New Medications: Out With the Old?

Aug 27, 2013
Few new medications represent real breakthroughs. Dr. Curt Furberg advises waiting for good safety documentation before taking newly marketed drugs.

Which is better, new or old? “New! New!” the children scream.

We’re conditioned to always want to try the latest style, the “it” thing of the moment. And with the march of science and technology, there’s a good basis for that. But are newly developed medications better than older, established ones? Not necessarily – and it’s difficult to determine.

Comparative Testing Scarce

Few new drugs entering the market represent real breakthroughs. Most are “me-too” treatments.

There is no regulation requiring new medications to be better than older ones before they are approved by the U.S. Food and Drug Administration. And there is a shortage of good and fair head-to-head testing of new medications in comparison to proven existing drugs. Instead, the FDA requires tests against a placebo. Even when comparative effectiveness trials are conducted, they are expensive and can take four to five years to complete.

Thus, it can be difficult for doctors and health plans to determine if the newer (and typically much more expensive) medications add value – or add waste.

Tried Is True

Another thing to think about when weighing the pros and cons of new and established drugs is that older drugs have been on the market for many years. This market experience is important from a safety perspective.

For more than half of all new medications, a previously unrecognized serious adverse effect is detected during the first years of marketing. In some cases, this results in removal from the market or the addition of black-box warnings to medication labeling. There are always potential risks in taking a new medication. For this reason, many physicians and health plans prefer to wait a few years before they recommend a new drug, especially if there are good treatment alternatives available.

The clinical specialists at Express Scripts can be a good source of information for patients considering a new treatment.

For More Information

Express Scripts members can find more information about new medications versus old medications – and download selected chapters of Knowing Your Medications: A Guide to Becoming an Informed Patient – by logging in to their member account. To purchase a copy, visit

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