Consumer Reports Best Buy Drugs™ is a public education project of Consumers Union, the publisher of Consumer Reports. Consumers Union is an independent, nonprofit organization whose mission is to work for a fair, just, and safe marketplace and to empower consumers as they research and buy products and services.

Consumers Union accepts no outside advertising. It has no agenda other than to promote and protect the interests of consumers.

Consumers Union’s revenue comes from the sale of information products and services, individual contributions, and a few educational grants. Consumer Reports Best Buy Drugs is funded largely from such grants. Consumers Union is governed by a board of directors who are elected by CU members and meet three times a year.

Visit the Consumer Reports Best Buy Drugs special section

Download the Consumer Reports Best Buy Drugs project brochure (116k PDF)

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The mission of the Consumer Reports Best Buy Drugs project is to provide consumers and their doctors with information to help guide prescription drug choices–based on effectiveness, a drug's track record, safety and price.

The project aims to improve access to needed medicines for tens of millions of Americans–because they lack insurance coverage for prescription drugs, because the prices of many medicines today are so high, and because many consumers and physicians may not be aware of proven and affordable alternatives.

Best Buy Drug reports provide information that will help you open a conversation with your doctor about prescription medicines–and particularly about which medicines will best meet your medical needs and give you the most value for your health care dollar.

The findings presented in each report combine an expert medical review of the scientific evidence on prescription drugs with their prices. The analysis compares and contrasts prescription drugs by category – that is, drugs in the same class that are used to treat a specific condition or illness such as high blood pressure, high cholesterol, heartburn or depression. Our reports can be downloaded to print out and discuss with your doctor.

Our website was designed to be accessible to a wide audience, including those with disabilities. It complies with a government standard known as “Section 508” of the Rehabilitation Act.

Our analysis of prescription drugs is based primarily on an independent and unbiased review of the scientific evidence on the effectiveness and safety of drugs in specific classes, such as drugs to treat high blood pressure, heartburn, high cholesterol, depression, or migraine headaches.

These reviews are conducted by teams of physicians and researchers at several medical schools under the auspices of the Drug Effectiveness Review Project (DERP). DERP is a first–of–its–kind 13–state initiative to evaluate the comparative effectiveness and safety of commonly used prescription drugs. The states use the information to help guide drug coverage policy for their Medicaid programs. Researchers at the Oregon Health & Science University (in Portland) coordinate the project. None of the research teams have any financial interest in any pharmaceutical company or product. Their detailed findings are presented in a series of technical reports. Those are available by clicking here. Dr. Mark Helfand of OHSU serves as a consultant to the Best Buy Drugs project, helping us translate the DERP analyses for consumers. Occasionally we rely on unbiased reports conducted by the Agency for Healthcare Research and Quality under a provision of the Medicare Modernization Act.

The drug prices we use come from a healthcare information company that tracks the sales of prescription drugs in the U.S. All the prices are national averages (for consumers who paid cash) based on data from pharmacies nationwide. As such, they may not reflect what you will pay at a local pharmacy. Indeed, prices for drugs vary quite widely, even within a single city or town.

Our Best Buy picks are based on a comparison of the drugs in that class to each other. The main criteria we use are a drug’s effectiveness and safety, the side effects it may cause, its’ convenience of use (for example, how many pills you have to take each day), its track record in studies and actual use, and of course how much it costs relative to others drugs. There is no set formula for choosing our Best Buys. The factors differ in each category, and some of those factors are quite subtle. However, in general, our Best Buys are chosen because they are: (a) as effective as all the other drugs in the category, or more so; (b) as safe and cause no more – and usually fewer – side effects than other drugs in the category; and (c) cost less on average than other drugs in the category. That is not always true, though. Several of the Best Buys have been chosen because of their superior effectiveness or safety profile even though they cost more. Overall, a drug’s effectiveness relative to its competitors is the most important criteria in choosing our Best Buys.

Our Best Buy picks may change over time as new scientific evidence emerges and/or as drug prices change. Also, new generic drugs may become available in a given category.

We update our price data periodically and present that in our Price Updates section. We update our full reports as needed. In 2008 and 2009 many of our reports will be updated.

This section provides some basic information on prescription drugs, their safe use, and the importance of talking with your doctor

Talking With Your Doctor

It’s important for you to know that the information we present in our reports is not meant to substitute for a doctor’s judgment. But we hope it will help your doctor and you arrive at a decision about which drug and dose of a drug is right for you, and which gives you the most value for your health care dollar.

We encourage you to take the information in our reports to your doctor. Individual needs vary and your condition may require special considerations that our reports do not address.

At the same time, bear in mind that many doctors do not routinely take price into account when prescribing medicines. Understandably, you may be reluctant to discuss the cost of medicines with your doctor. But unless you bring it up, your doctors may assume that cost is not a factor for you.

Many people (including physicians) also believe that newer drugs are better. While that’s a natural assumption to make in a society that puts a premium on new things (and is barraged with advertisements for them), the fact is that it’s not always true when it comes to prescription and nonprescription medicines. Studies consistently show that many older medicines, including generics and nonprescription drugs, are as good as–and in some cases better than–newer medicines.

Generic Drugs

Prescription drugs come in two basic forms–brand name drugs and generic drugs. Generic drugs are copies of brand medicines whose patents have expired. A generic drug has exactly the same active ingredients as the brand drug it copies. The only difference is price and how the pills look: generics are much less expensive and by law are not allowed to look exactly like the brands they copy (a certain color or shaped pill, for example).

Generics are widely misunderstood. Many people believe that because generics are older, they are not as potent or effective. The truth is that the vast majority of generics continue to be useful medicines even years after their approval, and many remain the preferred first-line treatment even after newer brand competitor medicines emerge. That is why today about half of all prescriptions written in the U.S. are for generics.

Another misconception is that generics are less safe or more likely to be tainted.

This, too, is not true. As the FDA attests in the information it provides on its Web site and in print, generics are every bit as safe as brand-name drugs. The FDA applies the same set of strict rules to generics as to brands. Both must meet exacting specifications for their ingredients and manufacture. FDA requires generics to have the same quality, strength, purity and chemical stability. And generics must work the same way in the body. Both are tracked for their safety over time. Instructions to doctors and patients about the use of generics must be the same as for the brands they copy.

Indeed, a good way to think about generics is as “tried and true.” They have met the test of time–most generics come on the market 12 to 15 years after the brand drug they copy was first approved.

In contrast, it’s not uncommon for doctors and drug companies to find problems with new drugs that come to light only after they are approved. That’s because even though new drugs undergo years of study to prove they are safe and effective, those studies may have involved only several thousand people; once a drug is used by millions or people, new problems can and do crop up.

In some cases, of course, new brand drugs eclipse older generics in terms of both safety and effectiveness. That is to be expected, and reflects medical innovation and progress.

But such advances are not as prevalent as you might believe. In fact, a growing number of experts, doctors, medical and health groups and pharmacists believe that some newer and more expensive brand drugs are overused while many generic drugs are underused.

The reasons for this are complex but the main ones are:

• Brand-name drugs are widely promoted and advertised to doctors, while generic drugs are only minimally promoted. Brand marketing includes one-on-one sales pitches from drug representatives.
• Brand drug makers give doctors millions of doses of the newest drugs to hand out to patients–free. This gets patients taking the newest medicines, which can be the most costly. Some of these will be better than available generics. But many will not.
• Brand drug companies, but not generic companies, give doctors free gifts and often pay their way to seminars and lectures, or even out–of–town conferences, to hear about new drugs.
• Brand-name drug makers pay thousands of doctors every year to either give lectures on the newest drugs or use them as part of clinical studies. Both can be useful enterprises but doctors often get used to prescribing the new drug instead of older reliable drugs.
• Brand drug companies spend tens (or even hundreds) of millions of dollars advertising their drugs directly to the public. Generic firms hardly advertise their drugs at all to the public.

Federal and state laws in the last 20 years have encouraged the development of more generic drugs, and their wider use. For example, most states allow pharmacists to substitute the generic version of a drug when a doctor has written a prescription for the more expensive brand. But in many states, the pharmacists must ask the consumer permission to make the switch. Fearing they will get a drug their trusted doctor did not intend, many consumers still say no.

Our recommendation is that you talk to your doctor about your prescription when it is being written in his or her office. You should inquire whether the prescription is for a brand or generic, and learn why your doctor has prescribed one or the other. If you pay for your medicines out-of-pocket, because you lack insurance coverage for drugs, you should ask your doctor if there is a less expensive generic drug that would work for you.

If a pharmacist suggests substituting a generic, there is no reason to object. We suggest you call your doctor if you are concerned about this switch.

Download our Money Saving Guide: Generic Drugs – What You Need to Know

Keeping a Record of Your Prescriptions

It’s wise to keep a written list of all the drugs and supplements you are taking, and to periodically review this list with your doctors.

There are four main reasons to do this:

• First, if you see several doctors, each may not be aware of medicines the others have prescribed.
• Second, since people differ in their response to medications, it is very common for doctors today to prescribe several medicines before finding one that works well or best.
• Third, many people take several prescription medications, non-prescription drugs and dietary supplements at the same time. These can interact in ways that can either reduce the benefit you get from the drug, or be dangerous.
• And fourth, the names of prescription drugs–both generic and brand–are often hard to pronounce and remember.

Always be sure, too, that you understand the dose of the medicine being prescribed for you and how many pills you are expected to take each day. Your doctor should tell you this information. When you fill a prescription at the pharmacy, or if you get it by mail, you may want to check to see that the dose and the number of pills per day on the pill bottle match the amounts that your doctor told you.

Splitting Your Pills

Talk with your doctor about splitting your prescription tablets. Pill splitting (usually just in half) is an increasingly common practice and can be a powerful way to save money, especially if you have to take a prescription drug for a long time.

But not all pills can be safely split. You should not split pills without first talking to your doctor. Pill splitting also is best accomplished with a low-cost device (around $5–$10) designed for the purpose, and not with a knife. The device assures that the two halves you produce contain equal doses. With many medicines, taking the correct dose is critical to the drug’s effectiveness and safe use. Using such a device is also safer.

Download our Money Saving Guide: Splitting Pills

Why did Consumers Union initiate the Consumer Reports Best Buy Drugs project?
What’s on this Web site?
How should I use this information?
What if I have health insurance that pays for my drugs?
What if I have Medicare drug coverage?
What’s the evidence behind the Best Buy Drug evaluations?
How do we pick our Best Buys?
Will the prices for drugs on this Web site reflect what I’ll pay at the pharmacy?
Can I use the information provided on this Web site to buy drugs online?
Can I use the information provided on this Web site to buy drugs from Canada?
What if my doctor or pharmacist rejects your recommendations or Best Buy picks?
What is a generic drug? Are they just as good?
How can I contact Consumer Reports Best Buy Drugs?

Q: Why did Consumers Union initiate the Consumer Reports Best Buy Drugs project?

A: This project helps fill an important gap in consumers’ understanding of prescription medicines. It will tell you about the drugs available to treat specific illnesses and diseases, the differences among them, and how they stack up against each other. Our independent and unbiased reports will help you talk with your doctor about your treatment options, and improve your chances of getting a prescription medicine that both suits your medical needs and gives you the best value for your health care dollar. Our reports will also help you take your medicines safely, and stick with your treatment regimens.

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Q: What’s on this Web site?

A:The main thing you’ll find is a series of consumer-friendly reports on drug categories. Each runs 12 to 20 pages or so. A separate 2-page summary of each report is available as well, in both English and Spanish. You’ll also find a series of brief publications in the box titled, “Our Advice on Rx Drugs.” These will help you save money when you choose and purchase prescription drugs, even if you have health insurance. They are written to present basic information in a clear easy-to-understand way, and are available in both English and Spanish. All our publications are in PDF format so you’ll need Adobe Acrobat to download them.

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Q: How should I use this information?

A:The information on this Web site is not intended to replace the judgment of your doctors or pharmacists. It is meant to arm you with information to enhance communication with your health care providers. We urge you to print out the reports and show them to your doctor and/or pharmacist. Some doctors and pharmacists are not as familiar as others with the kind of scientific evaluations our reports are based on. Also, studies show that many doctors don’t typically take price into account when prescribing medicines, even for people who have no insurance coverage. So this information could help you open that discussion. The evidence shows quite strongly that many lower-cost drugs (such as generics) are just as effective as more expensive brand-name drugs.

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Q: What if I have health insurance that pays for my drugs?

A:You will learn about your treatment options and which medicines have been judged to be the most effective and safe. So regardless of price, you could learn that you have been prescribed a less effective drug or one which has raised safety concerns. Our reports also may guide you to medicines that are as effective or more effective than the one you are taking, and/or which have lower co-pays under your insurance plan. That is often the case these days with generic drugs, for example. You can learn here how the generic alternative in the category of medicine you need stacks up against newer brand-name drugs. In addition, choosing high-quality, lower-cost prescription (and sometimes non-prescription) medicines can help reduce health care costs overall for your employer, your health insurer, and you.

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Q: What if I have Medicare drug coverage?

A:The information on this Web site can help guide seniors to high-quality low-cost medicines that could save them money, especially if their drug expenses mean they could fall into the so-called "doughnut hole" where drug coverage temporary stops. This is true no matter what kind of Part D coverage you have.

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Q: What’s the evidence behind the Best Buy Drug evaluations?

A:Our drug reports are based on comprehensive, independent and unbiased reviews of the scientific evidence on the drugs in each class we evaluate. The reviews were conducted by teams of physicians and researchers at several medical schools under the auspices of the Drug Effectiveness Review Project (DERP). DERP is a first-of-its-kind U.S.-based 13-state initiative to evaluate the comparative effectiveness and safety of commonly used prescription drugs. The states use the information to help guide drug coverage policy for their Medicaid programs. Researchers at the Oregon Health & Science University coordinate the project. None of the research teams have any financial interest in any pharmaceutical company or product. Their detailed findings are presented in a series of technical reports. Those are available by clicking here. Dr. Mark Helfand of the Oregon Health & Science University serves as a consultant to the Best Buy Drugs project, helping us translate the DERP analyses for consumers. The drug prices we use are from a healthcare information company that tracks the sales of prescription drugs in the U.S.

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Q: How do we pick our Best Buys?

A:Our Best Buy picks are based on assessments of all the drugs in a class, and a comparison of the drugs in that class to each other. The main criteria we use are a drug’s effectiveness, it’s safety, the side effects it may cause, it’s convenience of use (for example, how many pills you have to take each day), its track record in studies and actual use, and of course how much it costs relative to others drugs. There is no set formula for choosing our Best Buys. The factors differ in each category, and some of those factors are quite subtle. However, in general, our Best Buys are chosen because they are: (a) as effective as all the other drugs in the category, or more so; (b) as safe and cause no more - and usually fewer - side effects than other drugs in the category; and (c) cost less on average than other drugs in the category. That is not always true, though. Several of the Best Buys have been chosen because of their superior effectiveness or safety profile even though they cost more. Overall, a drug’s effectiveness is the most important criteria in choosing our Best Buys.

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Q: Will the prices for drugs in our reports reflect what I'll pay at the pharmacy?

A:They might not. First, if you have drug coverage, you’ll only pay part of the cost for your drugs out of your own pocket. Your employer pays the rest. The prices and monthly costs we cite in our reports reflect the total cost paid for a drug, and they reflect the average price based on a nationwide sample of stores and pharmacies. Also, the prices we present reflect those paid by cash-paying customers (for example, people without health insurance). As such, they don’t include the discounts that your health plan or pharmacy benefit manager negotiates. The prices for drugs vary quite widely. So, if you are paying significantly more than the average price we cite for a drug, you may want to check other places you could buy the drug and talk to your doctor or pharmacist about the dilemma.

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Q: Can I use the information provided in your reports to buy drugs online?

A:Yes, once you and your doctor choose the drug that’s best for you, you can shop for it anywhere to try and get the best price. You will likely be able to beat the prices we cite by shopping online, where drugs are usually less expensive. You will also likely be able to get better prices at the large discount store in your area. Just like other products, many drugs are less expensive at such stores. If your doctor and you settle on several drug treatment options, you may want to shop online or at different stores to see which one is the least expensive under the terms of your health plan’s coverage. Be careful to use only reputable online Web sites.

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Q: Can I use the information provided in your reports to buy drugs from Canada?

A:Yes. If you and your doctor identify your treatment options, it may be worth evaluating whether you can save money by filling your prescriptions from a Canadian pharmacy Web site. The U.S. government permits such drug purchases for personal use only. Be aware that generic drugs are not less expensive in Canada or from Canadian Web sites. Only brand-name drugs are. We urge you to read our publication “Getting the Best Price on Your Drugs” when purchasing prescription medicines. It offers advice about buying from Canada or other foreign Web sites.

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Q: What if my doctor or pharmacist rejects your recommendations or Best Buy picks?

A:This is certainly possible. Our Best Buy drug picks are not intended to apply to every single person. Individual medical circumstances may well dictate that you need a drug that we have not recommended. We believe, however, that our advice will apply to most people who need medicines in the categories we evaluate. The important thing is to open a dialogue with your doctor about why he or she is choosing a particular drug for you. If your doctor rejects the scientifically based information we present, we think it is reasonable for you to expect an explanation.

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Q: What is a generic drug? Are they just as good?

A:A generic drug is a copy of a brand name drug, using the same active ingredients that work in the same way in the body. Generic drugs come in the same dosages as brand name drugs, and they have the same risks and benefits as their brand-name counterparts. The FDA holds both brand-name and generic drug facilities to the same high standards of good manufacturing processes. Generic drugs become available when a brand drug losses its patent protection. Generic drugs make up about half of all prescriptions. They can be viewed as "tried and true" and tested by time. However, in some cases (and not as often as is commonly believed) newer brand name drugs have fewer side effects or are more effective. Generic drugs are almost always less expensive than brands.

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Q: How can I contact Consumer Reports Best Buy Drugs?

A:If you have any questions that were not answered in these FAQs, please contact us.

Any organization interested in republication for broader distribution of the information on this Web site should contact Wendy Wintman at wintwe@consumer.org

Consumer Reports Best Buy Drugs™ is a public education project administered by Consumers Union, publisher of Consumer Reports magazine. It is partially supported with grant funds. The project's current main external sponsor is the state Attorney General Consumer and Prescriber Education Grant Program which is funded by the multi-state settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin.

The Engelberg Foundation provided a generous grant from 2004 to 2007 to fund the creation of the project. This included the development of our drug reports, the creation of our Web site, and a public outreach and communications effort to promote the use of the information. In 2008, the Engelberg Foundation provided a generous follow-on grant for on-going activities related to the project. Additional funding from 2004 to 2008 came from the National Library of Medicine, part of the National Institutes of Health. This support is under Information System Grant Number 1 G08 LM007934-01A1.

Consumers Union makes a substantial contribution of staff time and resources to the project. The grants give Consumers Union complete editorial independence and our evaluations of prescription drugs are based on objective, credible sources.

Best Buy Drugs Gets New Funding

Gail Shearer
Project Director

Steven Findlay
Managing Editor

Marvin Lipman, M.D.
Medical Editor

Chris Hendel
Associate Director, Health & Family, Consumers Union

Susan Herold
Media Coordinator

Keith Newsom-Stewart
Statistician

Ginger Skinner
Health Policy Assistant

Mark Helfand, M.D., M.P.H.
Director, Evidence-Based Practice Center
Oregon Health and Science University
Staff Physician, Veterans Affairs Medical Center
Portland, Oregon

Caralee Adams, Nancy Aldrich, Alicia Ault, Irene Levine, Marc Myers

Tara Montgomery, Director, Health
Trisha Brandon, Editor, ConsumerReportsHealth.org
Doris Peter, Consults Without Borders, LLC

Louisa Wong

Amy Billingham, Patrick Long, Pensare, Ltd., Washington DC

Theresa Thomas

Bill Benson
Health Benefits ABCs
Outreach Team

Sue Andersen
Health Benefits ABCs
Outreach Team

Gerald Gartlehner, MD, MPH
Associate Director, RTI-UNC Evidence-Based Practice Center
Cecil G. Sheps Center for Health Services Research
University of North Carolina
Medical and Science Advisor

Julie Donohue, Ph.D.
Assistant Professor
Department of Health Policy and Management
Graduate School of Public Health
University of Pittsburgh
Evaluation Team

Haiden Huskamp, Ph.D.
Assistant Professor of Health Economics
Department of Health Care Policy
Harvard Medical School
Evaluation Team

Joel Weissman, Ph.D.
Associate Professor of Medicine (Health Policy)
Harvard Medical School and Partners Institute for Health Policy
Massachusetts General Hospital
Evaluation Team

Michael Fischer, M.D., M.S.
Instructor in Medicine
Harvard Medical School
Associate Physician, Division of Pharmacoepidemiology and Pharmacoeconomics
Brigham & Women’s Hospital
Evaluation Team

Ira Wilson, M.D., M.Sc.
Associate Professor
Tufts New England Medical Center
Evaluation Team

Consumers Union deeply appreciates the participation of the following health care leaders, who generously agreed to serve on Consumer Reports Best Buy Drugs Advisory Board. Board members are unpaid. Participation on the board does not in any way imply responsibility for, or necessarily agreement with, the information, analysis and materials in our reports.

Nancy Wilson Ashbach, M.D., M.B.A.
Family Physician-Former Member Board of Directors
American Academy of Family Physicans

Jerry Avorn, M.D.
Associate Professor of Medicine
Harvard Medical School

Georges C. Benjamin, M.D.
Executive Director
American Public Health Association

Roger Herdman, M.D.
Senior Scholar
Institute of Medicine
National Academy of Sciences

Sharlea Leatherwood, P.D.
President
National Community Pharmacists Association

Jay Bhatt
President
American Medical Students Association

Lisa Schwartz, M.D., M.S.
Steven Woloshin, M.D., M.S.
Associate Professors of Medicine
VA Outcomes Group
Dartmouth Medical School

The following physicians and pharmaceutical experts served as professional peer reviewers of our drug reports. For a fee, they reviewed the scientific content of the reports. They are not responsible in any way for the final content, information, analysis or recommendations on this Web site or associated with the Consumer Reports Best Buy Drugs Project. That responsibility lies with Consumers Union.

At Consumer Union’s request, peer reviewers have disclosed any relationships they have with the pharmaceutical industry. It is common in the U.S. for leading physicians to receive some funding or gifts with financial value from pharmaceutical companies for various activities.

For the purposes of the Best Buy Drugs project, Consumers Union does not view such funding as compromising peer reviewers’ clinical judgment or integrity unless the financial remuneration they receive from the industry is or has been a primary or substantial part of their personal income.

Jeffery L. Anderson, M.D.
Professor of Medicine
University of Utah School of Medicine
Associate Chief of Cardiology
LDS Hospital & Intermountain Healthcare
Salt Lake City, Utah
Dr. Anderson reports receiving funding for research from several pharmaceutical companies in the past, but has no current grants. He also reports receiving fees from Merck, Bristol-Myers Squibb and Sanofi-Aventis for continuing education speeches to doctors. Dr. Anderson was executive director of clinical cardiovascular research at Merck Research Labs in 1998-1999.

Richard M. Bergenstal, M.D.
Executive Director
International Diabetes Center
Minneapolis, MN
Dr. Bergenstal reports receiving research funding from several pharmaceutical companies, including Pfizer, Eli Lilly, Novo Nordisk, and Eli Lilly. He also reports receiving speaking fees from Eli Lilly, Glaxo SmithKline, Novo Nordisk, Sanofi Aventis, and Merck.

Robert Bunning, M.D.
Associate Medical Director, Rheumatology
National Rehabilitation Hospital
Washington, D.C.
Dr. Bunning has received small amounts of funding from several pharmaceutical companies (unnamed) over the years to conduct research, discuss his clinical experience and attend meetings where arthritis medicines were discussed.

Daniel J. Buysse, M.D.
Professor of Psychiatry
University of Pittsburgh School of Medicine
Pittsburgh, PA
Dr. Buysse has received research funding from several pharmaceutical companies. He also reports having served as a paid consultant to 12 companies, including Eli Lilly, Merck, GlaxoSmithKline, Pfizer, Sanofi-Aventis, and Takeda.

Nananda Col, MD, MPP, MPH
Associate Professor of Medicine
Brown University
Rhode Island Hospital
Providence, RI
Dr. Col has received no funding from any pharmaceutical company for any purpose. She was the recipient of a Faculty Development Award in Clinical Pharmacology from the Pharmaceutical Research and Manufacturers of America, 1998-2001.

Lawrence Diller, M.D.
Assistant Clinical Professor
University of California
San Francisco, CA
Private Practice - Walnut Creek, CA
Dr. Diller reports no funding or support from any pharmaceutical company. He has written books and articles critical of the overuse of psychiatric medicines in children.

Adriane Fugh-Berman, MD
Associate Professor
Complementary and Alternative Medicine Masters Program
Department of Physiology and Biophysics
Georgetown University
Washington D.C.
Dr. Fugh-Berman reports no financial support or funding from any pharmaceutical company. She lectures at continuing medical education conferences; some of these have been funded by pharmaceutical companies. A fee is typically paid to all faculty at such events.

Raymond J. Gibbons, M.D.
Professor of Medicine
Division of Cardiovascular Diseases and Internal Medicine
The Mayo Clinic
Rochester, MNv Dr. Gibbons has received research support over the past 15 years from Wyeth-Ayerst, Burroughs-Wellcome, Genentech, Dupont, Rhone Poulenc Rorer, Smith Kline Beecham, as well as Aetna Insurance Co. and Medco Research.

Peter Glassman, MBBS, M.Sc.
Associate Professor, Dept. of Medicine
David Geffen School of Medicine
Los Angeles, CA
Dr. Glassman is a consultant in the area of pharmacy benefits and formulary management. He has clients in both the public and private sector.

Robin S. Goland, M.D.
Co-Director, Naomi Barrie Diabetes Center
Associate Professor of Medicine
Columbia University College of Physicians and Surgeons
New York, NY
Dr. Goland reports a current research grant from Eli Lilly and past research funding from Bayer, BristolMyersSquibb, Pfizer, GlaxoSmithKline, and Takeda.

Mark W. Green, M.D.
Director, Columbia University Headache Center
Clinical Professor of Neurology
Columbia University College of Physicians and Surgeons
New York, New York
Dr. Green has received research funding in the past from Glaxo SmithKline, OrthoMcNeil, Allergan, and Pfizer. He reports that all funds went into institutional coffers.

Lennox Hoyte, M.D.
Associate Professor and Division Director
Urogynecology and Pelvic Reconstructive Surgery
University of South Florida School of Medicine
Tampa, FLA
Dr. Hoyte reports serving as a paid lecturer and consultant for one pharmaceutical company.

Peter Jensen, MD
Professor of Child Psychiatry
Director, Center for the Advancement of Children's Mental Health
Columbia University/New York State Psychiatric Institute
New York, NY
Dr. Jensen reports current grants funds from McNeil Pharmaceuticals. He has served on the speaker's bureau of several pharmaceutical companies and also as a paid consultant to the industry.

Donald F. Klein, M.D., D.Sc.
Director of Psychiatric Research and the Department of Therapeutics
New York State Psychiatric Institute
Professor of Psychiatry, Columbia University
New York, NY
Dr. Klein reports "extensive collaboration" with the pharmaceutical industry over a 50 year research career in clinical psychopharmacology. He also reports an existing financial affiliation with Vela Pharmaceuticals. He has served in the past as a Senior Science Advisor to the Alcohol and Drug Abuse and Mental Health Administration.

Allan I. Levey, M.D., Ph.D
Chairman, Department of Neurology
Director, Alzheimer's Disease Center
Emory University School of Medicine
Atlanta, GA
Dr. Levey serves as an advisory board member for Acadia Pharmaceuticals and NovaDel. He participates in research activities with deCODE genetics. And he reports giving physician education seminars partially funded by Pfizer, Novartis, and Janssen Pharmaceuticals.

Jeffrey A. Lieberman, M.D.
Director, New York State Psychiatric Institute
Chairman, Department of Psychiatry
College of Physicians and Surgeons, Columbia University
New York, New York
Dr. Lieberman reports receiving grant funding for research from the following pharmaceutical companies: Bristol-Myers Squibb, GlaxoSmithKline, Janssen, Pfizer and Acadia.

Robert Lipsy, Pharm.D. FASHP, BCPS
Manager, Clinical Pharmacy Services
Health Net of Arizona
Assistant Clinical Professor
College of Pharmacy
University of Arizona
Tucson, AR
Dr. Lipsy has in the past received research funding from Merck, Lilly and Glaxo Smith Kline.

Jeffrey Lisse, M.D.
Acting Section Chief, Professor of Medicine
Department of Rheumatology
University of Arizona School of Medicine
Medical Director, Arizona Arthritis Center
Tucson, AR
Dr. Lisse has received research funding from several major pharmaceutical companies, including Pfizer, Aventis, Ciba-Geigy, Glaxo (now Glaxo Smith Kline), and Searle. He has received speaking fees or honoraria from Abbott, Eli Lilly, Centacor, Amgen, Pfizer, Merck, Proctor & Gamble, Aventis and Novartis.

Denis McCarthy, M.D.
Professor of Medicine
University of New Mexico School of Medicine
Albuquerque,
Dr. McCarthy has served on the scientific advisory boards of numerous pharmaceutical companies over 25 years, including AstraZeneca. Merck, Johnson & Johnson and Wyeth-Ayerst. In this capacity, he was paid a consultant fee to attend meetings and deliver lectures on his research or clinical experience.

Steven E. Nissen, M.D.
Chief of Cardiology, Department of Cardiovascular Medicine
Medical Director, Cardiovascular Coordinating Center
Cleveland Clinic
Cleveland, OH
President-elect, American College of Cardiology (2005-2006)
Dr. Nissen has directed and/or participated in research sponsored by several major pharmaceutical companies, including AstraZeneca, Eli Lilly, Pfizer, and Sanofi-Aventis. He has also lectured at conferences sponsored by pharmaceutical companies and consulted to industry. He reports that he requests all fees from such activities be directed to charities. He accepts no personal reimbursement for directing or participating in research.

Phillip S. Norman, M.D.
Professor of Medicine
Asthma and Allergy Center
Johns Hopkins University School of Medicine
Baltimore , MD
Dr. Norman reports receiving no money recently from any pharmaceutical company for research or speaking. In 1997, research he conducted was supported by ImmuLogic Pharmaceutical Company. He currently serves on the data safety monitoring board for Neurocrine Industries.

Daniel Oates, M.D.
Assistant Professor of Medicine, Geriatrics
Boston Medical Center/Boston University School of Medicine
Boston, Mass.
Dr. Oates reports receiving no financial support, research funding or speaking fees from any pharmaceutical company.

James M. Perrin, M.D.
Professor of Pediatrics
Director, Division of General Pediatrics
Director, Center for Child and Adolescent Health Policy
Harvard Medical School/Massachusetts General Hospital
Boston, MA
Dr. Perrin reports no recent funding or support from any pharmaceutical company. He conducted research on a drug in the 1970s that was funded by Roche Laboratories.

Paul J. Perry, Ph.D., RPh, BCCP, FCCP
Professor of Pharmacy and Psychiatry
University of Iowa Colleges of Pharmacy and Medicine
Iowa City, IA
Dr. Perry reports research funding dating back to the 1980s from many pharmaceutical companies, including Eli Lilly, Bristol Myers Squibb, Pfizer, Park-Davis, Glaxo-Wellcome (now Glaxo Smith Kline), Ciba-Geigy and Jannsen Pharmaceuticals.

Diana B. Petitti, MD, MPH
Senior Scientific Advisor for Health Policy and Medicine
Kaiser Permanente, Southern California
Sacramento, CA
Dr. Petitti reports receiving research funding from Procter & Gamble. In the 1980s, she also worked as a consultant on an educational video funded in part by Ortho Pharmaceuticals.

Bruce M. Psaty, M.D., Ph.D.
Professor, Medicine and Epidemiology
Cardiovascular Health Research Unit
University of Washington
Seattle , WA
Dr. Psaty reports receiving no money from any pharmaceutical company to conduct research. He has attended meetings sponsored by pharmaceutical companies, with reimbursement for travel and expenses. He has served as an expert witness on matters pertaining to prescription drugs, with compensation from attorneys representing drug companies.

Sunil V. Rao, M.D.
Assistant Professor of Medicine
Duke University Medical Center
Chapel Hill, NC
Dr. Rao reports receiving research funding from The Medicines Company and Cordis Corp. He reports payments for lectures to doctors from Sanofi-Aventis, The Medicines Company, and Cordis Corp. He has served on the advisory boards of Sanofi-Aventis and Cordis. He is a faculty member and researcher at the Duke Clinical Research Institute, which conducts clinical trials on drugs with funding from government and pharmaceutical companies.

Robert Rosenheck, M.D.
Professor of Psychiatry
Yale Medical School
Director, VA Northeast Program Evaluation Center
New Haven, CT.
Dr. Rosenheck reports receiving research support from the following pharmaceutical companies: Eli Lilly, Janssen, Astra-Zeneca, and Wyeth. He also reports being a consultant to GlaxoSmithKline, Bristol-Myers Squibb, and Janssen.

Michael Schatz, M.D.
Chief, Allergy Department
Southern California Permanente Medical Group
San Diego, CA
Dr. Schatz reports receiving research funding from various pharmaceutical companies, including AstraZeneca, Merck, GlaxoSmithKline, and Sanofi-Aventis. He also reports speaking, for a fee, at conferences sponsored in whole or in part by pharmaceutical companies.

Sheldon Sheps, M.D.
Emeritus Professor of Medicine
Division of Hypertension
The Mayo Clinic
Rochester, MN
Dr. Sheps has received no funding from any pharmaceutical company for any purpose for the past 15 years. Prior to that, he received occasional research funding.

Michael H. Silber, M.B., Ch.B.
Co-Director, Sleep Disorder Center, Mayo Clinic
Professor of Neurology
Mayo Clinic College of Medicine
Rochester, MN
Dr. Silber reports receiving no funding or financial support from any pharmaceutical company for any purpose.

Gregory E. Simon, M.D. MPH
Investigator, Center for Health Studies-Behavioral Health Service
Group Health Cooperative
Seattle, WA
Dr. Simon reports research funding support from Eli Lilly, Pfizer, Abbott Labs, and Wyeth Ayerst.

Matthew Sorrentino, M.D.
Associate Professor of Medicine
Section of Cardiology
University of Chicago Pritzker School of Medicine
Chicago, Ill.
Dr. Sorrentino has in the past received funding from Pfizer, Merck, Ciba-Geigy, Parke-Davis and Merck to conduct research. He has given lectures sponsored by several large drug companies, including Pfizer, Bristol Myers Squibb, Schering-Plough and AstraZeneca.

Emer M. Smyth, Ph.D.
Research Assistant Professor
University of Pennsylvania
Philadelphia, PA
Dr. Smyth reports no funding from the pharmaceutical industry for any purpose.

William W. Storms, M.D.
Clinical Professor
University of Colorado Health Sciences Center
Director, The William Storms Allergy Clinic
Colorado Springs, CO
Dr. Storms reports receiving research funding from various pharmaceutical companies, including AstraZeneca, Pfizer, Novartis, Genentech, GlaxoSmithKline, and Sanofi-Aventis. He has served as a consultant to and on the speaker's bureau of several of the same companies.

Scott Stroup, M.D., MPH
Associate Professor of Psychiatry
Adjunct Associate Professor of Social Medicine
University of North Carolina
Chapel Hill, NC
Dr. Stroup reports being a consultant to: Eli Lilly, Janssen, Astra-Zeneca, and Pfizer. He has spoken at events sponsored by Lilly and Pfizer.

Stewart J. Tepper, M.D.
Director, The New England Center for Headache (Stamford, CT)
Assistant Clinical Professor, Neurology
Yale University School of Medicine
New Haven, CT.
Dr. Tepper reports receiving research funds and lecture and speaking fees from several major pharmaceutical manufacturers, including AstraZeneca, GlaxoSmithKline, Merck, Novartis and Pfizer.

Gerald W. Volcheck, M.D.
Consultant, Division of Allergic Disease
The Mayo Clinic
Rochester , MN
Dr. Volcheck is currently a principle investigator on a study of an allergy drug. The multi-center study is being funded by Genentech. He reports no other recent funding from pharmaceutical companies for research or speaking.

Barry D. Weiss, M.D.
Professor, Dept. of Family and Community Medicine
University of Arizona College of Medicine
Tucson, AZ
Dr. Weiss reports previous funding from pharmaceutical companies for participation in research on several drugs. He also reports serving on a paid advisory panel related to the development of drugs to treat urinary incontinence. He has a current grant from Pfizer to conduct research in the area of health literacy.

The Consumer Reports Best Buy Drugs Project has worked with numerous organizations to raise public awareness about the project and to help consumers learn how they can get better value for their prescription drug dollar. These include national and local organizations, senior and community groups, labor unions, employers, insurance companies, and pharmacy benefit managers. The national organizations listed below are among those who have helped us spread the word.

Organization	Web site
AFL-CIO	www.aflcio.org
Alliance for Retired Americans	www.retiredamericans.org
American Federation of State, County and Municipal Employees	www.afscme.org
American Medical Student Association	www.amsa.org
American Public Health Association	www.apha.org
Common Cause	www.commoncause.org
Consumer Federation of America	www.consumerfed.org
Families USA	www.familiesusa.org
National Committee to Preserve Social Security and Medicare	www.ncpssm.org
National Education Association	www.nea.org
U.S. PIRG	www.uspirg.org

In 2001, the Oregon state legislature established a bold program to review the comparative effectiveness of drugs in various therapeutic categories. The program was dubbed the Drug Effectiveness Review Project or DERP. As of early 2008, the project had expanded to 13 states.

The project provides a comprehensive independent review of the scientific literature and evidence on the effectiveness, safety and adverse effects of the drugs in each category. A team of physicians and researchers coordinate the reviews, working in partnership with experts across the country. Each of the participating states helps fund the reviews, and the results are posted on the DERP Web site. States use the results to shape prescription drug coverage choices for their Medicaid programs.

The Consumer Reports Best Buy Drugs project is designed, in part, to bring the DERP findings to the public at large. In addition, one of our project's consultants has been a DERP leader and helps us translate the DERP findings for consumers.

A team of well-known and highly regarded health policy researchers periodically evaluate the Consumer Reports Best Buy Drugs Project.

Julie Donohue, Ph.D.
Assistant Professor
Department of Health Policy and Management
Graduate School of Public Health
University of Pittsburgh

Haiden Huskamp, Ph.D.
Assistant Professor of Health Economics
Department of Health Care Policy
Harvard Medical School

Joel Weissman, Ph.D.
Associate Professor of Medicine (Health Policy)
Harvard Medical School and Partners Institute for Health Policy
Massachusetts General Hospital

Michael Fischer, M.D., M.S.
Instructor in Medicine
Harvard Medical School
Associate Physician, Division of Pharmacoepidemiology and Pharmacoeconomics
Brigham & Women's Hospital

Ira Wilson, M.D., M.Sc.
Associate Professor
Tufts New England Medical Center

This page is for doctors, pharmacists, health professionals, health administrators, educators, and counselors.

Consumer Reports Best Buy Drugs is a grant-funded public information project administered by Consumers Union, the non-profit publisher of Consumer Reports magazine. The reports and publications on this Web site are written for consumers. Their intent is to deepen consumers' knowledge and understanding of their prescription drug options and choices. They aim to enhance communication between consumers and health care professionals.

Our reports are based on systematic reviews of the scientific research. These reviews are conducted under the auspices of the Drug Effectiveness Review Project, a unique initiative funded by 13 states. The actual reviews are conducted by teams of researchers at several "Evidence Based Practice Centers" (EPCs), which are selected to perform this kind of work by the federal Agency for Healthcare Research and Quality (AHRQ). The EPC at the Oregon Health and Science University (OHSU) coordinates the DERP Project.

If you have not heard of DERP, we refer you to their excellent Web site: http://www.ohsu.edu/drugeffectiveness/description/index.htm. This site contains the detailed drug reviews on which our reports are based.

The DERP reports undergo extensive peer review before final publication. Our drug class reports, which render the lengthy DERP analyses into language and a context that consumers can understand, undergo a separate peer review process. Indeed, Best Buy Drug reports are produced independently of DERP although, under contract, one of the leading DERP researchers at OHSU helps us "translate" the DERP reports into a consumer-friendly form.

Consumers Union bears sole responsibility for the content of our reports and our recommendations.

We encourage you to tell your patients or clients about Best Buy Drugs. If you are interested in distributing our reports or other publications in your office, or by other means, please email us at crbestbuydrugs@cu.consumer.org.

The Best Buy Drugs project had an outreach component in Arizona, California, Georgia, Maryland, Pennsylvania and Minnesota through 2007. The following contacts can provide you with information about any ongoing efforts related to Best Buy Drugs.

• Overall and for Maryland: Bill Benson, Health Benefits ABCs -- (301) 270-4099 -- or tbcg@starpower.net (Benson)
• In Georgia: Kathleen McNulty, Atlanta Regional Commission -- (770) 218-1976 -- kmmcnulty@bellsouth.net
• In California: Janet Nelson, California Health Advocates -- (916) 231-5110 -- jnelson@cahealthadvocates.org
• In Minnesota: Janine Stiles, Minnesota Senior Federation -- (651) 645-0261 -- jstiles@mnseniors.org
• In Pennsylvania: Lynn Heitz, Center for Advocacy for the Rights and Interests of the Elderly -- (215) 545-5728 x227 -- heitz@carie.org

• A brochure describing and explaining the Best Buy Drugs project
• Posters (11x14 and 20x30)
• A 10-minute DVD on Best Buy Drugs, with two physicians and a pharmacist
• A DVD with presentations from a March 2006 conference describing Best Buy Drugs in some detail.
• Printed summaries of all our drug reports in English and Spanish

If you would like to order any of these materials for outreach to a group or organization, please email CRBestBuyDrugs@cu.consumer.org

Clicking on the title will launch the described video clip. Each is about 10 minutes long and feature experts involved with our work.

Why did Consumers Union create the Best Buy Drugs project?

• Health Policy Director Gail Shearer explains our mission - helping consumers navigate the often confusing and costly prescription drug marketplace with unbiased information about drug effectiveness, safety and price.

The science behind our Best Buy Drug reports

• The Oregon Evidence-based Practice Center finds the best-available scientific evidence about prescription drugs - and then thoroughly examines that evidence and reports on it. Those reports are part of the building blocks of the CR Best Buy Drugs project. Director Mark Helfand, M.D., M.P.H., explains the systematic drug review process.

What exactly is the Drug Effectiveness Review Project?

• Created to help state Medicaid programs purchase drugs more wisely, this project considers the comparative effectiveness, safety and effects of drugs to treat a variety of illnesses. Deputy Director Mark Gibson, of the Oregon Center for Evidence-based Policy, discusses how the DERP project works.

How does Consumer Reports identify its "Best Buy" drug picks?

• Managing Editor Steven Findlay lays out how he and his team develop the consumer-friendly prescription drug reports, as well as our "Best Buy" picks, from a wide array of scientific, safety and pricing data.

The physicians' role in evidence-based prescribing

• Getting the best health outcomes for patients is a physician's top priority. C. Bernie Good, M.D., M.P.H., Department of Veterans Affairs, explains overcoming drug marketing influences and the 'new-is-better' bias to discuss the most effective and affordable medications with patients.

How pharmacists help inform consumers of effective, low-cost drugs

• Buddy Harden, former CEO of the Georgia Pharmacy Assoc., sees consumers everyday who can't afford their medicines. He explains how he looks for effective low-cost alternatives, opens discussions with physicians and negotiates drug insurance plans.

Helping consumers without Internet access find Best Buy Drugs information

• Bill Benson, outreach consultant, Health Benefits ABC

How consumers, patients react and use Best Buy Drugs materials

• Cheryl Schramm, Kathleen McNulty, Atlanta Regional Council; Marta Erismann, California )

How your organization can spread the word on Best Buy Drugs

• Lynn Ohman, outreach consultant

(April 24, 2008) - Attorney General Hardy Myers today announced a grant of more than $4 million to Consumers Union (CU) that will ultimately help consumers make the safest and most effective prescription drug choices. "The multi-million dollar grant will give CU, the nonprofit publisher of Consumer Reports, the assistance needed to provide consumers with free and unbiased information when sorting through the confusing prescription drug market," Myers explained. In addition to being a member of the Special Committee of Attorneys General that made the grant, the Oregon Department of Justice will act as Grant Administrator.

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Today Attorneys General from around the country announced (www.doj.state.or.us) a $4.4 million grant to Consumers Union that will fund a public education program designed to eliminate huge gaps in public knowledge about prescription drugs. With close to $10 billion dollars spent on drug advertising each year, the airwaves are saturated with drug promotions that often provide incomplete and inadequate information about drug choices.

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(April 10, 2008) - The strongest painkilling drugs - called opioids - should not be first-line treatments against chronic pain, and are only moderately effective when they are prescribed, according to the latest report from Consumer Reports Best Buy Drugs™, a public education project of Consumers Union. Doctors and patients should instead first try less risky and less expensive pain relievers, such as acetaminophen (the ingredient in Tylenol), non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB and generics), and naproxen (Aleve and generics), or non-opioid prescription pain medicines. Evidence indicates that these common painkillers used by millions of people at low doses everyday to treat mild aches and pains are often just as effective as opioids - and less risky - against chronic pain when used at somewhat higher doses, the report concludes. Long-term use of the opioids has been linked to a decrease in sex hormones leading to both a loss of interest in sex and impaired sexual function; a decline in immune function; and an increase the body's sensitivity to pain. These problems don't appear to be permanent and will go away when use of the opioid is stopped. The report - written for consumers - compares 12 opioid medicines.

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(September 5, 2007) – Some anticonvulsant drugs are effective in treating bipolar disorder, fibromyalgia, and various kinds of pain, but the widely prescribed drugs are not always the best initial choice to treat those conditions and some are quite expensive, according to the latest report from Consumer Reports Best Buy Drugs®, a public information project of Consumers Union. The report compares and analyzes 12 anticonvulsants. Scientific evidence backs only a few in treating the three disorders. That is significant because many of the 12 drugs are commonly prescribed “off label” to treat mental health and pain problems. “The evidence is either weak or non-existent that some of them help people or are the best drugs to use,” says Gail Shearer, project director of Consumer Reports Best Buy Drugs. Doctors and patients should be more cautious and deliberative in using these drugs.

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(July 16, 2007) – Newer prescription drugs to treat type 2 diabetes – including much-promoted Avandia and Actos – are no more effective or safe than older drugs and cost significantly more, according to the latest report from Consumer Reports Best Buy Drugs, a public information project of Consumers Union. The report is based primarily on an in-depth analysis being released today of the scientific evidence on oral diabetes drugs by researchers at Johns Hopkins University. The analysis screened the findings of over 216 published studies and was sponsored by the federal Agency for Healthcare Research and Quality. An article based on the new analysis is being published today on the Web site of the journal Annals of Internal Medicine.

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(April 12, 2007) – For most people who need a blood-thinning drug to help prevent a first or repeat heart attack or stroke, aspirin is the drug of choice, according to the latest report from the Consumer Reports Best Buy Drugs® project. Aspirin is one of four drugs in a class of medicines called antiplatelets. The other three are Aggrenox (a combination of aspirin and the drug dipyridamole), clopidogrel (Plavix), and ticlopidine (Ticlid). The medicines decrease blood clotting, which evidence now shows is intimately tied to heart attack and stroke risk. As a result, the use of aspirin and other antiplatelets has skyrocketed in recent years. “This report will help doctors and consumers clarify the choices when it comes to use of blood-thinning medicines,” said Steven Findlay, managing editor of Consumer Reports Best Buy Drugs. “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.”

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(Feb. 13, 2007) - Prescriptions for the cholesterol-lowering medicines known as statins rose by an average of 500,000 a month between October 2005 and December 2006, according to a new analysis by Consumers Union and Consumer Reports Best Buy Drugs. The increase was enhanced by the availability of simvastatin - the generic version of Zocor - one of two new generic statins that came onto the market in the latter half of 2006. The shift suggests aggressive moves by doctors, insurers, pharmacy benefit managers, pharmacists, and consumers to use the new generics.

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Download analysis (170k PDF File)


(Jan. 25, 2007) - Doctors and medical professionals can now access Consumer Reports Best Buy Drugs' independent reviews of prescription drugs via a popular personal digital assistant (PDA) drug reference guide, the Tarascon Pocket Pharmacopoeia®. Users of this software can quickly review Best Buy summary reports that compare drugs on effectiveness, safety, and price based on the available scientific evidence.

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(Jan. 22, 2007) - A widely available nonprescription drug - Prilosec OTC - is as effective a treatment for heartburn and acid reflux disease as prescription drugs costing many times more, according to Consumer Reports Best Buy Drugs, a public education project of Consumers Union.

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Consumer Reports Best Buy Drugs
1101 17th Street, NW Suite 500
Washington, D.C. 20036
Phone: 202 462 6262
Fax: 202 265 9548
email: CRBestBuyDrugs@cu.consumer.org

We encourage linking to our Consumer Reports Best Buy Drugs™ web site because it furthers our public education goals, which include broadening distribution of important information about drugs. It is not necessary for you to sign an agreement with Consumers Union if you intend only to link to the Consumer Reports Best Buy Drugs™ materials from your own web site without using any of our trademarks.

If you would like to obtain print copies of our reports or other materials from Consumers Union for purposes of distribution, please send your request to us at CRBestBuyDrugs@cu.consumer.org identifying the type of material you want to distribute, the number of copies you need, and the intended purpose of your proposed distribution.

Consumer Reports Best Buy Drugs provides information for you to use in discussions with your physician or other qualified health provider. We encourage you to print out our drug reports for discussion with your health care provider. However, please note that the content is for educational use only and is not a substitute for professional medical advice, diagnosis, or treatment.

Unfortunately, we cannot help you with individual medical questions and we ask you not to send us your private medical information. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard, avoid or delay in obtaining medical advice from your doctor or other qualified health care provider because of something you have read in our reports.

We follow a rigorous editorial process to help ensure the information we provide is accurate and describes generally accepted clinical practices. If we find, or are alerted to, an error, we will correct this as quickly as possible. However, Consumers Union and its authors, editors, publishers, licensors and any suppliers cannot be responsible for errors or omissions, or any consequences from the use of information provided by Consumer Reports Best Buy Drugs.

If you've found our Best Buy Drugs reports useful, we'd like you to let others know about the project. If you have an upcoming doctor's appointment, or are planning a trip to the pharmacy, you can share an information packet on Consumer Reports Best Buy Drugs with your healthcare professional. Doctors and pharmacists are on the front lines of bringing down drug costs, and you can assist them. Click here to have us send you an information packet, either by mail or email.

Consumers Union works to give all consumers access to safe, effective and affordable prescription drugs. Many people have trouble getting the medications they need because they cost too much or their health plan won't pay for them. Some people have trouble with specific medications because they don't know about side effects or they don't get complete information from an advertisement.

Our advocacy campaign, Prescription for Change, provides consumers with timely information about prescription drug issues and efforts at the state and federal level to improve safety, effectiveness and access to medicines. Click here to learn more about this work or how you can be involved.

It's that time of year again. Open enrollment for 2009 for the Medicare Part D drug benefit takes place from Nov. 15 through Dec. 31, 2008. You should enroll by Dec.15, though, to avoid potential coverage lapses and problems filling your prescriptions. Your coverage will be in effect from Jan. 1 through Dec. 31, 2009.

If you are already enrolled in a Part D stand-alone plan or a Medicare Advantage (managed-care) plan that incorporates drug coverage, you can switch plans during open enrollment.

If you are turning 65 in the next three months, you can enroll now, too, under Medicare rules that encourage enrollment between three months before and three months after you turn 65. You might pay higher premiums if you enroll more than three months after your 65th birthday, unless you already have a prescription-drug plan that is the same as or better than Part D. However, individuals with incomes less than $15,600 (and resources of less than $11,990) in 2008, or married couples with incomes of less than $21,000 (and resources of less than $23,970) might qualify for extra financial help from Medicare to pay prescription-drug costs. People who are enrolled in both Medicaid and Medicare at the same time will be automatically enrolled in a drug plan. If those plans don't cover their prescription drugs, they can switch to another plan every month without paying a penalty.

Now three years old, the Part D drug benefit is complex and difficult to understand. First, if you have drug coverage that is as good as or better than a Medicare plan (through work or a good retiree policy), you need not enroll in a Part D plan. But everyone else probably should enroll; it's government-subsidized insurance that is well worth it because you never know when you might get sick and need medicine.

Second, whether you are enrolling for the first time or considering switching, you might have dozens of private plans to choose from, with differing premiums, co-payments, and levels of coverage—including which drugs are covered. As a result, we strongly urge Medicare beneficiaries to:

The difference between picking a plan that is right for you and choosing one that isn't can be thousands of dollars per year in premiums and out-of-pocket drug expenses.

You can find the basics about the benefit and Part D plans at Medicare's Web site. This site can answer most questions. It also links to the Medicare Part D "Plan Finder," which allows you to compare offerings and coverage options in your area and lets you know which drugs a plan covers. This site also gives you more information on how to get what Medicare calls "Extra Help"—additional subsidies to support enrollment in Medicare Part D if your annual income falls in the appropriate level. You can also call 800-633-4227 for Part D assistance.

The independent nongovernment Medicare Part D Web site that Consumer Reports recommends is sponsored by the Medicare Rights Center, a nonprofit, consumer-oriented group. The site is comprehensive, high quality, and easy to use. It, too, will give you the basics and other detailed advice on the Part D benefit.

Other Web sites offer Part D help, and some are useful. The best way to search for these plans is to type "Medicare Part D" or "Medicare drug benefit" into an Internet search engine. But use caution: You'll see a lot of insurance company-related links that aim to sell you on a Part D plan. You can't rely on those sites to give you unbiased advice. We'd recommend avoiding those sites and only using them to compare plans and benefits once you have done some homework on Medicare.gov and independent sites or with credible written material.

If you'd prefer a book, check out "Medicare Prescription Drug Coverage for Dummies," a new title in the "For Dummies" series. It's long (384 pages), but it can be skimmed for advice pretty easily (much like other Dummies-series books). It includes tips such as: Don't pick a plan based on a friend's or relative's recommendation; unless he or she takes the exact same drugs you do, the plan may not be best for you.

Be wary of ads and sales pitches from insurers and insurance brokers. The majority of print, TV, and radio ads don't clearly offer enough information for you to make a wise choice. In this context, avoid picking a plan just because it has a familiar name or brand. Written material is suspect, too. A federal government review recently found that a majority of the written materials that Part D insurers had prepared last year failed to meet government marketing guidelines for accuracy and clarity. After receiving complaints, the government has banned door-to-door sales and telemarketing of Part D plans, but written pitches can still be mailed as long as they don't contain enrollment forms. If you have a broker you trust, consult him or her. But watch out for brokers pushing certain plans. The government is trying to "levelize" the commissions that brokers earn on some Medicare sign-ups, but until that change goes through, brokers can still earn more pushing some plans than others.

According to recent advice, you shouldn't switch plans if you're happy with the one you have, the premium is reasonable, most of your drug costs are covered, and you didn't fall into the "doughnut hole" (the gap in Medicare prescription coverage) last year.

That advice may apply again this year for most people, but even the government agency that runs Medicare and the Part D benefit (the Centers for Medicare and Medicaid Services) has advised people to shop around this year. The main reasons:

Be sure to compare your current Part D plan with other plans available in your area. We advise narrowing your options to three or four as soon as you can, using the Medicare plan finder or by studying written material. You can also call plans directly and talk through their offerings. Be prepared with specific questions and create a comparison table in writing or on your computer.

Be especially attentive to any change in coverage of drugs you must take on a long-term basis, such medications for high blood pressure, diabetes, or high cholesterol.

The big issue for many people is figuring out whether they are at risk for hitting the doughnut hole. The doughnut hole refers to the way the government structures the Part D benefit. About 25 percent of plans offer gap coverage when in the doughnut hole, but the coverage is not as generous because the government does not subsidize it.

In 2009 the doughnut hole (or coverage gap), as dictated by the government, occurs when your drug expenses (what you and the plan together spend) hit $2,700. The gap continues until you have spent $4,350 out of your own pocket. At that point, coverage starts again and will pay 95 percent of your drug expenses.

So if you take many drugs, especially expensive brand-name drugs, the coverage gap can be intimidating and should be the central issue in your choice of a Part D plan.

In 2009 about half of national insurers offering Part D plans will offer some coverage in the doughnut hole. That includes big national insurers such as Aetna, Cigna, CVS Caremark, Humana, Medco, and United Health Group.

Most plans that cover the doughnut hole pay for generic drugs, with limited or no coverage for brand-name drugs. But that generic coverage varies. Six percent of plans in 2009 will cover all generics; the majority will cover about two thirds of generics. The fact that Part D plans generally cover only generics in the doughnut hole has been viewed as a drawback, and it is one if you have to take more expensive brand-name drugs. But more generics are available these days, and many generics meet the needs of people taking chronic disease medicines.

Bottom line. If you take prescription medicines while on Part D and you went into the doughnut hole last year (about 1 in 4 did in 2007), or if you think you might fall into the hole this year, consider enrolling in a plan that has coverage in the doughnut hole. But we recommend that you weigh how far you might fall into the doughnut hole and balance your premium expense against expected drug costs.

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We also recommend regular "drug checks" with your doctors. The best way to keep your prescription drug expenses down is by making sure you are taking medicines that give you the best value for your money. Visit www.CRBestBuyDrugs.org to find many alternatives to high-priced drugs.

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That's because you'll pay a higher monthly premium for a plan that has coverage in the doughnut hole. The average monthly premium cost for a plan that covers some of the doughnut hole will average about $74, the Kaiser Family Foundation reports. That's compared with an average monthly premium of about $33 for a plan with no gap coverage.

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So for an extra $492 or so a year in premiums, you would have some security of coverage in the gap, and possible protection from significant expenses if you take many drugs or suddenly fall ill. But if you anticipate expenses in 2009 that are only marginally into the doughnut hole, a plan that offers gap coverage might not make sense.

There's another important strategy to avoid the doughnut hole: Lower your drug expenses from the start. Talk with your doctor about taking or switching to lower-cost medicines. That might mean switching from some expensive brand-name drugs to generics. But that strategy could save enough to protect you from the doughnut hole in 2009. In that case, you won't need a more expensive Part D plan with added coverage.

In a new analysis by the Consumer Reports Best Buy Drugs team, for example, Part D enrollees who need to take medicines in 2009 for high cholesterol, high blood pressure, heart disease, diabetes, or arthritis (or for a combination of those ailments) stand to save between a few hundred dollars and more than $5,000 per year by switching to lower-cost medicines. The study looked at more than 250 Part D plans in six cities (by ZIP code) using Medicare's plan-finder tool.

For example, a senior with diabetes in Phoenix could save from $497 (lowest-cost plan) to $737 (highest-cost plan) by switching from the brand-name drug Januvia to another drug, the generic metformin. Likewise, someone with chronic arthritis in Atlanta who had been taking just one drug—the brand-name Celebrex—and switched to generic ibuprofen could save from $555 to more than $1,500.

Shopping wisely for drugs will save you money, too. That might mean buying drugs online or through mail order, comparing prices at local pharmacies and discount stores, and getting 90-day supplies of any medicines you take on a regular basis. Many people are reluctant to buy online or by mail order, but both practices are perfectly safe once you learn how to do it.

If you prefer to get your drugs from the local pharmacy, be aware that even in a single town or city, prices can vary from pharmacy to pharmacy by up to 50 percent, although your co-pay share might be set. Fortunately, some large ("big box") discount stores are competing more aggressively with pharmacy chains, including offering discount programs that price most generics for as little as $4 for a 30-day supply.