WASHINGTON, June 3-The departure of Vioxx (rofecoxib) from pharmacists' shelves last September triggered a boomlet for Mobic (meloxicam), which then boosted its price by 9%, according to a Consumers Union analysis.
At the same time, prescriptions for Celebrex (celecoxib), the only surviving Cox-2 inhibitor, have plummeted from 2.1 million per month in October to just one million a month in March.
On the other hand, the bottom line is that consumers are probably paying less overall for pain relief these days, said the author of the analysis.
The Consumers Union report claims that Mobic prescriptions increased by 136% between September 2004 and March 2005. Vioxx was withdrawn from the market in September following the finding that long-term daily use of Vioxx was associated with an increased risk of non-fatal thrombotic events.
Bextra (valdecoxib), another COX-2 inhibitor, was pulled from the market on April 7, following reports that use of the drug not only increased the risk of cardiovascular event but was also associated with serious and unpredictable skin reactions that can be fatal.
Mobic's price tag has risen by 9% since Vioxx was pulled from the market, which is about three times the rate of increases for other NSAIDS during the same period, said Steven Findlay, managing editor of Consumer Reports Best Buy Drugs and author of the analysis.
Mobic costs more than $100 a month, or roughly twice as much as generic ibuprofen or naproxen, both drugs given a "Best Buy" rating by Consumers Union. But Mobic is a comparative bargain compared with Celebrex, which costs about $130 a month for the 100 mg doses and $212 a month for the 200 mg doses.
Findlay alleges that the new report confirms the observation that drug company marketing influences both physicians and consumers in the choice of drugs, an impact that may be greater when both are confused by the unexpected withdrawal of a popular drug such as Vioxx. Mobic was widely advertised in late 2004 as an alternative to Vioxx when that drug was withdrawn. In addition to advertising, media reports also frequently mentioned Mobic and generic ibuprofen as alternatives to Vioxx.
Asked whether consumers are spending more for relief of arthritis pain since Vioxx was withdrawn, Findlay said the Consumers Union analysis didn't address that question. But he said it is unlikely that spending for NSAIDs is higher now than it was when Vioxx was dominating the market.
And even though Mobic appears to be the biggest beneficiary of the Vioxx withdrawal, there has also been a bump in prescriptions for other less expensive NSAIDs such Voltaran and Cataflam (diclofenac) which increased by 27% during the month after the Vioxx withdrawal. Relafen (nabumetone) prescriptions increased by 22% during the same period -- and script for these drugs continued to climb through March for a total increase of 59%. Ibuprofen prescriptions increased by 28% from September through March.
Naprosyn (naproxen) prescriptions also shot up after the Vioxx withdrawal but declined "sharply after the release in December of a study suggesting naproxen, too -- like the Cox-2 drugs -- may raise the risk of heart attacks and stroke," the report states.
Related article: