Iowa’s largest health insurance provider is hoping to reduce the number of prescriptions Iowa doctors issue. Wellmark Blue Cross and Blue Shield says too many Iowa doctors are prescribing expensive drugs like Vioxx and Celebrex when a much cheaper drug like aspirin or ibuprofen will do. Starting August 1st, Blue Cross will make doctors explain why they’ve prescribed the more-expensive anti-inflammatory drugs before they’ll pay a claim. Blue Cross V-P Sheila Riggs says some Iowa communities have drastically higher usage rates of Celebrex, Vioxx and Bextra. Riggs says the Iowa communities of Britt, Des Moines, Hampton, Hamburg, and Mason City have the highest usage of the prescription anti-inflammatory drugs — twice as high as places like Cherokee, Decorah, Manchester, Pella, and Waukon. Wellmark paid out about 11-million dollars last year for the three anti-inflammatory prescription drugs — and Riggs says that directly impacts premium costs. Riggs says businesses that pay the insurance premiums for their employees are the ones that’re having to shoulder the financial burden of over-usage of pricey drugs. Wellmark officials say they’ve concluded most people could treat their aches and pains just as effectively with significantly cheaper over-the-counter drugs. Wellmark’s chief medical officer says drugs like Celebrex and Vioxx are not an appropriate first line therapy for minor aches and pains. He concedes many patients believe a cheap, over-the-counter medication can’t be as good as an expensive prescription, but he says one of the reasons a drug like aspirin is available over-the-counter is because it has stood the test of time and has a proven safety record.