Heartburn meds Nexium and Prilosec have been in the news lately because of the possibility that they may increase risk of heart attack. While the jury’s still out on this, it’s fascinating to look at the amount of money that’s been poured into the marketing of these drugs.

Last week, the Food and Drug Administration announced that AstraZeneca, maker of both drugs, had found what might have been an increased risk for cardiac trouble in a 14-year study comparing the drugs to surgery. In reviewing the data, the agency said it agreed with the company that the result seemed to be a statistical fluke.

The FDA’s rather confusing report seemed to be an attempt at greater transparency following widespread criticism for its handling of alleged dangers of other drugs, including the arthritis medication Vioxx and the diabetes treatment Avandia. While most pharmaceutical experts agree there seems to be no heart danger from Nexium or Prilosec, their marketing has costly side effects.

Before its patent ran out, Prilosec was a best seller for AstraZeneca. When its patent ran out in 2001, the company
did everything it could to keep those profits..here’s where the brilliance comes in..the company basically developed an almost identical drug (Nexium) and launched one of the most expensive campaigns ever to try to get patients and doctors to switch from Prilosec to Nexium. And this campaign paid off..

At this point, who hasn’t heard of the “little purple pill”? More than 7 million Americans now take Nexium, according to the drug company. And IMS Health, a company that tracks pharmaceutical sales, reports that Nexium earned more than $5 billion in sales in the U.S. last year, making it the second highest grossing drug after Lipitor, the cholesterol-lowering medication hawked by a celebrity doctor in TV and print ads.

Prilosec now costs about $30 a month. Nexium costs about $200.

Drug safety legislation introduced in the US House would have allowed for an advertising moratorium on new drugs with serious safety risks for the first 3 years the drug is out on the market. This provision was stripped out by 3 NY House members. An advertising moratorium on drugs with serious safety risks would have been an important consumer protection, since most drug side effects do not appear until the drug has been taken by millions and is on the market for at least 7 years.

But not to worry says PhRMA:

The industry’s trade group, Pharmaceutical Research & Manufacturers of America (PhRMA), believes drug ads benefit public health by encouraging people to see their doctors about conditions they might not otherwise know they can treat. Safety shouldn’t be a concern, says Scott Lassman, PhRMA’s senior assistant general counsel. “Our feeling is that when a drug is approved, the FDA has already made an assessment that it is safe.”

Vioxx, Zyprexa, Avandia, Paxil..for some reason, I don’t feel so reassured.