Aspirin and its expensive substitutes: prescribing patterns and cost implications.

Relatively expensive nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly prescribed products, although many rheumatologists continue to recommend aspirin as the initial drug of choice for a variety of musculoskeletal problems. We reviewed 100 charts of patients given NSAIDs in a VA clinic to see how many had relative contraindications for aspirin, such as previous salicylate intolerance, peptic ulcer disease, gastrointestinal bleeding, or failure to respond to aspirin. Only 28% of patients on the expensive preparations had any of these problems noted in their charts. With an average retail cost difference of $14 to $29 per month, large potential savings exist for those who purchase anti-inflammatory products, if physicians would initially prescribe aspirin for appropriate patients.