According to a new report released today by one of the nation's largest pharmacy benefit managers, Express Scripts, COX-2 inhibitors such as Vioxx and Celebrex are often prescribed to patients who would just as likely benefit from far cheaper alternatives. COX-2 inhibitors are believed to be gentler on the body's digestive tract than less expensive non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen and naproxen.

But the new study, which uses medical and prescription data from a Midwestern health plan covering over 300,000 people, indicates that over 75 percent of Vioxx and Celebrex prescriptions were for patients who did not appear to be at risk for gastrointestinal side effects. A spokesperson for Express Scripts, which provides coverage for 50 million people in various health plans, says that with many patients, NSAIDS are often just as effective as expensive COX-2 inhibitors. The group says the over-prescribing of Vioxx and Celebrex is contributing to rising health care costs.

The release of the study comes in the wake of a June 1 article published in the British Medical Journal (BMJ), which says the makers of Celebrex, Pharmacia Inc., misled consumers with false data from a September 2000 clinical trial. According to the company, Celebrex caused fewer ulcers and ulcer complications than other similar medications during the trial. The Journal, however, says during the second half of the trial, most ulcer complications were found in patients using Celebrex.