The Little Purple Pill Problem

iStock_000010770938XSmallForbes magazine calls it “a parable of what’s wrong with health care [costs].” We think that the popular drug Nexium is a scandal for a different reason – what it does to your digestion.

AstraZenica, the international pharmaceutical company worth $46.8 billion, began selling a drug called omeprazole in 1989 under the brand name Prilosec. It is a proton pump inhibitor, and it was marketed as a treatment for heartburn, peptic ulcer disease, and GERD (gastroesophageal reflux disease). Two years before the patent expired, AstraZeneca changed the formulation slightly and started selling it as a new patented drug, Nexium. What the drug company did not want was for consumers to stay with Prilosec, essentially identical to the new drug, once the old drug came off patent and the price collapsed.
This strategy worked. Nexium is easily AstraZeneca biggest seller, bringing in $5 billion so far. And part of that is its cost: $2,000 for a year’s supply. While the drug company says an average consumer only pays a $30 co-pay for Nexium, a recent Forbes article points out that the rest of us are paying for it with higher health insurance rates.
The article also provided more details about how the company managed the switch from Prilosec to Nexium: “Intense marketing around Nexium coincided with price increases for Prilosec, pushing many patients to Nexium. Doctors, easy to woo with drug sales reps bearing samples and company-commissioned research reports, were happy to write scripts for the new drug—and oblivious of the economic implications. Insurers and their corporate clients mostly wimped out, paying full freight for Nexium. Nobody wants to be the bad guy with employees’ health coverage. But the sum of many dubious coverage decisions adds up; the nation’s health spending keeps rising at 5% to 6% a year.” Prescription drug spending accounts for about 10% of the total health pie—which is estimated to be around $260 billion for 2010.
This is scandalous in a number of ways. First, Nexium is little different from Prilosec, which can be purchased for $13.50 for a month’s supply at Costco. The difference is, one version is patented and the other is not. The company has always justified the drug by pointing to a single study that found Nexium was three percentage points better at preventing a rare form of esophageal damage than Prilosec.
But even worse, as we reported last year, acid blockers like Prilosec and Nexium incorrectly treat most people’s stomach problems, including heartburn and GERD, by turning off acid production.
While it seems counterintuitive, recent studies suggest that the problem for most stomach sufferers is not too much stomach acid, but too little! Other maladies—bloating, belching, constipation, indigestion, and even thinning hair or breaking fingernails in women—may also be the result of too little acid. So antacids may actually be making the problem worse.
If antacids and acid blockers are a cause rather than a cure for stomach problems, this would rank as one of the major medical errors of history. For more information about why most stomach sufferers may need more stomach acid, not less, see Your Stomach by Dr. Jonathan Wright.

30 comments

  1. I couldn’t agree more with the Purple Pill Problem. I continually see patients who need help with GERD, start with the purple pill and end up with a host of other problems. I personally prefer herbal solutions that have been time tested and are safe. I use Traditional Chinese Medicine and Chinese herbs with all my patients. A formula call Bao He Wan (Preserve Harmony Pill) can be bought in pill form or granules and works every time.

  2. If people would start to realize the importance of food and what it does to ones body one might not needs these Drugs. If you eat well, healthy organic raw fruits and veggies, stay away from Saturated and Trans fats and eat more Omega 3 foods such as Walnuts, Avocados and Flax seed (freshly ground) you will really start to feel differently, in a Good way! My husband suffered from indigestion, bloated stomach after eating and changed his diet and he no longer gets those symptoms. He feels healthy, has less headaches, lost weight (cut out processed foods, gluten and sugar) and has more energy. Care about what you put in your body and it will help tremendously. 🙂

  3. In case this MIGHT be of interest to you, I feel I should pass it on to you. You may disregard.
    Dianne Gaschler

  4. You’re completely right about this! Heartburn seems to be caused by too little acid rather than too much. I’ve been taking a health food supplement that includes enzymes and stomach acid whenever I have heartburn, and it turns it off right away. This has been clearly known for about 20 years, if I’m remembering when I heard about this accurately.
    And it is a BAD error for the medical community!
    I just wish it were the major error! There are SO many more, and many of these errors have MUCH worse results for the American public!
    The major two that I’m aware of at the moment are using the group that includes drugs like Fosamax, Actonel, Boneva, etc. to treat bone density problems. These drugs have been proven to LOWER the density of bone formation and weaken bones. But the drug companies have misrepresented this drug as a cure for the very problem it creates!
    The other is the lack of information on hypothyroidism for doctors, including and especially endocrynologists. They are given inaccurate tests that leave millions of people in this country suffering from undiagnosed low thyroid function so that the doctors can sell them drugs that inhibit all the bad symptoms, but leave the problem untouched so that the drug companies can profit by selling lots of cholesterol (if your cholesterol is high, your thyroid function IS low), antidepressants, weight loss products, laxatives, analgesics, and more.
    All this, so drug companies can profit!
    It’s long past time that Americans change from drug company care to actual health care!

    1. Your reply regarding bone density drugs, etc. to treat bone density problems are true. Our bones have two special cells that work together to maintain the health and density of bone tissue. One cell makes new cells in areas that need replenishment or strength, build-up cells. The other cell eats weakened or damaged bone cells, demo-cells. This is what these drugs do. They inhibit the production of the demo-cells allowing the bone to appear larger. This bone becomes spongy and pourus and increases the risk of breaking because of the weakness. I am glad to have prevented my mother’s medical doctor from putting her on Fosamax.

  5. Actually Proton Pump inhibitors are ‘small potatoes’ for medical errors of history.
    Western medicine’s major reliance on vaccines is a fatally flawed paradigm. Vaccines are a major money earner for Pharmaceutical companies but play into a basic misunderstanding of how the immune system works.
    The T1 system (in the gut) accounts for 80% of the immune system while blood born ,T2,accounts for less than 20%. Yet medical education is all about T2 immunity.Vaccines work exceptionally efficiently at heightening the T2 immune response-that;s what they’re designed for. However, it is this hyper-response which plays out in the T2 system as asthma, allergies,seizures, anaphylaxis and the myriad of auto-immune disorders we’re seeing at epidemic levels at present.
    As the numbers of vaccines rise ,so does the “victim count”. The latest piece of breathtaking news was that Gardasil INCREASES the risk of cervical cancer!
    See Dr Natasha Campbell McBrides” utube presentations on her “Gut and Psychology Syndrome”
    to begin to understand how TRUE immunity works.

  6. There are so many natural alternatives that are equal to or more effective with little or no side effects that need to be offered to American patients. Don’t let the pharmaceutical industry run wellness in this country.

  7. Johann,
    Can you please give me the name of the supplement you are taking for heartburn?
    thank you!
    Joyce

  8. I agree that it is scandalous that these drugs – originally intended to be prescribed for short term (4-8 weeks) treatment are now being prescribed for years or indefinitely. The long term effects include multiple nutritional deficiencies due to the inability to absorb nutrients properly.
    I have seen patients who have been on long term acid-blocking drugs presenting with iron deficiency anemia, zinc deficiency, osteoporosis, chronic diarrhea, chronic stomach pain (ironic, isn’t it!) H. Pylori infections, fatigue, etc. The doctors who prescribed the drugs for them generally tell them that their symptoms have nothing to do with the medication!
    It is a symptom of the ignorance and arrogance of allopathic medicine that it does not consider the fact that we have stomach acid for a reason! It is necessary to digest food, absorb nutrients, and kill bacteria such as H. Pylori and also parasites.
    While it is difficult to get off of these medications, due to their tendency to cause a ‘rebound effect of increased stomach acid for a while if you stop them abruptly, with the help of a knowledgeable holistic practitioner, it is quite possible. Using DGL Licorice and other supplements to heal and soothe the stomach lining can be very helpful.

  9. Far too many MDs do not even bother to learn anything about drugs. At best they make notes based on what the rep tells them, and that seems to be the end of it. Pardon the bad pun, but Nexium really sticks in my craw with regard to one such MD.
    I had been suffering terribly from joint pain (osteoarthritis due to overuse). On the MD’s advice, I took ibuprophen for the pain – as little as I could tolerate – but it started causing GI bleeding. So I asked him for a more effective pain medication that would be easier on my GI tract. He prescribed Celebrex, of all things – a little something to exacerbate my GI bleeding (AND aggravate my allergy to sulfanamides). How nice. In concert with that, he prescribed Nexium which he thought would counteract the GI bleeding. What an idiot. I never set foot in his office again, and never paid my final balance.
    There really has GOT to be a law. Between their suppressed negative outcomes of drug trials and their aggressive marketing – neither of which contribute to improved patient outcomes – Big Pharma needs to get a thorough housecleaning. It would also help tremendously if their ties to academic institutions – med schools in particular – could be completely severed.

  10. I take dycyclomine or bentyl. I did take Prilosec at one time on the advice of my doctor who treated my gastric problems. He switched me to Prevacid. He later switched me to Ranitidine. I take it now once in the morning and once in the evening.

  11. I am so tired of paying for other people’s lifestyle disorders, which are preventable. Poor eating habits, smoking, drinking, drugging (legal and illegal) are all preventable habits the results of which we all as American taxpayers pay for. I am so tired of Americans refusing to believe that pesticide and herbicide residues on their commercially grown food cause them problems as they accumulate in the fatty tissues. I am tired of Americans thinking that agribusiness has America’s best interests in mind, that the FDA protects us from tainted food, the unknown effects of GMOs and ill-conceived drug treatments. WAKE UP. WRITE TO THE PRESIDENT, WRITE TO TOM VILSACK, WRITE TO THE FDA. DEMAND THAT THEY DO THEIR JOBS! Stop buying gmo food, stop buying Monsanto products. Put the Out OF Business by not buying any of it. Vote with your dollars.

  12. Scandalous indeed! The public be damned when it comes to money for the pols, government and drug companies.

  13. Just follow meals with a diluted lemon or lime juice or unfiltered apple cider vinegar. Good grief, I have insurance, but it pays for nothing that I do to keep myself healthy. The last four drugs that I have been prescribed over the last few years created such reactions that I was taken off almost immediately and all are in “BLack Box” warnings now. Had I stayed on them, irreversible and devastating consequence might have been my experience. What a con. Our diets and our doctors should be researched and followed as though our lives depend on the research and practice of actual health practice. It does.

  14. This is a no shocker. I’ve been very aware of the political and profit driven behavior of drug companies for far too long. Here’s another example: Eli Lilly’s patent on Prozac (fluoxetine) expired in the United States in August 2001 prompting an influx of generic drugs onto the market. Prozac was rebranded “Sarafem” for the treatment of PMDD in an attempt to stem the post-patent decrease in Eli Lilly’s sales of Fluoxetine. What really concerned me was that there were women who were already taking ‘ Prozac’ that were also prescribed ‘ Sarafem’ for PMDD. These women were receiving a double dose and it made me realize how dumbed down our doctors are today. Drug companies fund medical schools/education and so is it no surprise that doctors graduate as loyal drug pushers? They are brainwashed from day 1 to believe that these companies are there to help them be better health care providers.
    Years ago after the Vioxx scandal, doctors began switching their patients to the other new drug, Celebrex. How ridiculous was that? Why do people entrust their lives under a dr’s care? I think we need to constantly remind ourselves that we are very gullible and motivated by fear of the unknown as well as desperate when we or our loved ones are ill. Doctors are just gullible people with medical degrees and that doesn’t make them good doctors anymore than it makes them a good auto mechanic If you suddenly don’t have a car to drive and you visit an auto dealer and the salesman knows your in a desperate pinch, do you really believe that the salesman will have compassion for you and give you a better deal? Of course not. The sales person will capitalize on your desperate need for a car. . Don’t be intimidated by a physician’s diploma. The doctor patient relationship often fuels the haughty arrogance of the medical community because we tend to treat them as if they are above us in some way. Get real. At one time I actually believed that doctors were scientists with a passion driven desire to solve a person’s illness by applying their knowledge. Doctors are NOT scientists. . Now, I’ve truly accepted that going to a doctor OR veterinary doctor today is really going to amount to nothing beneficial. It’s a waste of money but even more so, it’s become dangerous and life threatening. The Obama administration has done nothing to reform healthcare. All they did was reform Big Insurance ( with their interests ultimately protected). Last night on Larry King, Michael Moore talked about how we have allowed corporations to become the US Government.That statement is SO true. And Americans are concerned about becoming a socialist republic? Please, we are already a socialist republic governed AND controlled by corporations who have NO interest in our well-being. AKA Fascism. Come on America! Use your logical mind, listen to your heart and do something to put an end to this NOW!

  15. I’ve been on prilosec, or a like version, for more than a dozen years. I have GERD and hiatal hernia with diagnosed “Baretts’ esophagus”. I’ve followed the alternatives with the contention we have “to little” acid. Every time I try and get off of prilosec, with these methods, my restriction comes back and the reflux is the same old burning/scarring problem. Soooo I’m concerned that there seems to not be a soloution to the problem, outside prilosec, and that these alternatives have not been well researched or improved upon and are merely continually put forth as the alternative to prilosec. I’d like to find an actual effective alternative, as these seem completely worthless. I might add that I definately am NOT a proponent of prilosec as I’m suffering the side effects but cannot get off it!

    1. I have been on Prilosec/generic for about 6 months now, and it’s been really good for me. I am natural remedies certified, but I was born with genetic dysfunctions that gave me all the bad symptoms of diarrhea, GERD, heartburn, esophageal scarring, anal burning, and hemorrhoids that all finally went away with the Omeprazole. Recently I found I can live with taking it every other day since it is a slow release med. I check my labs and make sure that my nails and bones are still strong. But nothing else gets me into the doctors office accept for diagnosis. I prefer to treat/study my and my families ailments and treat naturally. Now if I could change my genetics….

      1. I’m addicted to Prilosec too! When I stop I get intense heartburn when I eat.
        I’ve noticed that I can skip a day with no severe effects, so I think I’ll try your every-other-day approach.
        I’ve read that these symptoms may be reduced by losing weight. The theory is that the excess weight straightens a naturally-occurring bend in your esophagus, allowing stomach acid to get into your throat, where it causes burning.

  16. The drug companies have hijacked the whole health care system and the FDA and CDC and brainwashed the state medical boards and physicians. If a doctor were to advise a patient to simply take a tablespoon of raw apple cider vinegar before each meal, eat properly and supplement with Betain HCL and probiotics, think of the money and human suffering it would save; but the doctor would probably lose his license for practicing “outside of the standard of care”. Keep up the good work to raise public awareness.

  17. I have to share my story w/all…I have ‘GERD’ – have tried ALL of the other products [brand & generic] for this problem only to find out that there had been break through and had caused esophageal scarring! ‘the purple pill’ has been the only one to make it all go away!!!! If I stop taking the meds my esophagus goes into spamming fits that makes you feel like you are going to vomit but can’t, break out into a cold sweat, and it takes a few minutes for it to go away- it comes on w/out ANY warning. Astra Zenica has supplied my pills for free for over 5-years due to our income and lack of health INS. In my mind they have saved my well being…Also I have tried to NOT take these pills for more than a month at a time- the same thing happens as with any other pill that does [so they say] the same thing as the purple pill…generic pills are tweeted just enough so they can sell & make money. Most generics DO NOT WORK IN MY BODY!

  18. I’m still waiting for someone to claim sucess with alternative treatments to GERD, etc. Other than prilosec or generics and lay out just exactly what they took and how etc.
    Harry D. Kline

  19. I wouldn’t know about this purple little pill, because I don’t take synthetic medications. The best thing for acidity is a salad – eat one or brocoli daily. I do know though that if I eat too much lasagna or pizza and have an acidity problem (and no salad) I take a spoonful of liquid chlorophyll in water; or two or three split-cell-wall chlorella tabs. Works for me and I get no side-effects.

  20. I have heard that damage to the esophageal sphincter is a cause of heartburn problems. Whether it is caused by the reflux of acid before or after is the question. My guess would be many other factors play a role in causing the damage, but to me, it makes more sense that an actual physical problem with the valve of the esophagus is the root of most reflux issues.
    I don’t see how producing too much stomach acid can happen. The stomach is designed to cope with the consumption of food with enzymes, fluids, acid, and mucous are all produced to break down and/or absorb excesses when they occur. Of course, bad lifestyle habits most likely contribute to the former and the latter, but to add, the more we learn about agricultural malfeasance, the answers begin to become more apparent as well (i.e., the studies conducted on lab rodents with GMO grain).

  21. I’ve been on the “purple pill” for over 11 years and when I tried to switch to generics, prilosec, it didn’t work for me so I had to switch back. Yes I noticed my nail problem and hair problem, but never attributed it to Nexium. However, last yaer I started using Tresemme Anti-Breakage shampoo to help my hair and voila…my hair is so healthy now and doesn’t break, another bonus, my nails started to grow! I am a medical transcriptionst and thought that because I’m on the keyboard that is why my nails were doing so poorly. Well now that i have that problem solved, i.e. hair, nails., is there anything else this Nexium pill causes? For you folks with the hair and nail problems, try Tresemme Anti-Breakage shampoo, it works!!!

  22. Huh. Hard to take this “report” too seriously when considering that Prilosec and Nexium aren’t even the same drug.

  23. Of all the drugs on the market this one is probably the one that is the most damaging. There are so many other options for people but we must also all understand that we too are organic of the earth and all chemicals will make us sick including your deodorant, skin care toothpaste etc… There are natural alternatives to everything, there are amazing testimonials on the internet and if you google -acid reflux young living essential oils – that is just one of many. Also check out this fantastic Australian company – BioHawk and the work of Dr Cliff Hawkin. Might I add they are working with Mother Nature not against her. Authentic and with integrity to make a life worth living not just a keeping a life alive.
    Check it out, and eat a caveman diet…we haven’t really evolved to GMO grains… everything starts in the GUT. If you decide to bust a move and take control I am a Young living Independent Distributor, to register (www.youngliving.com) here are my details Sara Nadin #1224844 (google – Young living Essential Oils Acid reflux)

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