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Research ArticleOriginal Research

Sample Closet Medications Are Neither Novel Nor Useful

Kari L. Evans, Steven R. Brown and Gerald W. Smetana
The Journal of the American Board of Family Medicine July 2013, 26 (4) 380-387; DOI: https://doi.org/10.3122/jabfm.2013.04.120330
Kari L. Evans
From the Department of Family and Community Medicine (SRB), University of Arizona College of Medicine, Phoenix (KLE); the Banner Good Samaritan Family Medicine Residency, Phoenix, AZ (SRB); and the Division of General Medicine and Primary Care, Harvard Medical School, Boston, MA (GWS).
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Steven R. Brown
From the Department of Family and Community Medicine (SRB), University of Arizona College of Medicine, Phoenix (KLE); the Banner Good Samaritan Family Medicine Residency, Phoenix, AZ (SRB); and the Division of General Medicine and Primary Care, Harvard Medical School, Boston, MA (GWS).
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Gerald W. Smetana
From the Department of Family and Community Medicine (SRB), University of Arizona College of Medicine, Phoenix (KLE); the Banner Good Samaritan Family Medicine Residency, Phoenix, AZ (SRB); and the Division of General Medicine and Primary Care, Harvard Medical School, Boston, MA (GWS).
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    Figure 1.

    Percentage of yes and no answers regarding novelty and usefulness of most commonly found sample drugs. RCT, randomized control trials.

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    Table 1. Characteristics of the Medications Most Commonly Found in Sample Closets and Their Costs
    Trade NameGeneric NameDate Initially Approved by FDASites Containing Sample (n)IndicationsMost Common Initial DoseAWP*
    BystolicNebivolol20079Hypertension5 mg daily$68/30 tabs
    CrestorRosuvastatin20039Hyperlipidemia10 mg daily$157/30 tabs
    JanuviaSitagliptin20069Type 2 diabetes100 mg daily$244/30 tabs
    MicardisTelmisartan19989Hypertension40 mg daily$124/30 tabs
    ToviazFesoterodine20089Overactive bladder4 mg daily$159/30 tabs
    AvodartDutasteride20018Benign prostate hyperplasia0.5 mg daily$129/30 tabs
    CymbaltaDuloxetine20048Depression, anxiety60 mg daily$183/30 caps
    DiovanValsartan20018Hypertension80 mg daily$97/30 tabs
    LipitorAtorvastatin19968Hyperlipidemia20 mg daily$183/30 tabs
    LovazaOmega-3-acid ethyl esters20048Hypertriglyceridemia4 g daily$190/120 1-g caps
    PristiqDesvenlafaxine20088Depression50 mg daily$153/30 tabs
    SeroquelQuetiapine19978Schizophrenia, bipolar disorder200 mg BID$749/60 tabs
    ActosPioglitazone19997Type 2 diabetes30 mg daily
    AmitizaLubiprostone20067Chronic idiopathic constipation24 μg BID$272/60 caps
    CelebrexCelecoxib19987Joint pain100 mg BID$176/60 caps
    EnablexDarifenacin20047Overactive bladder7.5 mg daily$167/30 tabs
    LevitraVardenafil20037Erectile dysfunction10 mg$21/tab
    MaxaltRizatriptan19987Migraine headache5 mg$32/tab
    SavellaMilnacipran20097Fibromyalgia50 mg BID$146/60 tabs
    SpirivaTiotropium20047COPD1 capsule (18 μg) daily$289/30 caps
    SynthroidLevothyroxine20027Hypothyroidism100 μg daily$21/30 tabs
    TrilipixFenofibric acid20087Hyperlipidemia, hypertriglyceridemia45 mg daily$54/30 caps
    VytorinEzetimibe and simvastatin20047Hyperlipidemia10/20 mg daily$148/30 tabs
    • ↵* Cost of a 30-day supply of the most commonly used initial dose of the medication.

    • AWP, average wholesale price; Cap, capsule; COPD, chronic obstructive pulmonary disease; FDA, US Food and Drug Administration; tab, tablet.

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    Table 2. Medications Most Commonly Found in Sample Closets and the Relevant Guideline to Evaluate Usefulness
    Trade NameGeneric nameRelevant Guideline
    SynthroidLevothyroxineAACE 200214
    MaxaltRizatriptanAAFP/ACP-ASIM 200215
    LevitraVardenafilACP 201016
    CelebrexCelecoxibACR 201217
    JanuviaSitagliptinADA 201218
    ActosPioglitazoneADA 201218
    CymbaltaDuloxetineAPA 201019
    PristiqDesvenlafaxineAPA 201019
    AmitizaLubiprostoneASCRS 200720
    LovazaOmega-3-acid ethyl estersATP III 200421
    CrestorRosuvastatinATP III 200421
    LipitorAtorvastatinATP III 200421
    TrilipixFenofibric AcidATP III 200421
    VytorinEzetimibe and simvastatinATP III 200421
    AvodartDutasterideAUA22
    SavellaMilnacipranEULAR 200823
    SpirivaTiotropiumGOLD 201024
    BystolicNebivololJNC VII25
    MicardisTelmisartanJNC VII25
    DiovanValsartanJNC VII25
    ToviazFesoterodineNICE 200626
    EnablexDarifenacinNICE 200626
    SeroquelQuetiapineNICE 200627
    • AACE, American Association of Clinical Endocrinologists; AAFP, American Academy of Family Physicians; ACP-ASIM, American College of Physicians-American Society of Internal Medicine; ADA, American Diabetes Association; ACR, American College of Rheumatism; APA, American Psychiatric Association; ASCRS, American Society of Colon and Rectal Surgeons; ATP, Adult Treatment Panel; AUA, American Urologic Association; EULAR, European League Against Rheumatism; GOLD, Global Initiative for Chronic Obstructive Lung Disease; JNC, Joint National Committee; NICE, National Institute for Clinical Excellence (UK).

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The Journal of the American Board of Family     Medicine: 26 (4)
The Journal of the American Board of Family Medicine
Vol. 26, Issue 4
July-August 2013
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Sample Closet Medications Are Neither Novel Nor Useful
Kari L. Evans, Steven R. Brown, Gerald W. Smetana
The Journal of the American Board of Family Medicine Jul 2013, 26 (4) 380-387; DOI: 10.3122/jabfm.2013.04.120330

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Sample Closet Medications Are Neither Novel Nor Useful
Kari L. Evans, Steven R. Brown, Gerald W. Smetana
The Journal of the American Board of Family Medicine Jul 2013, 26 (4) 380-387; DOI: 10.3122/jabfm.2013.04.120330
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