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20 September 2005 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians. These highlights are not intended to substitute for articles as sources of information. For an embargoed copy of an article, call 1-800-523-1546, ext. 2656, or 215-351-2656. Leave fax or e-mail and article topics.

Canadian Drugs on Internet Are Much Cheaper Than U.S. Internet Drugs

A December 2, 2004, survey of drug prices of 41 retail brand-name medications advertised on Web sites of 12 Canadian pharmacies and 3 large American pharmacy chains found that 43 of the 44 drugs were less expensive at the Canadian pharmacies (Article, p. 397). The three drugs more expensive at the Canadian pharmacies were drugs for erectile dysfunction (impotence). Researchers estimate that Americans could save approximately 24 percent per dose if they purchase their prescription drugs from Canada.

Study Finds Second-Generation Antidepressants Similar

Researchers comparing published studies of the efficacy, effectiveness, safety and side effects of second-generation antidepressants in treating depression found not much difference among them (Article, p. 415). "Response rates differed only minimally and overall rates of adverse events and discontinuation of therapy were similar ," they say. Second-generation antidepressants include selective serotonin reuptake inhibitors (SSRIs), selected norepinephrine reuptake inhibitors, and other drugs. Adverse effects (side effects) differed, but few studies used a standardized scale to measure these effects. Researchers conclude that choosing the most appropriate antidepressant for a given patent is difficult.

Targeted Health Program for Musculoskeletal Disorders Reduces Short- and Long-Term Work Disability and Is Cost Effective

A study of a program that treated 13,077 patients with musculoskeletal disorders (painful conditions of the muscles, bones, tendons, and joints) with either regular care or a special health program found that the special program shortened temporary work disability and reduced the number of patients who went on permanent disability (Article, p. 404). Regular care included treatment by a primary care physician with referral to a specialist if needed. The targeted program included unlimited visits to a rheumatologist, education, and free medications. While the special program was relatively expensive, by the end of the second year, the program saved between $8 and $20 for every dollar invested and overall saved more than $5 million.

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