Great post - and probably countless other outrageous examples.

I bet at one time, fish oil and other drugs used to be free in Detroit for the auto workers as well.

Perhaps MPS will privatize and the abuse will end there, too.

This reminds me of another dilemma.  My "sickcare" insurance company called me to inform me of a service that could save me a co-pay every 3 mos for the two thyroid meds I take, if I am willing to use a mail-order pharmacy.  But that would mean taking my business away from the small, independent pharmacy I like, a business that is locally owned and provides excellent, fast service.  I feel strongly about supporting local independent business and keeping the dollars in the community as well as rewarding good service.

The co-pay savings would be tempting, I suppose, except that my husband's employer also provides an second insurance plan to him that reimburses most of our co-pays and some other out of pocket approved medical expenses.  

Then she appealed to the argument that not using the mail order pharmacy costs my primary insurance company more money, which contributes to higher premiums, which is also a good argument.  

Not sure where to whether to make the change or not, considering all the factors and the big picture.    But I do know by taking this thyroid medication, I'm saving money for myself and my insurance provider in the long run, because prior to my hypothyroid diagnosis, my former primary care doc was willing to prescribe all sorts of meds to treat symptoms, and ignoring the underlying thyroid condition was definitely contributing to worse long-term health.

That is amazing. Also beware of Advicor( generic lovastatin and niacin at brand prices). Vytorin is another example of combining a generic drug with anything, calling it something new, and charging brand prices,AND persuading docs to prescribe them. It does not speak well when far too many MDs and DOs go along with this.

From the Costco website you can buy
Slo-Niacin® 500mg 150 tablets for $12.99.
http://www.costco.com/Browse/Product.aspx?Prodid=11118583#

From drugstore.com it will cost $324.96 for 150 tablets 500mg of Rx Niaspan.

Richard--

Yet another drug company rip-off that we should talk about!

Many insurance plans cover prescription meds but not over-the-counter.  So the consumer saves himself money choosing the more expensive prescription medication.

It is all part of the sad reality of "the system."  Expensive medical treatment options get funded, studied, and generate huge cash flows = costs for society/consumers/insurance companies, non-health care businesses.

In-expensive:  Healthy, preventive,  diet and life style choices, including supplements as vitamin D3 and fish oil, struggle for recognition in general medical practice.

Preventive health care generally is non-existing.  
Individual practitioners mostly practice reactive health Care.
Health Care organizations seem to be mostly focused on "Predictive Health Care:"  focusing on treatments that predict a solid flow of income for health care businesses.

Lovaza is a Rip-off.

I take Country Life, Ultra Omega's DHA/EPA product.

- DHA 500 mg (per 2 softgels)
- EPA 200 mg (per 2 softgels)

Cost is $11 for 120 count.

That's an appalling attitude that the good Teacher had about their State paid prescription plan. It's that kind of sense of entitlement that has caused governmental spending to swell so much.

My Doctor prescribed me Niaspan about 2 years ago but I have never had the prescription filled. Once the free samples ran out, I mail-ordered Endur-acin instead. I can get 1,000 - 500mg tablets for $73.50 (not counting a modest shipping charge) which comes out to 7.35 cents each or 14.7 cents a day for my dosage (1,000mg in the evening) -or- $53.66 a year. The same dosage of Niaspan is $1,412.44 a year (not counting shipping and/or sales tax).

I know the Endur-acin works because even my Doctor has been impressed with the improvements of my NMR lipid results. Liver function is fine too.

I prefer Endur-acin over Slo-Niacin because Slo-Niacin has hydrogenated vegetable oil in it. Endur-acin uses a wax matrix for 6-8 hour extended release instead.

As for fish oils, I use Life Extension brand which isn't the cheapest, but I like the oil fruit extract (to protect LDL from oxidation) and sesame lignans (to protect from lipid peroxidation & to prevent the production of the highly inflammatory arachidonic acid among other things) they put in it. It's still WAY less expensive than Lovaza.

Keep up the good work Doctor Davis.

Having seen Dr D's comments on pharma grade fish oil, I was going to comment on Niaspan too.  I changed Cardiologists and mentioned I had started taking Niacin. The change in triglycerides was over -30% which was pleasing and I asked if perhaps I should have a prescription grade in case there were "impurities" I might not want in the over-the-counter niacin. She gladly provided the prescription and to my shock, it was C$370/3months supply ! I have gone back to the generic sustained release "Now" brand from the health food store for C$7/60tabs........... combine that with Vitamin D, K2 and Walmart's fish oil.....who knows, maybe I can get off statins

Dr. Davis, please do a blog post on the Niaspan vs. Slo-Niacin "difference"!

My cardiologist is adamantly in favor of Niaspan.  This is probably the result of his (and thus his pts.) being a high-value target of pharmaceutical marketing. The generous sampling the rep unabashedly slathers on this doctor and his staff is pretty obvious.

Personally, I don't see Niaspan as being more effective, although that is what the doc mentions when questioned.  Since I am now taking 2,000 mgs. daily the cost difference is --quite-- obvious.

What is your opinion of the efficacy of Niaspan vs. Slo-Niacin?  All I can get out of my doctor is "it doesn't work" with regard to Slo-Niacin.  Does it?  Niaspan is looking like a pretty expensive "cure" at this point.

On Niaspan:  My doctor insisted that this was the only clinically appropriate  form of niacin.  I checked the price - $118 per month, 1 1/2 years ago. I didn't fill the Rx and continued with regular niacin.

Yes, we should talk about Niaspan vs. Sloniacin. To come near-future.

Good post -- you clearly put some thought into it.

As a chemist who regularly analyzes fish oils/omega-3-acid ethyl esters, I can tell you that there is a huge difference in active ingredient (EPA and DHA) and quality (source, mercury content, peroxide content, etc.) between fish oil products.

Lovaza is the most "clean" and pure form of EPA + DHA-fortified fish oil on the market.  I would not recommend anyone (who would definately benefit from Lovaza) -- simply go out to the local supermarket or drugstore and buy a fish oil product.  They would not be getting the same benefit.  You know why?  The FDA has not evaluated them.  

Lovaza only (not Costco-branded fish oil) has been approved by the FDA for the treatment of triglycerides.

I have a question and I don't know who to ask.  My Dr. has been on vacation during the last few weeks and I can't even get his office to return my calls.  This isn't an emergency, but has become very annoying.  The problem all started three weeks ago when my Dr. put me on Lovaza to help raise my cholesterol Ever since, everytime I do # 2, I can't stand the smell.  Every plug in my bathroom wall has an air freshener plugged in to it and I've even opened the windows.  Still, I can smell it up and down the hallway and into my den, living room, bedroom and even kitchen.  I'm embarrassed to have anyone over the smell is so bad and it lingers hours after I flush.  The only good news is that I caught a cold over Xmas and was extremely congested for a few days.  Not being able to breathe sure made going to the bathroom much better.  Has anyone else taking this medication experienced this?   Or is it just me?   I'm not worried about the cost of the medication, as money is not a problem for me.  Any comments or suggestions would be much appreciated.

That's funny because I have a friend that uses Lovaza and with with insurance they only pay 30 dollars a month. Wait, let me take that back. They pay 10 dollars a month with a coupon that they are given. So I am not sure where you are getting that outragious number.  Also, my pharmacist quoted the "without insurance price" and it still didnt come anywhere near the price that you are quoting for Lovaza.  Most importantly, I would much rather use a product that is clinically studied and fda approved vs a product that is not.

Sorry, but I'm afraid that you're wrong on the price.

And if you believe that FDA approval is a necessary stamp of approval, then you have, like my colleagues, fallen victim to their brand of market propaganda.

Thanks for all the infor. I have been taking Lovaza for 3 months and have found no difference in my blood work, HDL, LDL, Tri...increase of Lipitor from 10 to 20 only thing that helped lower. Want to continue fish oil, but searching for good quality brand. I don't see the value of Lovaza formerly Omacor. Any suggestions?
Thanks,
Sue

I just bought 220 capsules of omega 3 fish oil equivalent to Lovaza at Target for $5.99

Very high triglycerides, as you all know, is a very serious and life-threatening condition.  Therefore, it is very important that any medication you take for treatment must be FDA proven and scientifically backed.  This is true for a few reasons.  First, there have been zero studies done to show the effects of Costco brand fish oil pills on patients with high triglycerides.  So, you cannot assume, simply because the pills you are taking "claim" to have a certain amount of Omega 3 in the them, that they actually do (supplement labeling is self-submitted by the company, and not regulated by any external or 3rd party agency).  Secondly,  the other components in fish oil, and maybe in Costco brand (no one knows because it isn't on the label) can actually inhibit the bioavailablity of Omega 3, most notably, Omega 6.  And, nowhere on the Costco label does it tell you how much Omega 6 is in it.  We also cannot underestimate the importance of purity with these compounds: a top selling brand of fish oil found stores like CVS was recently recalled because it was found to have large amounts of fire retardant in it!  These supplements are NOT regulated by the FDA.  Thirdly, be careful when you compare costs.  The cost of hospitalization due to acute pancreatitis (a risk of very high triglycerides) far outweighs the cost of taking Lovaza for even several years.   If you have a real disease, you need a real drug.  And, until Costco does a prospective long-term clinical trial to show that it lowers triglycerides, it should not be used in place of Lovaza.  Finally, I am a living example of how taking a high-potency supplement form of Omega 3 barely lowered my triglycerides, yet within 2 weeks of being on Lovaza there was a significant difference.  I am now at my goal.  So, before you knock a company, that, in my opinion, has saved my life, please do your research and do not mislead people into thinking that an Omega 3 is an Omega 3 is an Omega 3.  If your insurance covers the most potent, the most pure, and the ONLY proven Omega 3 pill on the market, you should be thankful.

A membership to Consumer Labs is one way to check the actual content and purity of at least some supplements, as it is an independent test and less subjective.

Regarding the debate over Slo-Niacin vs. Niaspan, I researched this and found that Slo-Niacin has FULLY HYDROGENATED OILS as a base (check the ingredients listed on the bottle).  This can't be good(?)  What do you think, Dr. Davis?  Thanks!

So just because it is approved by the FDA means it is the only good source.  Sorry but no!  The FDA has allowed many dangerous items to hit the market to only go back and recall them later.

I would much rather use a fish oil that was independently tested than any thing tested by the FDA.  IFOS 5 star rated fish oil is the only stuff I have been using.  Actually my whole family has been using them with great results for many different issues.  I am not here to promote any particular brand over another so I will not say which one I am using.  Every batch is independantly tested for purity and for mercury, toxins, and what not.  

I see a lot of people saying they get the stuff at GNC or Target or Walmart.  I do not believe you are getting the same quality and from the labels I have read you need twice as many pills to get the same amount of EPA DHA that I get per capsule.  Minimum I want 600mg of combined EPA & DHA per 1000mg capsule usually at a 2/1 ration 400/200.

I pay around $25 for a 90 capsules and I take 3 a day.  Less than $1 day and I know they have been tested.

Not sure where Dr. Davis' numbers come from either. I just got Lovaza for $29.09 for 120 caps. I guess Milwaukee has higher prices. That's $0.24 per cap, less than a dollar/day. Each cap has 840mg EPA+DHA. Dr Davis, can you sight where your info comes from?

When I first researched fish oil, I came to use Res-Q 1250. This brand has the claim of getting it's fish oil from Norway, supposedly purer. From Amazon, it was a total of $46.95, (price+shipping), for 200 caps, and only specified a range for EPA+DHA of 690-755mg. This came to $.023 per cap. So, I'm paying $0.01 more per cap, for a more concentrated product. And I get to write off the expense on taxes, not a big thing, just an observation/benefit I don't get buying over the counter.

Anyone else tried Res-Q? Does anyone have info on the purity of Lovaza?

Mike Randle:

You only paid that much because your insurance covered the rest. IF you were paying full price, then the only explanation is they charged you the wrong price.

If you want to see what Lovaza retails for check out a big discount online pharmacy: http://www.prescriptiongiant.com/lovaza-omega3acid-ethylesters-capsule-p-3141.html

It costs 10x more than there than what you're claiming you bought it for.

from the WSJ
"There's no evidence Lovaza works better or is purer than high-end omega-3 dietary supplements -- such as those made by Nordic Naturals Inc., of Watsonville, Calif. -- which cost less than half as much as Lovaza does per gram of EPA and DHA.

A 2004 analysis of 44 kinds of omega-3 supplements by ConsumerLab.com, based in Scarsdale, N.Y., found that none had unsafe levels of mercury or PCBs. And Lovaza wasn't used in most of the promising clinical trials with omega-3.
"
   URL for this article:
http://online.wsj.com/article/SB119975627038373627.html

Well, I just got a prescription for Lovaza, and I got it specifically because I cannot afford to BUY fish oil (or any other supplements). While I would agree that it's very likely a rip off and that there are indeed suitable and lower cost replacements, I neither do I wish  to compromise my health. My feeling is that the vast m of Americans enjoy a very high standard of living, and that on the whole ours is unquestionably the most spoiled, ungrateful and narcissistic society on the planet. I'm surrounded by people driving gigantic gas guzzling trucks and SUV'S and filling up shopping carts with things at Costco - you would be hard pressed to know that there's any real "suffering" at ALL going on. I go to a community college where I would say the majority of kids parents buy them cars, and they all have laptops and iPods.. something I never did growing up - and evidently the majority of freshman students at the local State University come form households earning more than $100,000 a year. My father brought  home $30,000 a the peak of HIS 30 year career... and I have to try and get by on less than $8,000 per year. SO.. I don'[t really feel so terrible about letting other people , most of whom are doing considerably better than I am ( to say the least!) share the cost. And yes, I'm grateful. And yes, CERTAINLY the FDA needs to crack down and  the insurance companies need to start paying for lower cost and more competitively priced medications and supplements. I think there IS (thankfully) a nascent rise of awareness and acknowledgment of the important role preventative medicine can play in our health, too.  Unfortunately we have an oligarchy here now and the food industries and Big Pharma have a stranglehold on Wsshington with all their lobbyists and influence. it's disgusting.

In the face of  the unrepentant greed that forms the basis of our entire culture and society today,  should I ignore my own health and go wiThout? Well I don;t feel that great about it, but for now I'll take the Lovaza,  at least until such time as I CAN pay for the admittedly far more sensible and lower cost fish oil.

I'm baffled as to WHY the insurance companies won't just pay for the fish oil and save a hell of a lot of money, LOL! Crazy.

Well, given that I live in the wealthiest most spoiled, ungrateful arrogant and narcissistic society on the whole planet , surrounded by overfed people driving gas guzzling behemoth trucks and SUV'S and who regularly fill up entire shopping carts with consumer goods, booze and comestibles, and given that I cannot afford fish oil or any other supplements on my income of less than $8,000 a year, and although I certainly concur that the whole Lovaza thing is largely a rip off concocted by Big Pharma, I'm disinclined to compromise my health and i can't say that I feel particularly guilty about it . I go to a community college surrounded by kids whose parent buy them cars and who all seem to have iPods and laptops, and I just read that the majority of the incoming freshman at the local state university  (that's STATE, not Stanford or UC Berkeley, which are also packed full at whatever THEY cost per year.. somewhere around $60-70,000 I'm guessing) come form households earning over $100,000 a year.  What occurs to me is that for beign in a supposed "recession" people really arent' hurting all that bad.

I'll take the Lovaza, and I'm grateful, and as soon as I can afford the cheaper fish oil then I'll avail myself of it. In the meantime, we should all focus more on exercise and preventative medecine, and we need to ensue that the insurance companies pay for lower cost replacement therapies and supplements. we alsoneed to break the starnglehold that Big Pharma AND the food industry have over Washington and the insurance industry (in Big Pharmas case anyway) with all their lobbyists. Our entire culture and society is BASED on greed, profit and excess consumption, so what do you expect?

I also hope and pray that the FDA will grow some balls and crack down hard and do the regulating they're supposed to be doing. late night television is a madhouse with all the snake oil and "mens enlarging" medications being hocked.

So yeah.. do I feel bad taking the Loraza? Sure it ought to cost less.. but given the unmitigated, unrepentant greed and selfishness I see going on all around me all the time - nah, not really. As  I said, I'll take he Lovaza for now , and I'll bet you I'll have MY house in order LONG before everyone else does.

I just purchased CVS 1200mg Omega 3 Fish Oil (240 softgels). They had a special buy 1 get 1 free for around $20.00. 1 softgel gives you 1200mg of fish oil which is a total of 360mg omega 3 fatty acids. In order to get the same dosage of Lovaza would that mean I will have to take 9 or 10 pills a day? My doctor prescribed me Lovaza but I can't afford it. Next time I will get the Costco brand! Thanks for your help!

I like Nordic Naturals Omega-3 liquid purified fish oil from anchovies and sardines (lower on the marine food chain), with a lemon flavor.  

1 teaspoon has 1725 mg omega-3 FA, including 825 mg EPA and 550 mg DHA.

I am so glad you posted this -- what a rip off.  The claim about purity and safety is B.S. now that there are independent third party labs like IFOS (International Fish Oil Standards) that verify safety and no mercury, etc.  

I think the best Omega-3 with high amounts of EPA and DHA out there are Dr. Sears Omega-RX (www.omegarx.com) and Omapure (www.omapure.com).  Both ultra pure and tested by IFOS. I use Omapure as it is cheaper.

It's great to hear so many "experts" commenting on how the healthcare industry works!  Does anyone know how much medicines contribute to every healthcare dollar spent??  How about 10 cents.  That's right... one tenth!  I wonder if the good Dr. knew that?

Society loves to point the finger at pharmaceutical companies for driving the cost of medicine and healthcare.  Hmmm... medicine contributes to a whopping 10 cents per dollar...so I wonder what really drives the healthcare ship???  How about all of those patients not taking their meds and ending up in the ER or on the operating table.  I bet that costs a pretty penny.  How about all the patients on anti-hypertensive meds who aren't taking their second dose because of the asymptomatic nature of the disease.  They feel fine, so why worry about taking their drug.  Next thing you know they wake up in the middle of the night, take an ambulance to the hospital and several hundered thousand dollars later have a triple-bypass surgery.

Managed Care Companies run, no sorry, dominate the healthcare industry!  MCO's dictate how doctor's should do their jobs and what drugs they "are" or "are not" allowed to prescribe to their patients!  Raise your hand if you knew many of these MCO's actually pay your doctor's salary?!  Raise your hand if you knew your doctor gets dinged everytime he/she writes a brand drug vs a generic drug?  Simply put, the United HC's of the world determine what drugs are deemed "worthy... errr... cheaper" for patients to take.  Pretty scary to think you can go to your doctor for a serious condition and not get the "best" drug (for your condition) because his/her formulary list- from the MCO company, doesn't allow it.  It's all about money!

Does anyone care if many of these "evil" pharma companies have hundreds of drugs in various phases of testing to cure illnesses such as cancer, HIV or diabetes?  Do you think a company, generating zero profit, can re-invest in testing and bring a new drug to market? Profit leads to testing which leads to cures!!!

There is a major misconception that generic drugs are 100% bio-equivalent to brand drugs.  Not true.  In fact, the FDA only requires generics to come within 15-20% bio-equivalent/bio-available to branded drugs.  This means if you are given a generic drug, one month your drug can come in at 80% equivalent to the branded drug and the next month be at 120%!  That means your generic had a 40% swing in bio-e from one month to the next!  This can lead to major tolerability issues, which could lead to a catastrophic episode, which leads to MORE money spent on healthcare!

Branded drugs are not a rip-off.  Branded drugs are approved by the FDA and are not the same as over the counters!  

There is a reason Lovaza costs more than any old dietary supp you can buy at GNC.  Every Tom, Dick and Harry pharmacy is making their own "pharmaceutical, doctor recommended omega 3".  Without the FDA regulating, who's to say your getting what they say you are?  Who's to say the EPA/DHA is 500mg's one month and 200mg's the next?  NO ONE!  That is why they are called supplements, not drugs.
Hypertriglyceridemia or hyperdyslipidemia are serious diseases.  They are a precurser to coronary artery disease and must be treated with great urgency!  An over the counter supplement, not approved by the FDA, not mandated to provide the EXACT SAME chemical makeup every month is not sufficient to treat such a serious condition!

Let your insurance pay for your medicine.  Isn't that what it's for?  I don't know about you folks, but If I can get a drug that makes me feel better and live longer, I will!  I am not going to complain that "I" am the reason the healthcare industry is so expensive, because "I" got the best drug for me!!!!

I went to fill my script for Lovaza and they wanted $80 per 120 count or a 30 day supply. And that is after my insurance kicked in. I know many will say it's a small price to pay compared to the effects of not filling it, but when you have to choose between getting a prescription filled, or feeding your family, I think most will feed the family. I would love to be able to get my meds as cheaply as some seem to be getting them.

My tri"s were over 550 and my Dr. put me on Lovaza. I was amazed at the cost when I picked up the script. I paid 20 and the insurance paid 160. The total being 180. My last script stated that the insurance paid 180, totalling 200. I agree, it seems rediculous, but my tri's are below 200 in 4 months. I have physically compared, by sight only, the color of lovaza vrs. "off the shelf" and the LovazA is MUCH clearer. I would hate to think its all the same, I really do think that Lovaza is better than store bought. I could be wrong, but I am not going to take store brands and compare tri numbers to see if I am right or not, thats what labs are for. I also take tricor 145 which costs $165 for 30 pills. I pay 20 and my numbers look good. I am NOT willing  to start experimenting to see what happens if I stop taking it or go to another cheaper drug. After a DVT and 3 PE's, I take what the Doc sais and I listen well. The PE's should have killed me, if high cost drugs keep me alive then bring em on baby. What about the 25 years I paid for health care and went to the Dr. once a year for a physical and never got a script or as much as an aspirin? I know its expensive now, but thats why they call it INSURANCE!

Hmmm, what to do about the high cost of a Rx fish oil to treat high triglycerides?  Or even the cost of OTC fish oil?  

Since consuming too many carbohydrates can raise triglycerides to unhealthy levels and is likely to be a significant CAUSE for the problem, rather than simply looking for an agent to reduce the triglycerides, what about the NO-COST option of nipping the problem in the bud and sharply curtailing or even eliminating starches and concentrated sugars?  Better for the waistline, better for the lab numbers and BG control, better for the wallet!  

Yes, there is life after bread and starchy side dishes.  Is it always easy when wheat and starch seem to be lurking in, on, or under everything in a meal?  No.

Is it tempting when well-meaning, clueless, or even health saboteurs deliberately push the high carbs foods on you?  Yes, sometimes.  

But a long-term strategy (remember the phrase "today is the first day of the rest of your life"?)  of substituting non-starchy veggies for the starchy sides or main dish at a meal, along with adequate high quality protein and natural fats, yields massive benefits, including not needing to spring for that expensive Rx fish oil.  

But too many people seem to think that they can continue the misguided habits that got them into an unhealthy predicament in the first place, because they're covered - by health insurance and a doc who will find the right Rx (pricey fish oil or otherwise) to mop up the mess.

Dr. Davis, I definitely think you are right that some of the Lovaza defenders who comment on your Lovaza posts are working for "the industry".  No doubt in my mind.

Anna...while I'm no expert on hypertriglyceridemia, I would venture to say that not all people have a say in whether their trigs are elevated or not.  Just like cholesterol, it can be hereditary and diet or not, will still have elevated numbers.

While eating a "non-starchy" diet may help, it's not going to work for everyone.  

As far as the Lovaza supporters being "pro-pharma", I say let's hear their thoughts!  It's evident a lot of posts/people have no idea how the healthcare industry works, nor how the cost of drugs work.  I would rather read an educated post, from someone who knows the industry, than a random tirate from a car salesman tired of paying too much money for his meds.

The problem with the media, and internet blogs is people believe what they read. People will come on this forum bashing Lovaza and walk away thinking it's a total rip-off and all pharmaceutical companies should go to hell.  I gotta think there's a reason why the FDA approves Lovaza over a GNC dietary supplement.

"The problem with the media, and internet blogs is people believe what they read."

I think most people believe those things that support what they already believe (confirmation bias) and they rarely challenge their beliefs with contrasting information.  We all fall victim to this to a certain degree - I know I was in that trap years of "trusting the experts" years ago and going along with whatever they recommended and my health suffered for it.  I won't be that passive anymore.  

When I learn that there's more to an issue than I been led to believe, then I try to "circle" the issue and gather information from all angles I can identify, also paying attention to the motivation, credibility, and experience of the source.  Whenever possible, I take my time and sift through the info multiple times.  

I wouldn't say I "know the industry" but I know people who work in pharma sales & marketing as well as drug development.  We live in an area with a lot of biotech and pharma businesses, so lots comes up in conversation.  My husband is a basic research scientist for a non-profit institute (with lots of friends and colleagues in Big Pharma) so he's a great resource for me to bounce ideas off of and separate the wheat from the chaff.   My gut impression is that the public places far too much trust in the "experts" and could do with a lot more critical thinking when it comes to their health, but they'd rather be passive and instead rely on labels, whether it's "FDA approved", "USDA certified organic" , or Fair Trade".  is vigilance necessary with the supplement industry?  You bet!  It's buyer beware all around.  

I've learned to pay little attention to mass media health information because nearly all of it is misinformed, oversimplified, and incomplete, if not outright wrong.  Internet information is extremely useful, but as you are right to point out, one needs to be careful as there is a lot of garbage info online, too.  

I think one needs to be open to new information, but not necessarily accepting of it all, and be willing to adjust views when the best information you can find supports a change of view, even if it is a 180° shift and contrasts with the Conventional Wisdom.

The current full price in NY for 120 capsules (30 day supply) of Lovaza is $156. After insurance kicks in, it's about $31.

Try  Coromega Omega 3.  The cardiologist told me it is one of the best-absorbed supplements and it is not perscription.

The cost numbers mentioned in the original post don't make sense the way they were stated.  

If people are taking 4 caps per day, and the OP states the cost is $70 per capsule, then that's $280 a day.  That would then be $280 a day x30d with a scrip written for #120 capsules a month = $8400 a month??  No way.

It's more likely that $70 is someone's co-pay with insurance, and that's the cost per month to fill a prescription for 30 days.  I'd think that's what the OP meant, per month.  

I'm in Wisconsin, but not Milwaukee.  I have a good HMO plan and I'd bet a scrip for Lovaza is nowhere near $8400 a month, which would then be $100,800 a year.

Do a Google price check. It comes out to $8400 a year average more or less depending on your dose and quantity taken per day and where you fill your scrip, your health plan, etc.

I appreciate all the info on Lovaza, but still have a question, I haven't seen addressed.  After trying nearly every statin available, my cardiologist prescribed Zetia.  I told my GP that I thought it was causing loose stool, and he switched me to Lovaza.  Six months later, my TG levels are the lowest in years, but I have developed severe calf and thigh pain.  Cardiologist stated Lovaza could not cause this pain, but the GP says it can, and took me off Lovaza as of 6/25.  Anyone else ever hear of leg pain (frequently associated with statins) caused by Lovaza?

First off you can't just look at the amount of mg of the softgels but the purity of the omega-3 components. Pharm or commercial grade products are much more purier than OTC products. For example take organic produce vs non-organic produce, you can usually buy non-organic items which are bigger and cheaper in price than true organic ones but everyone knows that the organic produce is much more purier and better for you.

Second as for price it really depends on your insurance. With my insurance I only pay $25 for a 3 months (90-days) supply at 4 tabs/day that's 360 tabs, that only cost me $100 for an entire year which is comparable with OTC ones.

I know how y'all can really stick it to big pharmaceuticals... just stop buying pills altogether and let whatever disease ravage your body. When it's all over, you, well, your families, can show them how much money you saved not buying meds by showing them the bill for your funeral.

Please be careful when taking large doses of niacin.  Large doses of niacin can cause very serious (potentially life threatening) side effects.  The risk increases as the dose gets higher.  Since niacin sold as a dietary supplement may have a higher dose than labeled, it's really only safe to use in smaller doses, where dose variations can be easily handled by the body.

The risk for serious side effects also increases when you take a slow or extended release formula.  This is because there are two ways the body processes niacin.  The first route handles a small stream of niacin.  Slow release formulas keep this first route busy for extended periods of time, which ends up increasing the risk of dangerous side effects.  The second route handles larger, "overflow" amounts when the first route is maxed out.  The niacin processed through this second route is processed more safely with a lower risk of dangerous side effects.

In other words, it's safer for your body to quickly process a flood of niacin than for it to process it a little at a time.  Unfortunately, the safer, second route causes the most obvious, common, and annoying side effect, flushing.  But rather than see flushing as a side effect to be avoided at all cost, we probably should see it as a sign that the niacin is being safely processed by our bodies in a way that also produces the greatest health benefits.

I'm not sure why a doctor would start someone on Niaspan or another slower-release formula without first trying them on a safer, immediate release product.  Sure, flushing can be very uncomfortable, but it's not the end of the world.

Personally, I looked at the pros and cons, and decided that I could not accept the risk of taking an OTC formula in large, poorly regulated doses.  I also could not accept the risks associated with extended release formulas.

For me, the safest choice is an immediate-release, pharmacutical-grade product such as Niacor, which, thankfully, is also reasonably priced.  Don't be surprised if your doctor and pharmacy are unfamiliar with Niacor.  I had to spell it for my doctor, and my pharmacy didn't stock it, so they had to order it for me.

I am working for a Norwegian health food company. No, I am not an employee, but a text consultant. No sales pitch here. The new stuff on the market is Krill oil. Krill is way down on the food chain, subsisting on animal plankton. The omega-3 from this krill oil is in a liphoform form, that allows it easilier penetrate the cell membranes.
Now, in Norway I buy this by mail order for about $150,- a year, with a one capsule a day dosage, 300mg.
I do believe that this product is commercially available in the US. Look for it.
As far as plaque depsotits in your arteries are concerned, there is a new "drug" available, vitamin K2. Check it out. There has been some serious research done on this. The Amsterdam  Study, 4800 people, 7 years. University of Maastricht, Netherlands.
This is the real McCoy.

Anders Gjersoe

Oslo

anders.gjersoe@nutricon.eu

Lovaza has lowered my triglicerides when diet, exercise, and OTC high dose multiple capsules of fish oil supplements did not. I do agree that the price is too high but Lovaza has helped me finally meet my goal of normal lab values of triglicerides so I am willing to pay the price. By the way, my arthritis pain has decreased also since taking Lovaza.

Do you even have high LDL?  What are YOUR health concerns that we taxpayers may take on in 'shifting' of dollars.

I just found out that my LDL is 164 and I'm a super healthy guy.  I eat properly and exercise every single day with no vice habits to speak of.  In fact I work my ass off to stay healthy so as NOT to 'burden' the system.

I'm doing some 'homework' here because my doc just prescribed Lovaza for me. While I understand the notion that there are possible generic equivalents I won't know for 3 months if this stuff even works for me.  In the meantime I will not be made to feel as a 'freeloader' for finding out.

My Grandfather died from Heart Disease at 60.  That's only 17 years from now for me.  I'm not ready to die for the sake of saving you a few dollars and I don't appreciate being bucketed as a selfish, pill popping degenerate.  Yeah- you did come off that way, believe it or not.

I so rarely go to the doctor that don't feel that I've burdened my fellow taxpayers at all as I pay more taxes than 80% of the population.  When is my time?  What gives anyone the right to judge others for finding a life saving health solution?

If Lovaza works for me I'll ask my doctor about the generic solution as on paper it makes sense.  Until then- judge less and leave your posts to the facts please.  You aren't the only one giving hard earned pay to the government.

I like this fish oil because it's the only one that doesn't cause Fish Burp.  The drug store and Nutrition store brands all cause you to burp nasty fish burps.  I am willing to pay $55.00 a month to not have that side effect.

Fish oil doesn't work anywhere near how Lovaza works. What "fish oil" product do you know that can reduce triglycerides by 50% in three months, from 800+ to about 400? Rip-off my arse. It works. BS "fish-oil" products don't.

J--

In the last 1000 patients, around 5 have used Lovaza. The rest have used fish oil from the health food store, pharamacy, or a store like Sam's Club.

The store-bought fish oil works great at a far greater price, including in people with familial hypertriglyceridemia, i.e., triglycerides of 500-2000 mg/dl. Yes, fish oil from the health food store works great.

The cost is ridiculous and unreasonably high.  However, I must say that the over-the-counter medications are

1.  Not regulated to guarantee it's composition.  Meaning they do not have to prove that what they say is in the capsule, is in the capsule.  I'm not saying that the company is lying.  I'm just saying that there is absolutely no 3rd party regulation of it's quality.

2.  That goes the same with it's mercury content.  Lovaza is tested to ensure that it is mercury free (or at least only has an acceptable level).  There are some brands of over the counter's that say mercury free, but remember those claims are not required to be proven.  


With that said, I take an OTC brand that I trust (somewhat blindly), but remember that it costs money to ensure that medications are safe, and that cost is given to the customer.

On another note:  slo-niacin, releases in a way that produces a toxic metabolite that harms the liver.  It is not released the same way that Niaspan is, which doesn't give the toxic metabolite.  

Sort of ironic that the two unsafe forms of niacin (immediate release and slo-niacin) are available with out a prescription, and the only safe form requires a prescription.

Just food for thought from a lowly pharmacist.

Thanks for your comment, Michael.

However, I believe you've fallen for the bait: There are plenty of data documenting the ABSENCE of mercury and pesticide residues from fish oil nutritional supplements.

The notion that Lovaza is pure and nutritional supplements are not is simply not supported by any of the independent test that have been conducted, including a study by Consumer Reports and two by Consumer Lab (an excellent service, by the way).

Yet another conspiracy on the Internet.  Lovaza was and has never been as expensive as the blogger claimed.  Stick with cardiology and stay away from math.

My cardiologist has prescribed Lovaza for 6.9 ratio of TC over HDL. Trigs are normal.  I have been taking Lovaza for three weeks.
My concern is that HDL has dropped by 7 points to 30mg/dl. Has anyone had this reaction?

yes, if you drink at all your HDL will drop mine did. doctor said try stop drinking for a month and see if it changes positively.trigs will drop with Lovaza, but HDL will also drop if you are still metabolizing alcohol and associated carbs with it

Thank you for the comment about alcohol.  I don't drink alcohol but I have been taking a beta blocker, Atenolol, for about 20 years and wonder if that messes with the cholesterol numbers.

That is amazing that the posters will take a statin instead of red rice yeast. You can get reductions in LDL instead of taking an expensive rip off drug called a statin. Wait, you take that statin because it is an indicated drug that is powerful enough to give you the drops you need in LDL and also has hard clinical data behind it as well as specific dosing. Lovaza is a highly purified and esterfied (stabilizing process) form of omega 3. There have been many independent studies even by consumer guide (and others) that have tested supplements from walmart(etc) and found little to no omega 3's in them.  This is because the contents aren't regulated by the FDA so they can put whatever they want on the label. Also, the supplements aren't stabilized so the omega 3's oxidize (break down) rapidly on the shelf. You will never have what is on the label in the actual pill because it is following simple chemistry. Lovaza is stabilized and has a shelf life of aprox 2 years. When you look at lipids you need between 3-4 grams of epa and dha a day to get reductions in TGs and inreases in HDL. These studies were done by Mayo clinic. Lovaza is 3.6 grams of Pure esterfied epa/dha. You can do the math on the supplements to equal Lovaza but what is on the label in the supplements is not what is actually in the pill. If you don't believe me send your walmart brands to a lab to be tested. The cost is $14. They can be done at any lab or state college that has a science department.
There have been studies comparing Lovaza to supplements and it took between 15 to 18 supplements a day to equal Lovaza. Published in the journal of cardiovasc risk.
Lovaza is to treat a specific disease not to be taken as a daily supplement. If you need TG reductions or HDL increases go with a perscription drug not a food supplement. If you want to take an omega 3 supplement take the stuff at walmart because yes it will give you some omega 3 and is less expensive.
As to the cost, a high majority of insurances will cover Lovaza for LESS than a $30 copay. If it were a rip off the ins co's wouldn't cover it at a 2nd tier and would have many prior auths. The company that makes Lovaza also has rebates of $20 a month which will put the copays to LESS than $10 a month. Very inexpensive! The cash price with no perscription coverage (just checked) is $140 a month. If you do not have insurance i would venture to say that you probibly can not afford any branded drug and gerics are the best option. However, there is no generic Lovaza so an option like gemfibrozil is probibly your best option. However, if you are currently on a statin there are bold warnings against the use of the two drugs so I wouldn't take the two drugs together because you could get rhabdomyolysis (breakdown of muscles).
Do not just listen to people bashing a product with out doing some research on your own. The FDA and American Heart Association both reccommend perscription omega 3 (Lovaza) and not supplements for the treatment of TGs and HDL! Are you going to believe independent orgs like AHA or the FDA or people on the internet that don't have a full understanding of the difference between an FDA approved and regulated drug compared to a non regulated food supplement. It is funny that people on this post recommend a supplement that they probibly sell and make money off of. So remember that as well.

Last Anonymous--

Your comment is so full of misinformation, I'm tempted to make it the focus of a blog post to show how far misinformed people can be.

If you have an analysis showing that fish oil supplements don't contain EPA + DHA, I'd like to see it. I have never seen any such analysis. In fact, the opposite has been true: Analyses from Consumer Report and Consumer Lab have show accurate labeling for all brands tested.

I just paid $45 for this and when I Googled to find it was fish oil I felt dumb as hell.  

For that mark up you think they would cover the fishy smell up.

Going to over the counter.  Thanks for the info.

Lovaza is a 3rd tier drug on my insurance plan and I paid $115.00 for one month.  Will be changing.

I was told by my doc. that I has high triglyceride and that I had to rush to walgreens immediately and pickup the perscription LOVAZA that she was calling in. For a month supply, Lovaza cost me $200+ with insurance only covering $45. After getting home, I was very annoyed by the cost so I did some research and found that Lovaza isn't any special other then FDA approved. I found an over the counter omega-3 that has the exact same amount of omega 3 fatty acids for $25 per months supply. Lovaza is such a rip-off. To all.. if you doc perscribes Lovaza, ask them why they are not suggesting the over the counter and if they are getting any kick backs.

No one should feel guilty about using medical benefits. What everyone seems to forget is that every link in the chain of medical care is composed of millions of people, jobs, and salaries that are taxed and contribute to our greater wealth, and prosperity by the circulation of the money that is set in motion by this activity.  If we woke up tomorrow and found out that no one needed health care any more we would at once be blessed by the ability to be healthy but millions of people would be thrown out of work and indeed our economy would collapse as surely as it would if we did not need to eat, vacate .. LIVE anymore. To see health care as anything other than an important and productive part of economic life and the human journey is selfish and small minded in the least.

We need to maximize our use of medical insurance benefits to keep the economy going and to keep people in the healthcare/sickcare industry employed?  ROTFLMAO!!!  

I hope that is a joke comment.  I'm fairly certain it was made by someone employed in the pharmaceutical industry.

For grins, let's take the same logic, but we'll use another huge area of the economy that seems to keep growing and costing consumers more  - crime.

Criminals need to keep committing crimes to keep the economy going.  Can't have all the people in law enforcement, insurance claims, the judicial system, prisons, etc. losing their jobs because criminals decide to live lawfully, can we?  Think about all those prison guards, those parole officers, etc. who would have to find another occupation. OMG, what if lawyers were out of work and  unable to afford their high-end lifestyles?  There's no telling how much a lower crime rate might devastate the economy, so criminals need to keep that crime rate up, and perhaps work overtime to raise it a bit more, eh?

If the University of Michigan won't cover Lovaza because there is an equivalent available OTC then I think we are safe to say Lovaza is a rip-off. See for yourself:
http://www.benefits.umich.edu/forms/otc.pdf

I don't know where you get your figures from...At Walgreens, you can get Lovaza 1G for $1.75 a capsule...that is without a plan of any kind. My local drug store will give it to me for $1.33 a capsule...this is in New Jersey.  Your claims are outrageous and so are your figures!!!

This is a celebrated article as they all are. I from been wondering about this looking for some time now. Its gigantic to receive this info. You are reasonable and balanced.

To complain about someone using the insurance that they earn is just not right.  Our school factors in the cost of our insurance to our salary...the state does  not pay for our insurance!

One of the reasons I went to college was to qualify for a job  in which I could get insurance as I grew up w/o any and I know it's value.  I went from poverty to comfortable, but I had to work for it.  I also owe more in student loans than I bring home in 2 years.  I definitely use my insurance to improve my health!

WEll, I am 63 years old...do not have a prescription plan of any kind - and my husband and I pay $550/month for health insurance that has a $7500 deductible....It's, as Mr. Obama once said "house insurance".  I was prescribed Lovaza today after Lovastatin caused much lower back and leg distress....and I am going to have to rely on fish oil and will do research to get the best available....What else can a thinking person do?   Mary, Hershey PA

Ah, This is great! Dispells
some contradictions I've read

Per my doctor's orders, I have been taking 4 grams of fish oil per day.  I'm concerned about the recent lawsuit against several fish oil brand names over high PCB levels.

Wouldn't  this be a reason to take Lovaza, at least until we learn about the result of the lawsuit?  

Thanks for your opinions.

I will not comment on the cost issues but there is one one thing to keep in mind: Lovaza is NOT identical with omega-3 fish oil. Natural oils are triglycerides, while Lovaza is a so-called ethlyester. It is NOT a natural product, but a drug-like preparation that has been shown to lower triglycerides in man. This property has not yet been demonstrated natural omega-3's. Also, Lovaza is the ONLY etyhlester that can be legally sold. Health stores (or costco) can only sell natural supplements like unmodified fishoils, not drugs like Lovaza. One cannot simply asume that these chemically different compounds have the same effect in our body. It may be a possibility, but who wants to take chances when it comes to personal health?

My husband and I (both retired pharmacists) take OTC 500 mg niacin 3 times daily - he takes 3000 mg/day, I take 1500 mg/day.  We both have great LDL/HDL rations, high HDL, and my triglycerides dropped from 800 to below 150.  Need to start low dosage and work up over 4 to 6 weeks, and take with food, to reduce the rash and itching.  Also helps to have a little tolerance for an occasional itch.  But by and large, we have little or no side effects (8 years into the regimen).  1000 tablets Rugby brand 500 mg (not timed release) - a 3-month supply for both of us - costs less than $25.00.  By the way, before I took niacin, my Doc had me on two different statins; both caused undesirable side effects.  Check with your docs, folks - do yourselves a favor.

Joan R.

Omega three fatty acids are food. They are not drugs. They are essential fatty acids, especially for the nervous system. EPA and DHA are required for structural and signaling functions in the brain. DHA is the most important molecule in the retinal rods. Without DHA you would not see much at all. And in dark light you would be blind. Triglycerides go done nicely with this food intake. But you can simply buy a bottle of Norwegian fish oil, read the label to see what its EPA DHA content is per ml and take a tablespoon or two each day with your salad instead of olive oil, or any other oil. It is inexpensive compared to any pill form and it is as eating fatty ocean fish. If you eat farmed fish by the way you get little if any EPA DHA, since the are not feed EPA DHA food. Fish do not synthesize these fats. They eat them from up the food chain, starting from algae and plankton.

My wife and I are on Social Security and Medicare, with Medicare Part D prescription drug plans (PDP). My wife is already in the Medicare "donut" hole for 2010. Her endocrinologist just prescribed Lovaza to treat her triglycerides. He had previously prescribed Trilipix, but it caused her muscles to become inflamed and joints so sore that she could barely move.
The Medicare "donut" hole means she pays full retail for her prescriptions for the rest of this year, since she will barely reach the "catastrophic" level of drug costs by year's end. Even if she still had drug coverage, Lovaza is not covered by her Medicare drug plan.
I just checked at the web site drugstore.com, and the cost for her prescription - 1000mg capsules 4 times per day - is $179.66, or $2,155.92 per year. There is no way we can afford that kind of expense with our other medical expenses. We are exploring alternatives now, but Dr. Davis's recommendations sound good to us.

My ranitidine is $40ish at the drug store, $9 at the VA, and $5 at WalMart.

Our first child cost $10,000, our share was $2000.  After I made it clear I wasn't paying $50 for latex gloves (really) and $15 for a pitcher of water FILLED IN THE BATHROOM FAUCET (Really), the hospital offered to settle for $600, in writing, no damage to my credit.

So, why didn't the insurance company call and bitch and get the bill dropped to $4K or so to start with?

And remember, it was union activists who created this system.

the entire healtcare industry looks for how they can squeze insurance company for all they are worh and when the insurance company says they will not pay for "unnessicary" treatments the individual is stuck with an outrageous price. my GF broke her hand a while back and the ortho office charged her for medical treatment for a metacarpal fracture and they didnt even treat her. didnt even touch her hand. the just put a splint on her hand that cost $60, and charged over $800 dollars just for the Dr. to come in ad say there was nothing they could do. isnt that what the $300 office visit cost was for? i dont know but having a Dr. come in and say you need a splint qualified as medical treatment worth $800

I can't believe this thread has been open for an entire year!  Wow.  I would probably never buy Lovaza, but I would also never buy the "Sam's club" brand of fish oil capsules either.  The reason you get "fish burps" is because the oil has oxidized on the shelf.  High quality fish oil doesn't cause "fish burps".
   People have brought up some good points about third party testing and I agree with them.  After hearing about some of the drugs pushed through the FDA before proper safety tests were done, I wouldn't necessarily consider the FDA a good third party test (eg; Prozac and teenage suicide, Meridia and heart irregularities).
    Get a good quality fish oil, Nordic Naturals is good and independent-third party tested.  Keep it in the fridge and take two pills per dose instead of one.  It'll save you money and it's a good idea anyway.  Fish oil is good for you

My name is Michael Smith and I manufacture The purest Omega-3 in the world. Naturecol. I worked as a production chemist for GSK for 25 years until retirement. I am better than GSK, and my omega-3 is level better than anything that they can produce. One month's supply of Naturecol's Omega-3 EPA costs $34.99 ( 60 capsules/bottle)
2 a day delivers water-white Omega-3 EPA ethyl ester

www.naturecol.com
msmith@naturecol.com

Great article, we need more people like you explaining these prescriptions.  Well done and thanks!

Consider yourself lucky if your ins. company will pay for Lovaza. It is the best and well worth it.

I have been on Lovaza since March 29,2010. My cholestral and Trtriglycerites were both about 240
and I weighted about 240, in 3 months I have lost 45 lbs and my cholestral and triglycerites levels have dropped, down to about 166. Don't missunderstand me, the lovaza had nothing to do with my weight lost. I have insurance and a co-pay. I also have a discount card from Lovaza, So instead of paying 30.00 each month I pay 10.00.

I have been having a weakness in my body. cold like symptoms going on. I couldn't figure this out, I usually feel healthy as a horse. then I realized. the lovaza. I have been taking that for over 2 mos. I am going to start taking over the counter fish and flax seed oil starting tomorrow and I bet all this mess stops.

It is amazing the amount of awareness for our need for Omega-3's.  I have been studying this for the past 3 years.  It is important to make the healthiest choice which is not necessarily the cheapest choice in choosing which Omega-3 product to take. After my research I decided that the best choice is the only source in the world that has all 18 Omega-3's from the Green lipped Mussel Oil from New Zealand.  It is the safest, purest and most effective source that I have found.  My whole family has had amazing results with a product you can order online at www.mymoxxor.com/4life

I take Lovaza and have for a year. At one point during the year, I purchased a 3 month supply of 1G Omega-3 at sams club. This was shortly having my bloodword done. For 3 months I took the OTC brand. My blood was taken and when I went to the Doc, he said, the Lovaza isn't working we need to step up one of your other meds. I confessed to what I had done beccause he was going to change something I had just purchased a 3 month suppy of. SO there is apparently a difference. He eventually took me off of Zetia and put me on 2000mg of Niacin which is working well for me - it is not for everyone.

Just a comment here. Have you noticed how the music in the lovaza add drowns out most of what is being said. Lots of pretty pictures and music, but what are they saying. Sounds like "buy my fish oil". Oops, no they don't call it fish oil do they. Hmmm, "snake oil" maybe???

I had a shaking disorder that I was born with, about 7 years ago when I was 42, I heard about fish oil from a friend and started taking it and in about 3 months it got rid of my shaking completely. I told friends how I did it and they started taking it for some of their health problems and it helped everyone of them. I said then that the drug companies were going to get wind of the miracle of fish oil and exploit it.

First of all...and MOST important, if WE who have Insurance and Lovaza is covered...WE pay that premium every month the get the prescription rates that we do. SO...YOU do not pay ANYTHING for ANY of my prescriptions..Second...LIPITOR...
are you familar with the "possible" side affects??? Liver damamge...Muscle breakdown...I happened to be one of those "Unfortuanate" people who encountered those side affects, and I must say, it was not pleasant...My cholesterol elevation, is strictly gentic, and not caused from poor diet, or lack of exercise...Lovaza...has had a "POSITVE" results with myself...

Let me say that I have no idea if Lovaza is a good product or not.  Many people here are defending it and I am glad it works for them.  On the otherhand, as a regular user of Costco brand (and now LEF fish oil), I can definitely say they both have worked for me.  My triglycerides have dropped substantially and my HDL has improved with 4 of the high potency capsules every day.  A side benefit was that the fish oil reduced my inflammation so much that I was able to take myself off  a dangerous and potentially life threatening NSAID that I had used for years for chronic back pain.  OTC fish oil may not be as pure as Lovaza, but suggesting that a good quality, independently- tested fish oil is not beneficial is not true either.

It's a ploy that has been used before by the drug industry.  They cannot patent and charge large amounts for a product that exists in nature, so they must modify it enough to satisfy the FDA that it is patentable.    Whether it "is" or "isn't" fish oil is apparently up for debate, but I notice the amount of EPA and DHA in Lovaza is listed.  The fact that those are the major active ingredients in fish oil makes the drug company claims look fishy.(sorry, the word fits, despite the bad pun) Purity?  Research indicates that simply eating more fish has similar effects.  If the entire fish can be useful, why the need for such purity?  Fish oil supplements HAVE been tested for contaminants, and no major problems were found.  Drug companies seem to not only spend massive amounts on promoting their own products, but also challenge natural alternatives. They spend millions on lawyers(seen a warning on a natural supplement along the lines of "This product has not been proven to cure any disease....?  Big pharma lawyers at work)  and after reading many of these posts, I suspect they are even planting comments.  It's hard to beleive some people have bought into the company line so hard.  
Another rip-off: the EMSAM patch is an expensive version of a much cheaper drug that has been used for years in Europe.
BTW, I am a pharmacist's son.  I know how big pharma markets, and it's pretty overbearing.

We are talking here about a nutrient that is deficient in the diets of most of us.  

What they have done is package an essential nutrient as a drug.  Chris (8/9/10) has explained this.

Another reason we are so deficient is due to the excess omega 6's that are consumed.  If you have high triglycerides you should not be using any oils except olive and coconut and until the TG is under control, limit nuts and seeds to walnuts (high in omega 3)and macadamia nuts (higher in mono-unsaturated fats than olive oil)

And yet another reason for deficiency is corn-fed beef.  We need to be eating naturally raised animals if we eat meat.

The insurance companies could save a lot of money if they simply provided a monthly allowance to purchase supplements based on diagnosis.  They could also provide you with a list of supplements that had been tested by independent labs and found to meet standards.  Wonder why they don't?

The goal of pharmaceutical companies is to make all essential nutrients into drugs.

My doctor has told me that the ethel ester form of fish oil is the cheapest to produce and the Triglyceride form is 50% more absorbable?  He gave me a list of three fish oils that fit his criteria.  Nordic naturals, Fortifeye and Lifeguard.  I am taking Fortifeye omega.  here is a very interesting link on  How to pick a good fish oil,  http://www.fortifeye.com/index.php?main_page=page&id=43

I am glad to see Fortifeye mentioned! Thought I was the only one taking it.

I would not even consider Lovaza, but that is me. I HAVE learned how to identify a rip-off regardless of whether my insurance will cover it or not.

I am a Registered Nurse and an Independent Distributor for Advocare International.  Advocare has a product called OmegaPlex.  Has 600mg of EPA and 400mg of DHA.  (and 6IU Vitamin E)  Lovaza has 465mg and 375mg of EPA and DHA respectively.  One bottle of OmegaPlex has 90 capsules for 19.95.  Recommended dosing is 2 Caps BID with food. Same as Lovaza. Manufacture and formulation of ALL Advocare products follow FDA and USP protocols.  What I find interesting is how just because something is "FDA approved" the public thinks it is somehow better, safer than something that is not.  It is my opinion that the FDA is like any governmental department.  It is about money.  As an MD do you feel acceptable side effect percentages as high as 25% of patients is acceptable?  I do not.  The average patient has accepted that side effects are inevitable most often.  For example weight gain, increased lipid profile and increased fasting blood sugar in anti-depressants.  But wait...give them loveza and glyburide to counteract anti-depressant side effects...drug companies make money, FDA makes money, insurance companies make money and we, as you have already illustrated, pay more.  I do know that all supplements are not equal, but just because Loveza is FDA approved doesn't make it the "best" supplement.  With profits and jobs being supported by this, how does one know the research which preceded "FDA Approval" is non-bias and efficacious?  

Thank you for your time,
M

Ran into a problem Friday, when my doctor attempted to prescribe me Lovaza-it wasn't in the hospital's formulary, so he couldn't prescribe it.  We checked, and with the manufacturer's $20 monthly coupons, cost to me would be $10/month.

No HMOs or other nonsense involved.  I take 3 grams of regular niacin daily, as well as Zetia in the evenings, and 600mg Gemfibrozil before 2 meals.

The triglycerides are familial, according to testing, LDL are not satisfactory at over 1000.  I cannot take statins, as they break my muscles down & turn urine black.

MD is going to try another presciption fish oil product, when the distributor supplies the pharmacy.  Sure hope it helps!

I just picked up my prescription Lovaza - $40.00 for a month's supply (4 caps/day).  So that's the price - no lie.

What if I instead went to Costco and bought their high-potency fish oil. This is also an ethyl ester form. It costs $14.99 for 180 capsules, or $2.50 PCPM; each capsule contains 684 mg EPA + DHA. I would therefore have to take five capsules per day to obtain the same 3360 mg EPA + DHA per day. This would cost me 5 x $2.50 = $12.50 per month, or $150 per year.

I was copaying $35. Copay went up to $71 for 2011. I think I will be finding a substitute. I don't care how much research or clinical trials it went through, paying more than $30 for a months supply is a ripoff.

autism and self injurious behavior with seizures (epilepsy). Would Lovaza help. The answer is YES. It is absolutely a doctor prescribed drug that could AUGMENT AED (anti-epiletic drug) therapy and should be considered by Kaiser or any other physician in the treatment of autism with self injurious behavior and seizure disorder. Yes, people poo poo the FDA, but this Lovaza seems a welcome alternative and adjunct to the harsher other drugs prescribed for autism with seizures and behavioral challenges. So yes, let's take this into consideration. Golly, it seems like there is a total anti-pharm attitude these days, but apparently these people have NOT lived with debilitating behaviors like autism and self injuryious behavior and seizures. Clearly, an adjunct therapy like lovaza couldn't do much harm, in cases of autism and intraccable behavioral disorders, with seizures in the mix. And if medical insurance covers it, especially medi-cal, than for God's sakes....let the autistic population benefit from it.

What's amazing about this thread is that no one seems to ask WHY their is such a huge difference between prescription fish oil/niacin and over the counter supplements.  I buy the best quality supplements (well known for their purity checks,etc.) and still their prices are 1/10th that of the prescription version.


Some people here bluster and posture about how they would not "risk" taking anything subpar to an FDA approved drug.  But are you telling me that FDA approval raises the price 10 fold?  

For a nutrient that has been used commonly for a least 1/2 a century?

If that's the case we have another huge problem.  We are bankrupting ourselves due to the high cost of approvals/clinical studies and what the pharma's "have" to add on to make a profit.

This is ridiculous.  Excellent supplements are made.  There should be a way to test them and get them to the public without multiplying their cost by 10. Will a doctor only trust something that has passed through so many channels of approval that it either bankrupts his patients or his country in order to prescribe it?

That's just plain wrong.

What happened to common sense?  Have we completely lost it here in the US?

How is this post so great?  It's typical "big pharma and government sucks" bs.

Has anyone check the pricing claimed on this post?  Check drugstore.com

Did you know each pharmacy charges a different amount for drugs?  It's true (and unfortunate).  Make sure you shop pharmacies like you would shop different stores for cheaper produce.  

If you don't want to buy branded pharmaceuticals get a generic but it should be another persons right to blow there money on an expensive drug if they want to.  

Last thought, your premiums for insurance and drug coverage is going to keep going up because insurance companies are just a greedy as big pharma and the government!

Yes, I had a similar problem and almost ended up not being able to walk. Once I was off the Lovaza, all of those problems disappeared, although it did permanently affect my reflex response. Now when I step on sharp or uncomfortable things with my feet, I do not have the automatic reflex that pulls your foot away. Certainly an annoyance, but not as bad as having my legs burn and not always support me!

I have been having the same simptoms... have been off lovaza for more than a month but still having severe calf and thigh pain.  What did you take to stop it?  What kind of doctor did you talk to?  Thanks,  Oswaldo

I appreciate all the info on Lovaza, but still have a question, I haven't seen addressed. After trying nearly every statin available, my cardiologist prescribed Zetia. I told my GP that I thought it was causing loose stool, and he switched me to Lovaza. Six months later, my TG levels are the lowest in years, but I have developed severe calf and thigh pain. Cardiologist stated Lovaza could not cause this pain, but the GP says it can, and took me off Lovaza as of 6/25. Anyone else ever hear of leg pain (frequently associated with statins) caused by Lovaza?

I am having the same simptoms.... still after a month and more off lovaza.  I dont like it at all.  Whad did you take, do?   Thanks for any experience you could talk about.  Oswaldo

Before the supplements are released to the market, it must be scientifically proven as to be effective and safe.
herbal supplements online

Dude, flush as you go. . . .

A word of wisdom to all....I had the flu in February 2011. I was put on 4 or 5 different drugs..some had horrible side-effects...especially Plavix. It has been 11 months and I'm just taking aspirin. Statin drugs caused swelling in my lower face and tongue as well as other side-effects. Doctors, most, not all are out to make money as well as the big drug companies. You have the testimony of several educated people here...nurses, doctors etc. Why do you not believe them?...You believe your doctor. They have an inside look into what is happening across the board. Folks are being ripped-off. Now I'm not telling you what to take or what not to take....but listen to your body...if you have aches and pains before you took a certain kind of medicine, well what does that tell you? Your body is warning you that something is not right. There are many different natural ways to help yourself...but sometimes you just have to trust in God and search for the answer. It will not always be an easy answer for you as the drug companies do not want you to know the facts....they would go out of business. Do you see a Walgreens or a CVS on every other corner? Wake up folks what does that tell you? Some of these prescribed drugs will actually make you sickier.....some will make you feel like your dying and some will even kill you. I checked with my physician and ask him about Lovaza, he neither praised it or denied praise. I think Dr. Davis has a good point here, one I am willing to seek out on my own. I will try the fish-oil supplements for a while....truth is through diet and exercise you can bring your cholestrol and LDL's down because I have done it. Before you bash the source ....check out what is being said to you. I was told my cardiologist, by the way he was just at the hospital when I came in the emergencey room, received close to a $2000.00 kick-back which I was told was listed in his income-tax statement as a speaking fee. In other words...doctors are getting big kick-backs off our backs...no pun intended. He prescribed Plavix to me and that was were the kick-back came from....guess what folks? ...Plavix is in a class-action lawsuit now...It kills!....still believe all doctors have your best interest at heart? I think not....but not all doctors are that way...but I would venture to say the vast majority are......So listen to what your body tells you....check out the internet, a great source of information, and make an informative decision for yourself. Doctors rely on all of us being trusting and dummies. That's how they convince us to take some of these dangerous drugs.....so dangerous that they will kill you before the problem you have will. So all who believe pray....and all who don't, pray anyway for guidance...after all what do you have to loose but your life? I will be taking the fish-oil capsules instead of Lovaza as my research on the web as opened my eyes. I ask if Lovaza was all natural in the doctor's office and was told yes in a round-about way. So I ask a pharamist and was told it was natural but that it was compounded differently than regular fish-oil....well what is that suppose to mean? I have discovered it is a drug and does have natural ingredients in it but it is still a drug. I have learned from experience drugs cause side-effects...some mild and some life threatening. I will try natural.....natural food and natural fish-oil as specified in this article. Thanks, Dr. Davis for your enlightening information and carry on your crusade for all of the sick people out there including myself. I am glad I was led to this web-site. I have made my decision.

thank you so much. I have been in good shape my entire life. My job of 20 years has given me so
much stress i developed hypertension. I run daily i always eat well and i have no heart issues. My
doctor put me on benicar and lozava. i don't have high cholestrol so i wondered why but again i
figured she knew what she was doing and everything seemed okay until my insurance cut my
lovaza! but i realized why am i taking this anyway? why is it so expensive? i started taking
fish and flaxseed oil again and nothing has changed! i use the benicar sparingly now as i have
controlled my hypertension with lifestyle changes. i like my doctor she's very nice and caring
and listens and askes question but now i have concerns some of the things she's giving me
maybe isn't in my best interest and more having to do with the scamming healthcare system!
thanks again for reassuring me fish oil is just as good.

Regardless of what preparation you choose, you can determine the dose needed by adding up the EPA+DHA content. For the basic prevention effect, the starting dose for the Track Your Plaque program, you need a total of 1200 mg per day of EPA+DHA. Higher doses, e.g., 1800-2400 mg per day, may be required for correction of high triglyceres or postprandial (after-eating) abnormalities.

I think you're right that'll be the easiest solution and it'd be nice if you can add more about the same topic with different solutions and versions to understand all the alternatives.
23jj