Emergency Preparedness - medications, ScriptSave WellRx

by Leah Samera
University of Arizona College of Pharmacy
PharmD Candidate, Class of 2018

Ready, a public service campaign designed to educate and empower citizens to prepare for emergencies such as natural and man-made disasters, proclaims September to be National Preparedness Month (NPM). In the aftermath of Hurricane Harvey and in anticipation of Hurricane Irma, you may be wondering how to go about preparing for such events. This is especially important to consider if you have a chronic disease or condition.

Illness Follows Disaster

Studies have found that upwards of 70% of the Hurricane Katrina survivors had at least one chronic condition. Additionally, 58% of the visits to emergency treatment facilities in New Orleans after Hurricane Katrina were due to illness, 24% of which were associated with chronic diseases. The research on disasters’ effects on chronically ill patients only serves to reinforce the fact that these emergency situations can lead to both exacerbation and death from chronic illnesses due to direct stress of the disaster, interruption of care, or both.

Emergency Plans and Kits

Organizations like the American Red Cross recommend having an emergency plan and kit prepared for use during a disaster. Some obvious items that should be included in such a kit are water, food, and first aid supplies. However, it is also critical that you have a 7-day supply of your medications on hand as well as any other tools or devices used for your health such as hearing aids with extra batteries, syringes, blood pressure cuffs, et cetera. In order to have at least a 7-day supply of your medications, you must order refills of your prescription medications as soon as you are able rather than before you run out. It is best to keep these items together and in a location that is easy to get to in an emergency.

Planning Ahead

Medications should be stored away from heat, light, and moisture; if possible, keep them in their original bottles and store the bottles in a waterproof bag or container. If you have medications such as insulin that need refrigeration, have a freezer pack and cooler available. It is also important to stay up-to-date on all immunizations, including tetanus, especially if you have diabetes. Additionally, because the stress of these disasters can exacerbate your conditions, it is best to also make appropriate lifestyle changes such as restricting salt intake if you have high blood pressure or learning the carbohydrate counting approach if you have diabetes.

Other Handy Emergency Items

Other items that you should have handy in case of an emergency include any over-the-counter medications you may need like pain relievers, as well as your medication list and insurance card. It is important to keep an up-to-date medication list that not only catalogs the names of your current medications but also their strengths, indications, directions, and prescribers; any bad or allergic reactions you may have had to medications in the past should also be documented. Your prescription benefit card may be needed for approval of an emergency supply if you run out of or lose your medications, or if your medications get damaged or contaminated.

In the event that you end up requiring medications and health resources:

  • RxOpen.org maps open and closed pharmacies, American Red Cross shelters, and infusion centers in areas affected by disasters.
  • The charity Direct Relief provides free prescription drugs and medical supplies to low-income patients at community health centers or clinics.
  • Keep a list of nearby pharmacies and hospitals as well as their phone numbers.

By doing what you can to prepare for disasters, you can lower your risk of exacerbations of your health conditions. As the theme for NPM states: “Disasters Don’t Plan Ahead. You Can.”

References:

  • National Preparedness Month. https://www.ready.gov/september. Accessed September 7, 2017.
  • Kessler RC, Hurricane Katrina Community Advisory Group Hurricane Katrina’s impact on the care of survivors with chronic medical conditions. J Gen Intern Med. 2007;22(9):1225–1230. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2219784. Accessed September 8, 2017.
  • Sharma AJ, Weiss EC, Young SL, et al. Chronic disease and related conditions at emergency treatment facilities in the New Orleans area after Hurricane Katrina. Disaster Med Public Health Prep. 2008;2(1):27–32. https://www.ncbi.nlm.nih.gov/pubmed/18388655. Accessed September 8, 2017.
  • Be Prepared for an Emergency. Be Red Cross Ready! http://www.redcross.org/get-help/prepare-for-emergencies/be-red-cross-ready/get-a-kit. Accessed September 7, 2017.
  • Emergency Preparedness for Prescription Medications. http://www.mayo.edu/pmts/mc6000-mc6099/mc6012-39.pdf. Published 2016. Accessed September 7, 2017.

Are you concerned Hurricane Irma
may impact your prescription refills?
The State Law may be on your side; early refills are permissible.

For medications not covered by insurance,
the ScriptSave® WellRx program is here to help.

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pill boxes medication adherence

If your doctor has prescribed a medication for you, you want to be sure you’re getting the most benefit from that drug. Medication adherence is important to get the most benefit from the medications used to treat your condition. The causes of non-adherence, when a patient either accidentally or knowingly does not take medications as prescribed, can be complex. Non-adherence is often the result of cost; patients who simply can’t afford their medications. However, good habits and a good understanding of the medication can also be a big part of adherence, and can help you stick to your medication schedule.

Medication Adherence

World Health Organization defined adherence as “the extent to which a person’s behavior – taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider.” The concept that healthcare professionals manage medical conditions is true only in case of hospitalized patients. The bottom line is, medications don’t work in patients who don’t take them, or don’t take them as prescribed.

In an outpatient setting, the healthcare professionals’ role is limited to providing products (medications and/or monitoring devices) and educational tools. Taking medications, on time and properly, is left up to the patient or their in-home caregiver. There are several techniques to help you remember to take your medications as prescribed and manage their own medical condition. As the patient, you have the ultimate control for safe and effective treatment.

Two Steps to Medication Adherence
Adherence to medication can be achieved in two simple steps; understanding and behavior changes. Understanding includes knowledge of your medical condition and how your prescribed medication can help to manage it. Here are a few helpful websites:

  1. http://www.patienteducationcenter.org/ – The health-related content on the website is provided by Harvard Medical School. Medical conditions are listed alphabetically from A to Z.
  2. https://medlineplus.gov/ – Produced by the National Library of Medicine, provides reliable information on medical conditions, drugs, herbs, and supplements.
  3. https://www.wellrx.com/ – ScriptSave® WellRx allows you to search for the lowest prices on prescription medications at nearby pharmacies, and provides overviews of the medications. Our Ask a Pharmacist phone line lets you talk to a pharmacist about prescription medicines, dosing, or medication interaction questions. Registered members have access to a free suite of personal wellness tools in the Medicine Chest, including:
  • Ask a Pharmacist
  • Pill Reminders
  • Refill Reminders
  • Medication Information (in both English and Spanish)
  • Medication Videos
  • Mood-tracking (to review side effects, etc.)
  • Price-check and Pharmacy Locator

Behavioral changes mean finding ways to stay on track with your medication schedule. Finding the right tool or a combination of methods that fit best your lifestyle is key to medication adherence. Here are some ways to stay on track:

  1. Integrate your medication to your daily routine, such as brushing your teeth or watching your favorite TV show.
  2. Set one/multiple daily alarm using a clock, mobile phone, or computer.
  3. Ask a family member and/or friend give you a call remainder.
  4. Pill boxes are another way to organize your scheduled medications. Pill boxes are available in different forms that allow you/your caregiver to fill them daily, weekly, or even monthly.
  5. Medication charts can be developed by own or with the help of a healthcare professional. Keep an updated chart with medication names, dose, when you take them, and what are you taking them for. You can refer to the chart if you get confused with your medications.
  6. Plan ahead for medication refills and mark a calendar to make sure you always have your medication when necessary.
  7. If you have a smart phone, the free ScriptSave WellRx app can be used to remind you to take your medications, refill your medications, and track how the medications make you feel.

We hope these tips on medication adherence have helped. Download our free app from the iOS app store or the Google Play Store, and get registered to take advantage of our free medication adherence tools. If you’re struggling to afford your medications, visit www.WellRx.com to compare the cash price at pharmacies near you. You may find prices lower than your insurance co-pay!


For the best Rx price on
prescription medications,
visit www.WellRx.com.
Compare prices at more than
62,000 pharmacies nationwide.

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Behavioral health medications for anxiety or depression - image

Jenny Bingham, PharmD
University of Arizona College of Pharmacy

There are a number of mental conditions that shape mood and behavior. Any condition that affects a person’s thinking, feeling or mood, falls into a medical classification of Behavioral Health.  Such conditions may affect someone’s ability to relate to others, or maintain reasonable function every day. Each person may have different experiences, even if they have the same diagnosis as someone else.

Depression is the most common behavioral health condition in the general population1. Without treatment, depression can lead to decreased quality of life2, increased suicidal thoughts, and overall worsened health outcomes. The most common method of treating depression is to target serotonin and how the body uses it.  Serotonin regulates mood and ultimately is what makes you feel happy. When we have low serotonin levels, you can feel depressed or anxious. Antidepressants each have their own unique mechanism of action that are specific to certain neurotransmitters in the brain.

Anxiety can affect our ability to function due to excessive worry. Without treatment, anxiety can also lead to a worsened quality of life and can even be debilitating for some patients3. Anxiolytics are the medication class used to treat anxiety. The most common method of treating anxiety is to target serotonin and/or norepinephrine.  Norepinephrine is responsible for motor action, cognition, the body’s alert system, and feeling energetic.  When we have low norepinephrine, it is harder to cope with every day stressors and things that are beyond our control.

How do these medications work?  

These medications are often classified as reuptake inhibitors. They target the neurotransmitters serotonin and norepinephrine, to name a few.  Medications prevent the body from recycling these neurotransmitters. By preventing them from being recycled too soon, it allows the body a better chance to use them to improve mood and/or relieve anxiety.

What can you do to make them work better for you?

We know that the body needs certain building blocks to make serotonin and norepinephrine. An important concept to remember is that no matter how many medications are prescribes to treat these conditions, they don’t stand a chance at being effective without the right precursors; an interesting concept in today’s world. The majority with these conditions take more than one medication.

Step 1: What is your protein source?

The greatest building blocks for serotonin are things that you might already have in your kitchen.

Complete proteins are the main precursor for tryptophan, which is later turned into serotonin. You might think that tryptophan only comes from turkey on Thanksgiving, but did you know that you can also get it from eating beef, venison, buffalo, pork, fish, shellfish, cheese, cottage cheese, milk, yogurt, and eggs? 

The building blocks for norepinephrine are also found in your kitchen.

In addition to eating complete proteins, it’s also important to eat incomplete proteins as well. You can find these in nuts, grains, beans, legumes, and soy.

Step 2: What else is included on your meal plan?

When we think about serotonin building blocks, key vitamins play an important role as well.

  • Vitamin B6. Great nutritional sources of this vitamin are found in whole grains, vegetables, and nuts.
  • Vitamin B12. This vitamin is found in meats, fish, liver, and milk.
  • Folic acid and Vitamin D3 are often found in fortified foods.
  • Omega-3 Fatty Acids are found in fish, dairy, and grains.

Step 3: Don’t forget about your supplements and vitamins.

Over-the-counter supplements can help you fulfill your dietary need of the vitamins mentioned above. But, there is a caveat.  Did you know that you can actually take “too much” of a vitamin? When in doubt always review your supplements and medications with your pharmacist for safe use.

As a patient, take comfort knowing that you can control how well your medications work for you. You are the rate limiting factor in the equation. These simple modifications can make a world of difference with managing depression and anxiety. After all, the best investment you’ll ever make is in yourself.

References:

  1. Kessler RC, Ormel J, Petukhova M, et al. Development of lifetime comorbidity in the World Health Organization world mental health surveys. Arch Gen Psychiatry 2011; 68:90.
  2. Daly EJ, Trivedi MH, Wisniewski SR, et al. Health-related quality of life in depression: a STAR*D report. Ann Clin Psychiatry 2010; 22:43. 
  3. Kessler RC, Chiu WT, Demler O, et al. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62:617.

For the best Rx price on prescription
depression or anxiety medications,
visit www.WellRx.com.

Compare prices at more than
62,000 pharmacies nationwide.

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Role of vitamin d and statin induced muscle pain

by James Ketterer, PharmD

Statins are a class of drugs used to lower cholesterol and decrease the risk of cardiovascular events. They work by inhibiting an enzyme from completing an early step in the body’s process of synthesizing cholesterol. Statins are among the most commonly prescribed medications in the country. Approximately 1-2% of patients on statins report experiencing muscle pain. This pain can present itself in a variety of ways but most often results in flu-like aches and pains. The muscles may feel stiff or sore like the feeling after working out. This usually effects the larger muscles of the body such as parts of the back or thighs. This side effect is often responsible for patients discontinuing the use of these drugs.

Does Vitamin D Play a Role in Statin-induced Muscle Pain?

Do statins cause muscle pain? The exact cause of this phenomenon is not completely understood, but many researchers have hypothesized that vitamin D levels may play a role. Vitamin D is mainly produced in the skin from sun exposure. However, this source is not active. The liver and kidneys are responsible for activating the vitamin D which then plays a role in facilitating intestinal absorption of essential nutrients as well as balancing bone health homeostasis. Vitamin D deficiencies often present with similar muscle pain as those found as a side effect in statins.

Some researchers have theorized that statins could reduce vitamin D levels because certain types of cholesterol carry vitamin D and when the cholesterol is reduced, less vitamin D could be transported. On the other hand, many have theorized that since both vitamin D and statins are metabolized by the same enzyme in the liver, the use of statins could delay metabolism of vitamin D, thus increasing levels in the blood.

Muscle Pain in Clinical Trials

Clinical trials and various other studies and reports have yielded mixed results on muscle pain in statin users with low compared to high levels of vitamin D. A large analysis of these trials showed that more studies resulted in statin users having higher levels of vitamin D on average. One retrospective study divided statin users into 4 groups, 1 being the lowest vitamin D levels and 4 being the highest. Group 1 was 1.21 times more likely to develop muscle pain than group 4. Another study showed statin users with vitamin D levels of less than 15 ng/mL were 1.9 times more likely to experience muscle pain compared with non-statin users. The statin users with higher levels of vitamin D did not have higher risk for muscle pain compared with non-statin users.

When a patient experiences what is believed to be the side effect of a drug, they are often taken off of the drug to see if the symptoms resolve. If they do resolve, sometimes the patient is started back on the drug to see if the symptoms return. This a referred to as a “rechallenge”. One chart review showed that returning vitamin D levels to a sufficient level before a rechallenge in statin users who had experienced muscle pain, increased their tolerability to statins.

Do Vitamin D Supplements Help Reduce Statin-induced Muscle Pain?

Some studies have given vitamin D supplements to statin users experiencing muscle pain. While these studies were uncontrolled, they did show improvement in muscle pain in nearly 90% of patients.

These are just a few of the examples of research looking at the correlation between stain use and vitamin D levels as a possible cause of muscle pain. While nothing is definitive at this point, patients on statins that are experiencing muscle pain may want to explore vitamin D supplementation as a possible resolution plan. The benefits of statins are well documented in patients with heart risks. Any side effects should be attempted to be overcome before giving up on the statin and assuming it is the cause.

References:

Gregory, Philip J. ” Vitamin D and Statin-Related Myalgia”. Medscape. 2017. Web. 10 Mar. 2017.

Simvastatin.  Micromedex Solutions.  Truven Health Analytics, Inc. Ann Arbor, MI.  Available at: http://www.micromedexsolutions.com.  Accessed March 20, 2017.


For the best Rx price on statins,
visit www.WellRx.com.

Compare prices at more than
62,000 pharmacies nationwide.

 

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Congress just unveiled their long-awaited replacement plan for the Affordable Care Act (ACA, or Obamacare). Unfortunately, it’s likely to leave a huge hole in insurance coverage for many in the U.S.While America waits for the final “yay or nay” from Congress, a recent study from the Kaiser Family Foundation (KFF) makes note of how many are already struggling with healthcare costs,making it difficult to for those trying to find low-cost prescriptions.

Cutting Back to Pay Bills

According to the study, 43 percent of adults with health insurance report problems affording their deductible, and 29 percent say they have difficulty paying medical bills. Among those citing trouble paying their medical bills, more than 70 percent have cut back on vacations, spending on food, clothing or basic household consumer items. We feel these people should get assistance when it comes to paying for the prescription drugs they need. That’s why ScriptSave helps consumers find low-cost prescriptions at pharmacies near them—for free.

Making cuts to pay for medical bills - finding low-cost prescriptionsRising Prescription Drug Costs

The national association, America’s Health Insurance Plans (AHIP), has completed a study showing the majority of health insurance premiums are going towards the cost of prescription drugs.3

For those facing high out-of-pocket costs for prescription meds due to an insurance gap or high premiums, a free download of the ScriptSave WellRx prescription savings card might help. As a patient, the card (or mobile app) won’t cost a penny to use. If it helps, great—enjoy the benefit of a lower-cost medication. If not, then it didn’t cost you anything. That said, our average savings rate is 45% (with reports of savings up to 80%*), and the ScriptSave WellRx program is contracted with over 62,000 pharmacies, nationwide. You might be surprised to find out you’re eligible for low-cost prescriptions with your ScriptSave WellRx card.

ScriptSave’s long-standing mission has been to close the gaps in prescription coverage, and has a 20-year history of working with health plans and pharmacies to provide consumers with discounts on prescribed medications.

If you need to lower your prescription drug costs, ScriptSave WellRx offers help to everyone – regardless of income, age, or insurance coverage. Sign up today and save a little extra money next time you pick up your prescriptions.

 

References:

1 http://www.npr.org/sections/health-shots/2017/03/07/519001659/7-things-to-watch-in-the-gops-american-health-care-act

2 http://kff.org/health-costs/poll-finding/data-note-americans-challenges-with-health-care-costs/

3 https://ahip.org/health-care-dollar/

 

* Average and up to savings percentages are based on all discounted prescriptions that were run through the ScriptSave WellRx program in 2016. Discount percentages represent savings provided off of pharmacies’ retail prices for consumers who do not have a discount program and pay cash.


Prescription Savings News
See how much you can save on your prescription costs
at
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ScriptSave WellRx - Ask the Cash Price image

Always ask, “What’s the Ca$h Price?”
Always show your ScriptSave WellRx card

The ScriptSave® WellRx Facebook page sees a lot of interaction…and we love getting questions. By far the most common questions and comments we get from the public are those related to insurance.

  • “Can I use ScriptSave WellRx with my insurance?”
  • “How does it work if it’s not insurance?”
  • “I have insurance, so your card isn’t for me.”

For the record, not only is that last one a misconception among consumers, it’s also a fast-track to over-paying for your meds (and it’s the starting point for this blog post).

Here’s our “Honesty 1.01” post, on what to expect from ScriptSave WellRx and how to stretch your family’s prescription dollars.

  • Not Insurance
    ScriptSave WellRx is NOT INSURANCE. The discounts we’ve negotiated are off the cash prices for your medications. The prices you see in our free online prescription price look-up tool reflect the savings relative to what you would pay if you walk into the pharmacy as a patient with no insurance or other assistance.

So why is it so important to know the cash price? Furthermore, why is it ESPECIALLY IMPORTANT for those with insurance? The answer lies in an article everyone should read, published by Bloomberg News on Feb 24, 2017[1], and titled, “You’re Overpaying for Drugs and Your Pharmacist Can’t Tell You.”

The Bloomberg article highlights how, “Gag clauses stop pharmacists from pointing out a cheaper way” (and, yes, ScriptSave WellRx is one of those CHEAPER WAYS).

“[because of contractual constraints] Eric Pusey has to bite his tongue when customers at his pharmacy cough up co-payments far higher than the cost of their low-cost generic drugs, thinking their insurance is getting them a good deal,” states the article’s author.

Copays that look more like ‘You-Pays’

Pharmacy Benefit Managers (PBMs) and insurance companies use so-called “clawbacks” to generate additional revenue. “Clawbacks” are when PBMs tell local pharmacies to still enforce & collect the patient’s stipulated copay even when it is more than the cost of the actual medication being dispensed. To be clear, when this happens, the additional revenues that are created are not kept by the pharmacy – they are “clawed back” by the PBM

Clawbacks work like this, for example: the cost of a drug is $3.15, plus the pharmacist’s fee (his profit) of $5.83. This brings the total cash price to $8.98. However, owing to the contractual constraints placed on the pharmacy as a condition for being included in the insurer’s network of pharmacies, the pharmacist has to charge whatever copay is stated in the patient’s insurance policy; let’s say it’s a $20 copay for all covered Tier 1 drugs. So, what happens to the remaining $11.02 (the difference between what the pharmacist earns in profit and what the patient pays in copay)? Well, it is taken by the insurance company’s pharmacy benefit manager. In other words, regardless of whether the patient pays the lower cash price or the higher copay, the pharmacy still only makes the same $5.83 in fees. In theory, the pharmacist is no better or worse off regardless of whether the patient pays $8.98 or $20…but he is contractually prohibited from alerting the patient to the concept of paying cash, because he is obligated to always charge the stated copay.

These so-called copays might be better renamed, “You-Pays.” There is no shared (or co-) payment at all. In fact, the insurer picks up zero-percent of the tab on this transaction. Instead, the patient not only pays 100% of the medication cost ($3.15) and 100% of the pharmacist’s fee ($5.83), but the patient also pays an additional “You-Pay” fee of $11.02 to the insurer’s pharmacy benefit manager.

This is why knowing the prescription Cash Price is vital! ScriptSave WellRx - How Clawbacks Work image

The moral of the story is to always ask, “WHAT IS THE CASH PRICE?” and always SHOW YOUR SCRIPTSAVE WELLRX CARD. And, if you are fortunate enough to have insurance, be sure to only pay the copays, not the You-Pays!

Not only is the ScriptSave WellRx program free to all members, there’s also no cost to the patient if she or he asks for a quick price-comparison. However, you have to know how and what to ask. Our closing points, below, will wrap up our Honesty 1.01. Once you understand these points, you’ll be armed against spending unnecessary extra money at the pharmacy counter. Become a member today to get the best deals on your prescription medications..

  • Combining Discounts
    • Patients can’t combine discounts. Although that might be disappointing, it does keep things simple. Find out what your final out-of-pocket cost is with any other assistance/insurance program you have…then compare that to the ScriptSave WellRx price. Select the option that makes most sense to you & your family. HINT: our online pricing tool will help you determine the out-of-pocket cost under our program (but you can also ask the pharmacist).
  • What to Ask For
    • When you greet the pharmacist, hand over your ScriptSave WellRx card and ask, “Could you please price my prescription using the processing details on this discount card? …and, if you have insurance, also add, “…and please compare that to my insurance copay.”
  • Pharmacy Resistance
    • The pharmacies that are featured in our online pricing tool have contracted with us to accept the ScriptSave WellRx card. There are over 62,000 of them, and they process a LOT of scripts every day. They see a lot of different assistance programs and not all of these programs are created equal. Many are not at all “pharmacy friendly” or easy to work with. That being the case, there will be times when a pharmacist might not recognize your ScriptSave WellRx card. If you experience difficulty, we have a toll-free number 1-800-407-8156. Feel free to make use of it. Better yet, ask the pharmacist to call us (there’s actually a special dedicated toll-free number specifically for questions from the pharmacy).

Whether you’re benefit disadvantaged or not, you owe it to yourself and your family to be a savvy ScriptSaver and learn how to save money on prescriptions. Ask for the prescription cash price with your ScriptSave WellRx card next time you fill or re-fill, and avoid the “You-Pays.”

 

Reference:

[1] https://www.bloomberg.com/news/articles/2017-02-24/sworn-to-secrecy-drugstores-stay-silent-as-customers-overpay


For the best Rx price on medications, like
Crestor (rosuvastatin),
Celebrex (celecoxib),
ProAir HFA,

visit
www.WellRx.com.

Compare prices at more than
62,000 pharmacies nationwide.

Celebrex for arthritis pain - ScriptSave WellRx

If you struggle with arthritis pain, chances are you’ve tried a variety of anti-inflammatory medications for pain relief. While drugs falling into the non-steroidal anti-inflammatory category (NSAIDs) can help, they often come with gastrointestinal side effects. A major 10-year study has shown that Celebrex (generic name, Celecoxib) may not have the same side effects of similar drugs.

More than 24,000 heart patients and people at increased risk for cardiovascular disease were compared. Patients were given Celebrex, or either naproxen sodium (Aleve) and ibuprofen (Motrin or Advil). The study found Celebrex, which has been on the market for 17 years, was no more dangerous to the heart than either of the two NSAIDs, which have been on the market for decades. This should come as a relief to thousands of patients who have an increased risk of stroke or heart attack. The study also found that Celebrex was safer when it comes to gastrointestinal problems.

For more on the study, visit CBSnews.com.


For the lowest price on Celebrex (celecoxib),
visit www.WellRx.com.

Compare prices at more than
62,000 pharmacies nationwide.

 

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