To make a very long story short--- I have been giving out Celecoxib 200mg from a supply in my drug fridge for a couple of years now. I might give out 4 of them, taken once daily, for four days following a heel pain syndrome injection. I asked four pharmacists a couple of years ago " What would be your choice for an NSAID?", and they all said Celebrex. They thought that for short term, the fact that it works in a different cyclo-oxygenase cycle, makes it less irritating to the lining of the g.i. tract. A major paper in The New England Journal of medicine about four years ago looked at the cardiac history five and ten years down the road of taking the drug and concluded (as the Editor did, in an editorial they have in every issue) that it is "maybe safer than Motrin." Maybe the wrong drug is the over the counter favorite. Recently, I prescribed 24 Celecoxib 200mg for a patient with occasional gouty attacks, where it can be very effective, as are many of the NSAIDS. The cost was $175.00. Now, understand this is a generic drug that's costing $7.29 per pill. Of course, I got the Prior Authorization 2 page fax from the chain pharmacy. Having just read Jon Hultman's article in P.M.Magazine about the 700 million hours doctors waste on this task per year--I was is no mood to go through this charade. So I called up my patient, and said "Larry, come to the office and I'll give you twenty pills for $10." I've been getting them from Moore Medical for $23 per 100. Once it was $30 for a bottle. Big deal. That's still 23, or 30 cents apiece. So what is the story with this $175.00 cost? The story is that this is the fraud that Big Pharma commits every day on us countless of times. There was a time when Celebrex went off patent some 8+ years ago. Then, the name brand sold for $10 a pill and the generic was $7. It took years until an Indian firm produced them when it was selling for the $23 price. India, I understand is the country on earth that has the largest generic drug industry. No surprise they came up with it. I made a telephone call to the lady pharmacist and told her what I paid for them at the office. The chain pays less than that, obviously. " I asked "Why don't the part D insurance companies recognize the fact that it doesn't cost that much anymore?" One thing for sure, the chain is happy with that. But it is a humongous rip-off. And she had no answers for any of my questions, which I understood. American Medicine has become what I call "The Big Trough", and we are going to have to end that to survive ourselves.