to a third of the money we spend on pharmaceuticals because both doctors and patients have been brainwashed to always want the latest and greatest. But me? I like drugs that have been really well studied and are known to have infrequent and well understood interaction effects. In fact, new drugs actually make me kind of nervous. I am an insurance company’s dream patient.

SIX TRUTHS

Reclaiming power from those who abuse it often starts with telling the truth. And in "This Is How Authoritarians Get Defeated," MoJo's Monika Bauerlein unpacks six truths to remember during the homestretch of an election where democracy, truth, and decency are on the line.

Truth #1: The chaos is the point.

Truth #2: Team Reality is bigger than it seems.

Truth #3: Facebook owns this.

Truth #4: When we go to work, we're in the fight.

Truth #5: It's about minority rule.

Truth #6: The only thing that can save us is…us.

Please take a moment to see how all these truths add up, because what happens in the weeks and months ahead will reverberate for at least a generation and we better be prepared.

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SIX TRUTHS

Reclaiming power from those who abuse it often starts with telling the truth. And in "This Is How Authoritarians Get Defeated," MoJo's Monika Bauerlein unpacks six truths to remember during the homestretch of an election where democracy, truth, and decency are on the line.

Truth #1: The chaos is the point.

Truth #2: Team Reality is bigger than it seems.

Truth #3: Facebook owns this.

Truth #4: When we go to work, we're in the fight.

Truth #5: It's about minority rule.

Truth #6: The only thing that can save us is…us.

Please take a moment to see how all these truths add up, because what happens in the weeks and months ahead will reverberate for at least a generation and we better be prepared.

And if you think journalism like Mother Jones'—that calls it like it is, that will never acquiesce to power, that looks where others don't—can help guide us through this historic, high-stakes moment, and you're able to right now, please help us reach our $350,000 goal by October 31 with a donation today. It's all hands on deck for democracy.

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