An aspirin a day to keep the doctor away

As America s health care spending continues to grow, does it become the government s responsibility to use public health policy to campaign for and encourage practical actions officials believe we Americans should be taking to rein in healthcare costs? David B. Agus, professor of medicine and engineering at the University of Southern California, believes that this should be the case, generally, and his specific brief now involves aspirin for all.

His op-ed featured in The New York Times argues for an official campaign, on a par with anti-smoking outreach, recommending that women over age 55 and men over age 45 take aspirin on a daily basis. He even says we can use the same rationale in promoting aspirin use as we do to promote the vaccination of our children.

Aspirin has many physiological effects. It has long been used as an analgesic, ever since being discovered in 1897 by German chemist, Felix Hoffman, who worked for Bayer. Since then, many studies have confirmed that aspirin can reduce the risk of cardiovascular disease, to the point where the United States Preventive Services Task Force strongly recommends that men ages 45 to 79 and women ages 55 to 79 take a low-dose aspirin pill daily, unless one is at a higher risk for gastrointestinal bleeding or has certain other health issues. There is also new research emerging about the benefits of aspirin in cancer prevention.

So if this is such a wonder drug, should it be made standard of care for physicians to inform their patients about this health care intervention, that may potentially save untold billions in taxpayer dollars every year, questions Agus?

ACSH s Dr. Josh Bloom is intrigued by the rather obvious message behind this editorial. To me, it seems as if Agus is saying that cutting health care expenditures can be accomplished by using old drugs. I wonder if people will realize when in the interest of cost savings they are getting second- or third-line therapies simply because they are cheaper. If that s what is in our future, you get will what you pay for second- or third- rate medicine.

ACSH s Dr. Gilbert Ross wonders if such a policy might actually be a net health benefit after all, given the clear evidence of aspirin s reduction of cardiovascular events, the most common cause of death in the western world. Of course, aspirin comes with risks, especially relating to GI tract irritation and bleeding. Any such general recommendation would have to come with a clear directive to discuss this medication, as with all medications, with one s doctor.