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August 21, 1996

Cost Savings and Prescribing Protocols for Nonsteroidal Anti-inflammatory Drugs

Author Affiliations

Lutheran General Sports Medicine Center Park Ridge, Ill

JAMA. 1996;276(7):526. doi:10.1001/jama.1996.03540070022015

To the Editor.  —The goal of Dr Jones and colleagues1 of reducing the cost of NSAID prescriptions is certainly laudable, given the large number of these prescriptions that are written. It was impressive that these authors were able to effect such a substantial change in prescription-writing behavior using their protocol without adverse effects on patient or physician satisfaction. However, we have a concern with respect to the categorization of NSAIDs used in the study. We called 4 pharmacies near our institution and inquired about the cost of a 14-day course of generic ibuprofen (categorized as inexpensive) compared with 14 days of generic naproxen (categorized as expensive). The least expensive course for each was $8.69 for 14 days of ibuprofen (800 mg given 3 times a day) and $9.69 for 14 days of naproxen (500 mg given twice a day). Although there was a surprising amount of price variability among pharmacies, the