Agencies Will Disseminate Reviews to Doctors

Across the country, doctors are struggling to decide which pain relievers to prescribe now that they know that popular drugs such as Vioxx® and Celebrex® pose potentially serious heart risks.

"We are desperately in need of information," said Dr. Stephen Brenner, an internist in New Haven, Connecticut.

At least for two years now, physicians at the Mayo Clinic, the federal Veterans Affairs Department, and the Kaiser Permanente health plan have been limiting their use of Cox-2 inhibitors, such as Vioxx® and Celebrex®. That is because those three institutions undertook separate reviews of test data on various painkillers reaching the same conclusion: for most patients, Vioxx®, Celebrex®, and Bextra® did not work any better or provide any safety benefits beyond older painkiller drugs.

A large number of health care organizations have taken rigorous steps to close one of medicine’s biggest information gaps. They are scrutinizing findings about all drugs to determine which works best at the lowest cost to the patient.

The drive to base medical practice on such reviews is taking on more urgency as health care costs rise.

Dr. Eric Matteson, a rheumatologist with the Mayo Clinic, said such reviews also can help to counterbalance the forces that influence doctors in writing prescriptions, such as patients eager to get the latest drug advertised on television.

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