Thursday, January 12th, 2012

How Much More Does Aspirin Cost Today?

One thing aspirin is not: polarizing. If you are going to have a tiff with a friend, aspirin will not be the topic. Aspirin is actually a great unifier—it’s one of the sundries that can be found in every home across the country. Aspirin is easy to find, and it is here to help. With all sorts of things, of course, but between you and me, mostly hangovers. And people who are paranoid of incipient heart disease, they also are big aspirin fans.

Perhaps you yourself are one of those people who overindulge in the bendy elbows and/or quiet fears of your own mortality. So let’s look then at this unassuming little drug that has so insinuated itself into our lives, either the morning after or right before bedtime (or both!): does aspirin cost as much now as it did ten years ago, or thirty, or sixty?

Aspirin is on the surface a pretty blasé topic. It’s a pill. You take it. It’s supposed to make you feel better. But if you give it a good hard look, it’s actually pretty fascinating.

For instance, can you think of a more popular, more used drug in human history? Unless recreational drugs are included, you cannot. And that is for a medicine that is largely unchanged (other than in delivery mechanisms) since its popularity boomed at the turn of the Twentieth Century.

The predecessor of aspirin, the bark and leaves of a willow tree (either chewed, in the case of leaves, or as a powder made after boiling the two) has been used since the time of the Ancient Greek, and its effects were noted by no less a luminary than Hippocrates. The bark contains salicin, the natural compound that was turned into salicytic acid by European chemists in the early 1800s. This was further refined by German Felix Hoffmann, a chemist for the Bayer company in Germany in1897. The result, acetylsalicylic acid (aspirin!) relieved the symptoms of Hoffmann’s father’s rheumatism.

At the time, Bayer was in the business of producing dyes, and the industry of producing compounds for medicinal use as we know it did not yet exist. Bayer would market this aspirin to physicians in 1899, setting into motion the modern pharmaceutical industry, as Bayer applied the salesmanship and marketing expertise from its previous trade—selling dyes—to the business of making medicinal drugs for profit, which business has continued and prospered to the point where executives of Big Pharma are known to commute by helicopter. Think about that when you pop your daily aspirin before bedtime.

And actually, if you are thinking about that as you dose yourself, you might recall that Bayer is not only one of the oldest pharmaceutical companies, but also one with more than one skeleton in the closet, having once marketed heroin as a cough suppressant and also having been a little too close to a certain National Socialist regime. But, being an optimist, I note that the lessons of history learned by Bayer have not dissuaded it from keeping with its awesome logo.

Just what is aspirin good for? Not surprisingly, there is some disagreement to this, and there has been for years. As sure as each week will bring a new listicle, it will also bring a new study peddling a benefit/risk of aspirin. Could aspirin harm seniors eyes? Aspirin may reduce risks of repeat blood clots! Or simply, taking aspirin for heart has benefits and risks! But the three uses of aspirin that most everyone agrees on are: as an antipyretic, or fever-reducer, as an anti-inflammatory, and as a pain reliever.

Aspirin is first and foremost in our hearts an analgesic, which is the fancy word (from the Greek!) for a pain reliever. A doctor might disagree, and insist that aspirin is, like your acetaminophens and ibuprofens, a non-steroidal anti-inflammatory drug. But tell that to Mr. That-Last-Whiskey-Was-A-Mistake, who knows aspirin as the NSAID that will not harm your liver when mixed with alcohol, like acetaminophen or ibuprofen might. There are pain relievers that are dissimilar to aspirin, like your opiates and narcotics, but the big advantage of aspirin is that you are unlikely to be temped to make it in a trailer in the woods or otherwise destroy your entire life with it. (Analgesics are not anesthetics, by the way. Analgesics ameliorate pain, while anesthetics numb sensation.)

So let’s talk about pain, like, what exactly is it? Obviously, pain is, “Ouch!” or similar to Supreme Court Justice Potter Stewart’s definition of pornography: you’ll know it when you feel it. But that’s the mystery. Pain is felt, and to quantify it into some comparative metric leaves you deep in the weeds of neurology. No matter how well the field of medicine has broken pain down into something approaching a taxonomy, the only we can describe the pain we’re feeling is to, well, describe it. But the taxonomy is all very interesting (and morbid, and dry and filled with jargon, so be forewarned), with neuropathic pain being negative sensations detected by that part of your nervous system that you would ordinarily think of as nerves (the somatosensory system, as it’s called), and nociceptive pain being the pain detected by your peripheral nervous system from something affecting (or hurting) non-neural tissue. There’s even the kinds of pain that are difficult to recreate in a laboratory, like phantom pain, which is exactly what it sounds like, and psychogenic pain, which is generally pain caused by non-pain factors, like emotions or behavior. Psychogenic pain is my favorite of all, very emo. Even though none of us are strangers to pain, it remains a bit of a medical mystery.

But pain is definitely the reason that aspirin is as ubiquitous as it has been, and as it is now. More than a century after the mass production of aspirin, from forty to fifty million pounds of aspirin are swallowed per year, even with the availability of all of the other varieties of NSAIDs weaponized for different sorts of pain. Either, “An aspirin a day keeps the doctor away,” is a (mutated) aphorism that is still widely held, or there are forty to fifty people eating a million pounds of aspirin every year.

And for those of us who believe that the ritual consumption of aspirin will keep the doctor away in the sense of staving off myocardial infarctions, there’s good news and bad news. The bad news is, while medical authorities recommend daily use of aspirin for those who’ve already suffered heart attacks (for the anti-coagulant properties), and Sir John Vane won the Nobel Prize for his research in the 1980s that suggested that aspirin use reduces the incidence of heart attacks, neither of those proscriptions suggest that aspirin is the magic +3 amulet that we like to think it is. The good news is that I couldn’t find any doctors warning that aspirin causes heart attacks, so sleep easy.

But what is the expense? This time around, to get a historical sense we are consulting this handy bit of research from the Morris County Library, of Morris County, NJ. (Roughly speaking, Morris County is in the Executives Living In Mansions Driving Mercedes-Benzes region of the state. The library has taken an index of the price of goods/services advertised in a local paper every year for the past hundred years. So from this, here is a list of prices given for some years in which aspirin was one of the items surveyed, along with the number of pills for the applicable price. (The current price is taken not from the research of the Morris County Library but according to John at the Walgreens in Boonton, NJ.)

1932: Bayer's, $.24/24 ct bottle
1941: (No brand given), $.09/100 ct bottle
1947: Rexall, $.49/100 ct bottle
1950: Bayer, $.59/100 ct bottle
1952: St. Joseph's $.39/50 ct bottle
1964: Squibb, $1.39 – $1.96/2 200 ct bottles
1969: Bufferin, $.99-$1.49/100 ct bottle
1975: Bufferin, $1.09/100 ct bottle
1980: Bayer, $1.49/100 ct bottle
1987: Anacin, $3.69/100 ct bottle
1993: Bayer, $3.84/100 ct bottle
2004: St. Joesph's adult low strength, $6.39/100 ct bottle
2012: Bayer, $6.99/120 ct bottle

Now then, if you take that list, and then adjust all prices into 2011 dollars using the Bureau of Labor Statistics CPI Inflation Calculator, then pro-rate all prices to that of a 100-count bottle, and average out prices if a range of prices are given, you get the following:

1932: Bayer's, $16.39
1941: (No brand given), $1.39
1947: Rexall, $4.97
1950: Bayer, $5.54
1952: St. Joseph's $6.66
1964: Squibb, $6.09
1969: Bufferin, $7.64
1975: Bufferin, $4.58
1980: Bayer, $4.09
1987: Anacin, $7.35
1993: Bayer, $6.01
2004: St. Joseph's adult low strength, $7.65
2012: Bayer Safety Coated, $5.81

And where does this leave us? With the exception of 1932 and 1941 (the middle of the Great Depression for one, and the uncertainty of brand on the other, which might mitigate the price somewhat), the prices jump back and forth between four bucks and eight bucks, which seems a reasonable amount to pay because your head is freaking killing you, or you don’t want to die. But in another sense the jump is statistically significant: take the jump between 1980 and 1987, which is an 80% increase. There is a certain amount of volatility, a good bit of back and forth in the inflation/deflation of aspirin over the years.

But even with this swinging back and forth, aspirin remains under the ten dollar threshold, and considering the fevered attachment many of us have for this most successful medicine ever, still chemically derived from a compound found in willow trees after all these years, we may be lucky that aspirin is one of the products that is not subject to a historic trend of inflation in adjusted prices. Though to be fair maybe the price of aspirin has been influenced by the historic distribution of hangovers over time? Research for another day.

Previously: Books, Barbies, Televisions and Steak Dinners

Brent Cox is all over the Internet.

10 Comments / Post A Comment

whizz_dumb (#10,650)

Not polarizing? Uh, for hangovers I use ibuprofen THANKYOUVERYMUCH! But really, this was good.

Tulletilsynet (#333)

My sources inform me that St Joseph's children's asprin no longer tastes the same as the St Joseph's children's asprin that my sources and I used to sit under the house and chew up by the delicious bottleful. So my question for you would be this: how does the use of lower-quality and probably cheap-ass artificial orange flavoring play into this whole pricing thing?

areaderwrites (#592)

@Tulletilsynet Ah, but do you know what does taste just like old-school baby aspirin? Orange Mint Lifesavers in the cello "peg bag."

Plasmon (#204,863)

The price comparison is interesting, but the medical review you put together for the intro is not quite right. On the off chance that someone reads the Awl for medical knowledge, for the record:

– acetaminophen is not an NSAID. ASA and ibuprofen are NSAIDs.

– ASA is not an anticoagulant (like warfarin or heparin), it's an antithrombotic.

– acetaminophen can harm the liver, especially when mixed with alcohol. Ibuprofen and ASA do not. NSAIDs can harm kidney function (ASA usually doesn't), but that effect doesn't have anything to do with alcohol. NSAIDs and alcohol in combination will tend to cause gastritis (irritation of the stomach lining), but that would usually develop only with chronic use. So Awl readers are probably safe taking 1-2 Advil at bedtime to mitigate the hangover the morning after.

– pain is actually not the main reason ASA is so ubiquitous. ASA is the first line medication for secondary prevention of all sorts of vascular disease (coronary artery disease = heart attacks, cerebrovascular disease = strokes, peripheral vascular disease, etc). You link to an article saying that taking ASA has benefits and risks for preventing heart disease. That's true only for people *not known* to have vascular disease. For those with known atherosclerosis (previous stroke, MI, angina, etc), ASA's benefits hugely outweigh its risks in almost all cases. So a huge number of (mostly older) people take a baby aspirin daily. Meanwhile, most chronic and recurring pain (headaches, menstrual cramps, arthritis, back pain) is treated with acetaminophen and ibuprofen under various brand names and formulations.

–It's not even slightly controversial that ASA lowers the risk of heart attacks and other vascular disease, though lowering the risk doesn't mean perfect protection (people can and do have heart attacks while taking ASA). It's just that that benefit is very small in people who have no history and no major risk factors for vascular disease (high blood pressure, cholesterol, diabetes, smoking, age, family history) — small enough that it's not worth it to have everyone in the world on ASA given that there are downsides like gastritis and stomach ulcers.

– neuropathic pain is not a "negative sensation". Pain and tingling (paresthesiae) are positive sensory symptoms, as opposed to loss of sensation for touch/temperature/vibration/etc. The point of "neuropathic" modifying pain is that the pain does not reflect local tissue damage (as in nociceptive pain) but comes from abnormal function (often because of damage) of the peripheral nerves themselves.

…sorry to be pedantic.

I love the pedanticism!

bocadelperro (#9,676)

In Germany, Aspirin is a brand name, trademarked by the Bayer company, and it's about twice as expensive as in the US. To get generic aspirin, you have to ask for A.S.S. (no really). They also cell Asprin with vitamin C, which sounds to me like a recipe for an ucler/the worst heartburn ever.

metoometoo (#230)

I prefer weed.

cindih4bie (#204,820)

@metoometoo metooo

dianware73 (#205,517)

I like Bufferin

Ham Snadwich (#11,842)

@dianware73 I like Anacin.

Post a Comment