Tuesday, January 6, 2015

Why Switch to a New Blood Thinner?

Last time I needed a blood thinner, I received Xarelto.  That was 2013, and Xarelto was new on the market and very expensive.  Previously, I had used Coumadin (generic name warafin) with no significant problems.  The patent on Coumadin has expired, and as a result it was very inexpensive.

Today, Facebook showed me an ad placed by lawyers who are suing the maker of Xarelto in a class action, alleging that the drug causes excessive internal bleeding.  From what I can tell, however, the drug is still on the market.

Two of my friends recently needed blood thinners, and both received Eliquis, yet another new drug.  It is also very expensive.  Their doctors did not discuss alternatives, they just prescribed Eliquis.

So, what was wrong with Coumadin that suggested that I should take Xarelto instead?  There may well be an answer to that question, but if so I cannot find it.  A brief internet search suggested that the most serious side effect of Coumadin is sever bleeding, which is exactly the same problem alleged with Xarelto.   I have no medical training, and I have not done researched the issue extensively.  Nevertheless, I would expect that, if there were a clear reason why Xarelto was better than Coumadin (or why Eliquis is better than both) that it would be easy to find.  

Moreover, all other things being equal, it makes sense to stick with an older drug.  By definition, a new drug has no history and we do not know what other problems may arise with Xarelto after it has been in wide use for a number of years.  

I do not believe that our doctors are part of a conspiracy to sell us expensive medications.  But I am concerned that they do not do enough research, and simply accept the drug companies' claims that the new drugs are better.  And, we patients often respond to advertising by asking for the new drugs.  

The solution is to ask your doctor why he/she is prescribing a particular drug.  Ask for alternatives.  Ask about the risks and benefits of each.  Then make your own decision!    

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