How much do men really need to spend to treat the symptoms of enlarged prostate? For most men, doxazosin—a generic alpha-blocker—works just as well and is as safe as the heavily-advertised drug Flomax (a brand-name alpha-blocker). But the kicker here is the difference in price: doxazosin can cost $10 or less a month, whereas Flomax can set you back up to $246.
Our new Best Buy Drugs report is based on a systematic review of more than 60 studies, and the results clearly show that no one alpha blocker is better than another at relieving enlarged prostate symptoms. This type of research, known as comparative effectiveness, is the basis for all our Consumer Reports Best Buy Drugs reports.
But why doesn’t the public know that an effective, safe and cheaper drug already exists to treat the symptoms associated with this condition? One reason is advertising. And lots of it.
Drug makers spend enormous sums of money to get their drug’s name into your living room and emblazon it on your mind. In fact, in 2007 branded drug makers spent more than $5 billion on advertising to consumers, and another $15 to $20 billion promoting their drugs to doctors.
When it comes to Flomax, what the ads won’t tell you is that another drug—actually several drugs—already exist to treat the symptoms of enlarged prostate and they work just as well.
Flomax—actually considered to be a "me too" drug, one that isn’t a breakthrough drug and that is very similar to drugs already on the market for a specific condition—is a great case study on how that much advertising can result in more prescriptions written.
Roughly half of all men over age 55 have an enlarged prostate, and by age 80 about nine out of 10 men have it. It’s a normal part of aging. Many men won’t have any symptoms or their symptoms will be mild and not that bothersome. But about half will require medication or treatment, so there is a huge market of millions of men who need these drugs. And don’t think the drug makers haven’t noticed.
In 2008 alone, the makers of Flomax, Boehringer Ingelheim, spent more than $115 million advertising the drug to consumers—14 percent more than they did the year before, according to figures from Nielsen Media Research. All that advertising paid off. Flomax was among the top 20 most-commonly prescribed drugs that year, with 11 million prescriptions written, up almost 5 percent from the year before.
And here is the most jaw-dropping part: Consumers and their insurance companies shelled out more than $1.2 billion dollars for Flomax last year—a whopping 23 percent increase from 2007. (I mean somebody has to pay for those expensive print and television ads.)
Flomax, in particular, has another quality associated with it: sticker shock if you need a higher dosage. Flomax is only available in one dosage strength, 0.4 mg, so if you need to increase your dose to 0.8 mg—and some men do—you will need to take two pills, which doubles the cost. All the other alpha-blockers are available in varying strengths for about the same price, so even if you need a stronger dose, it won’t cost you much, if any, more.
And you may be able to slash your costs even further with your doctor or pharmacist’s approval: For some of these drugs, you may be able to get larger dosages of your pills and then split them in half with a $5 pill splitter available at most pharmacies. Keep in mind you can’t split extended-release or sustained-release drugs.
Bottom line: Flomax is an expensive drug and it’s no more effective or safer than other drugs in the same category for treating symptoms associated with having an enlarged prostate. If you find that you need treatment, ask your doctor first for a generic. Doxazosin is our Best Buy pick because it is as safe, effective and considerably less expensive than other similar drugs.
Read our latest Consumer Reports Best Buy Drugs report to learn more about the symptoms of enlarged prostate and the drugs used to treat it. Find out more about our Best Buy Drugs program that evaluates more than 200 drugs for dozens of common conditions.
—Lisa Gill, editor, Prescription Drugs
Read the full Best Buy Drugs report on drugs to treat enlarged prostate .