I am a big ibuprofen fan for all sprains and related inflammations. The ibuprofen strips in our medical cabinet usually expire before they get consumed and we throw it away, just like we threw away that strip of 200mg dose of ibuprofen last month. Having a backup of a strip of 400mg dose, I didn’t backfill the one I threw away.
Well, then a back muscle spasm hits me early this week. My typical dose pattern is to take 400mg dose on the day a sprain hits and use 200mg dose for a couple of more days. So I was happy with a day of my booster drug of 400mg and then I scout for my normal dose of 200mg. Went to three pharmacies in the neighborhood that morning and couldn’t find the 200mg dose (with the specific brand I use.) The last two pharmacists told me that people are hardly buying that dose. The last pharmacist religiously checked over-the-shelf stocks and then went to the back of the pharmacy to check the reserves. When he came back, he claims that he doesn’t remember refilling his stocks for that dose recently. As a nice salesman, he said he can get that for me in the next 24 hours, but that was a different story.
About 30 years ago, people are prescribed a 200mg dose for about a week and if the pain doesn’t go away, then only they are prescribed a 400mg dose. One should be hosting a monster level pain to consume 400mg dose regularly to start with. But as per the pharmacists I talked to, people use 400mg dose now-a-days as the default over the shelf medication.
Here are the economics – a 10 dose strip of (branded) 400mg costs INR 10.41, that is about USD 0.18. At such a low price, the packaging costs would have forced a 200mg strip to be priced almost the same or at least very close. Given the “more is better” consumer psychology, people might as well be using a 400mg dose when they could have comfortably used a 200mg dose.
In essence, are we super-sizing our drugs, knowingly or unknowingly? Keeping the scale of economics aside, we might as well be going for faster pain relief than containing the level of pain. That might be leading to super-sizing our drugs eventually. The fact that the manufacturer has a 600mg dose now (I found that while searching on my laptop for dosage levels that people use, I admit that I haven’t seen it in the pharmacy, may be because I haven’t asked for it) is an indication that we might as well be super-sizing our drugs.