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King of the Name Brands

Among prescribers in Medicare’s drug program in 2011, internist Hew Wah Quon of Los Angeles stands out as a high-volume prescriber of name-brand drugs. Only two of his top 10 drugs are generics. To see what drugs Quon prescribed and what they cost, click through the slideshow.

1 Plavix

18

Used alone or together with aspirin to help prevent stroke, heart attack, and other heart problems.
More info »

Number of prescriptions: 5,265, including refills

Patients receiving it: 648 (68% of his Part D patients received this drug)

Retail cost: $1,014,553 ($193 per prescription)

WHY IT MATTERS

A 2008 study in the American Heart Journal found that only around half of prescriptions for Plavix in a sample group were for uses supported by clinical trials. In 2012, this drug became available generically under the name clopidogrel.

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2 Crestor

38

Lowers high levels of cholesterol and triglycerides (fats) in your blood. This medicine is called a statin. More info »

Number of prescriptions: 5,250, including refills

Patients receiving it: 670 (71% of his Part D patients used this drug)

Retail cost: $733,862 ($140 per prescription)

WHY IT MATTERS

Crestor, known for its potency, is generally used by doctors if patients do not respond to less-expensive statins or experience side effects. The generic simvastatin is the most prescribed drug in Medicare Part D, far outpacing prescriptions for other statins.

3 Lovaza

82

Treats high levels of triglycerides, a fat in your blood. Used together with diet, exercise, and weight loss. More info »

Number of prescriptions: 4,708, including refills

Patients receiving it: 660 (70% of his Part D patients used this drug)

Retail cost: $427,508 ($91 per prescription)

WHY IT MATTERS

Lovaza is purified, concentrated fish oil, similar to supplements available in drugstores. Lovaza has been shown to reduce triglycerides but not lower risk of heart attack or stroke. Experts say it should only be used for patients with extremely high levels of triglycerides.

4 Evista

85

Treats and prevents osteoporosis (weak or thin bones) and decreases breast cancer risk in women who are past menopause. More info »

Number of prescriptions: 2,372, including refills

Patients receiving it: 305 (32% of his Part D patients used this drug)

Retail cost: $318,596 ($134 per prescription)

WHY IT MATTERS

In 2005, Evista maker Eli Lilly & Co. pleaded guilty and agreed to pay $36 million to resolve allegations that it illegally promoted Evista. Even though Evista only was approved by the Food and Drug Administration for the prevention and treatment of osteoporosis in post-menopausal women, Lilly was accused of promoting it for preventing other diseases.

5 Singulair

49

Helps prevent and control asthma attacks; treats seasonal and perennial (long-term) allergies.
More info »

Number of prescriptions: 2,345, including refills

Patients receiving it: 437 (46% of his Part D patients used this drug)

Retail cost: $342,741 ($146 per prescription)

WHY IT MATTERS

In 2009, the FDA added a warning to Singulair about neuropsychiatric events in some users, including agitation, aggression, anxiousness, dream abnormalities and hallucinations, depression, insomnia, irritability, restlessness, suicidal thinking and behavior (including suicide), and tremor. In 2012, this drug became available under the name montelukast sodium.

Flickr, Stephanie Dunham

6 Bystolic

121

A beta blocker that treats high blood pressure to reduce the risk of stroke and heart attack. More info »

Number of prescriptions: 2,225, including refills

Patients receiving it: 311 (33% of his Part D patients received this drug)

Retail cost: $129,293 ($58 per prescription)

WHY IT MATTERS

The FDA sent Bystolic’s maker, Forest Laboratories, a warning letter in 2008 for improperly promoting the drug as safer and more effective than competitors.

National Library of Medicine

7 Ammonium Lactate

259

Treats dry, scaly skin conditions called xerosis and ichthyosis, and temporary relief of itching.
More info »

Number of prescriptions: 2,202, including refills

Patients receiving it: 569 (60% of his Part D patients used this drug)

Retail cost: $50,167 ($23 per prescription)

WHY IT MATTERS

This is a generic medication.

8 Amlodipine Besylate

3

Used alone or with other medications to treat high blood pressure and chest pain (angina). Amlodipine is in a class of medications called calcium channel blockers. More info »

Number of prescriptions: 1,766, including refills

Patients receiving it: 299 (32% of his Part D patients used this drug)

Retail cost: $15,227 ($9 per prescription)

WHY IT MATTERS

This is a generic medication

National Library of Medicine

9 Actos

31

Used together with proper diet and exercise to help control blood sugar in adults with type 2 diabetes. More info »

Number of prescriptions: 1,454, including refills

Patients receiving it: 223 (24% of his Part D patients used this drug)

Retail cost: $262,209 ($180 per prescription)

WHY IT MATTERS

In 2011, the FDA warned the public that using Actos for more than one year may be associated with an increased risk of bladder cancer. Additional studies have reaffirmed the risk.

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10 Lidoderm

66

Treats nerve pain that is caused by herpes zoster, or "shingles." More info »

Number of prescriptions: 1,449, including refills

Patients receiving it: 486 (51% of his Part D patients used this drug)

Retail cost: $600,872 ($415 per prescription)

WHY IT MATTERS

A 2012 study found that 82% of prescriptions for Lidoderm in a sample population were for uses not approved by the FDA. While doctors can prescribe drugs for such uses, the drug maker has not demonstrated efficacy or received permission to advertise that use.

Flickr, Linda Woods