Aspirin Tops Three Rx Drugs In Preventing Heart Attack – Consumers Union
This article was originally published in The Tan Sheet
Executive Summary
Aspirin is the blood thinning agent of choice over three prescription antiplatelet medications for preventing first or repeat heart attack or stroke, according to a Consumers Union report
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Aspirin is the blood thinning agent of choice over three prescription antiplatelet medications for preventing first or repeat heart attack or stroke, according to a Consumers Union report. Aspirin is recommended for patients with risk factors for heart attack and stroke, but who have not been diagnosed with heart disease or suffered a heart attack or stroke, CU said in an analysis in its April 12 Consumer Reports Best Buy Drugs report. The analysis also advised using aspirin for patients diagnosed with heart disease and "stable" angina. "Almost all adults with risk factors alone are candidates for aspirin and do not need one of the other, more expensive antiplatelet medicines," the report said. The Rx antiplatelets included in the analysis are Plavix (clopidogrel), Aggrenox (aspirin/dipyridamole) and Ticlid (ticlopidine). The analysis was based on data from 39 studies directly comparing the drugs, pooled from more than 4,000 published studies. CU said dozens of studies support the use of aspirin in patients needing a blood thinner, noting in the report health care providers often refer to aspirin use for preventing a first myocardial infarction or stroke as "primary prevention." However, results of Bayer-supported research to be published in the May issue of the American Journal of Prevention Medicine show aspirin use for cardiovascular disease prevention is low even among at-risk patients (1 (Also see "Aspirin Use For CVD Prevention Low Among At-Risk Patients – Study" - Pink Sheet, 16 Apr, 2007.), p. 10). A researcher involved in the study, who also consulted with Bayer in a 2003 citizen petition to include a primary prevention indication in professional labeling for aspirin, said results of the AJPM study could encourage FDA to act on the petition (2 (Also see "Aspirin MI Primary Prevention Labeling Urged In Bayer Citizen Petition" - Pink Sheet, 17 Feb, 2003.), p. 3) CU's report also said aspirin is one of the least expensive medicines available. The report estimates the average monthly cost of aspirin, 81 mg to 325 mg dosed once daily, is $3 or less. Average monthly costs for Sanofi-Aventis/Bristol-Myers Squibb's best-selling antiplatelet medication Plavix, dosed at 75 mg once daily, are $150, according to the report. Costs for generic clopidogrel - which was launched briefly last year by Apotex but was later barred from the market - range from $26 to $134 per month, the report noted. Monthly costs for Boehringer Ingelheim's Aggrenox are estimated at $161 and for Roche's Ticlid, $180. "The almost incredible advantage here is that tens of millions of people can benefit from taking a medicine - aspirin - that is among the least expensive available and does not require a prescription," the publication said. However, the report noted aspirin is not appropriate for every patient. Plavix, when combined with aspirin, is a superior treatment for selected patients, including people diagnosed with "unstable" angina or acute coronary syndrome, who have had a heart attack or who have had angioplasty and stent placement in the past year. In addition, CU said Plavix is recommended in patients who have been diagnosed with heart disease and have stable angina, but cannot take aspirin for reasons such as a risk of stomach bleeding or ulcers. Aggrenox is recommended for patients who have had a stroke or transient ischemic attack, while the report said Ticlid should not be prescribed at all because it poses unique risks for thrombotic thrombocytopenic purpura and aplastic anemia, yet offers no advantages over other medications. The report is part of an ongoing series comparing the safety, efficacy and value of drugs by Consumers Union. A January 2007 Consumer Reports analysis comparing proton pump inhibitors recommended Procter & Gamble's Prilosec OTC (omeprazole) over AstraZeneca's Rx Nexium (esomeprazole) (3 (Also see "Prilosec OTC “Coverage Gap” Pitch Spotlights Medicare Payment Question" - Pink Sheet, 29 Jan, 2007.), p. 14). - Jessica Merrill, " 4 The Pink Sheet DAILY " ([email protected]) |