What REALLY Happens When Drugs Go Generic

[McCamy Taylor]

Yippee! Some of the most commonly prescribed drugs in America are going off patent. According to reporters that means their cost will plummet by somewhere between 20% and 80%. You will be able to get them more cheaply if you pay cash, and your copayment will be smaller if you are on insurance.

http://www.cbsnews.com/8301-504763_162-20082918-10391704.html

Sounds great! Too bad the savings will never materialize. Here is why:


Lipitor is the statin. Cardiologists have used it right and left for years in order to drive down bad cholesterol levels and save people from heart attacks. Folks who were on the older generic statins like Mevacor were all switched by their specialists. And primary care docs got the message and started doing the same thing. After all, the specialists know.

Well, recently, the cardiologists are starting to switch patients from Lipitor to Crestor, the new cholesterol fighting med in town. Why? I am not exactly sure myself. However, I do know that in 2008, Astra-Zeneca noted that Lipitor was going generic in a couple of years, which meant its own Crestor would become the premiere patent cholesterol drug. In order to corner the market the way that Lipitor once did, they would have to prove that Crestor was better than Lipitor. It would not have to be a big improvement. It would not have to be an across the board improvement. All they had to do was come up with one way in which Crestor was better than Lipitor. With Lipitor now a generic, its manufacturer would have no reason to fire back against Crestor’s claims, and Crestor would win the pr war by default. So, in 2008, the WSJ described how Astra-Zeneca was launching a fishing expedition called the Saturn Study to find that one piece of evidence that would make Astra-Zeneca a fortune.

http://blogs.wsj.com/health/2008/01/15/crestor-vs-lipitor-astrazeneca-takes-on-the-champ/

Prediction: Crestor will take Lipitor’s place as number one statin in this country.

Plavix. Same story as Lipitor’s. Astra-Zeneca just got FDA approval to market its Brilinta. The manufacturers are calling it “better” and “safer.” It has received approval for a wider variety of uses. Whether it is actually better or not, I can not say. However, I know that once Plavix is off patent, there will be no drug company to argue against Astra-Zeneca’s claims of improved safety. And any doctor who has a patient who happens to be taking Plavix when he or she suffers any kind of significant bleeding will be asked “Why didn’t you change your patient to the safer Brilinta?”

http://seekingalpha.com/article/281427-despite-approval-brilinta-s-fate-may-hinge-on-plavix-generics

Prediction: (Barring some unforeseen Baycol type disaster) Brilinta will replace Plavix as the anti-platelet drug of choice.

Singulair does not have a major competitor at the moment. However, the FDA is laying the groundwork for removing it from the market altogether. In 2009, the FDA added a black box warning about the potential for mood changes and suicidal behavior with Singulair. It did not pull the product from the shelves. However, as soon as the drug goes generic, there will be no major pharmaceutical company to lobby for it. And no one is going to care that a whole bunch of children and young adults with asthma are able to avoid taking corticosteroids (a much more dangerous medication which also causes mood swings in addition to many other problems) because of Singulair.

http://www.findingdulcinea.com/news/business/2009/june/FDA-Adds-to-Problems-for-Mercks-Asthma-Drug-Singulair.html

Prediction: Singulair will be taken off the market by the FDA. This will increase the number of asthmatics who have to take combination inhaled steroid/long acting beta agonist meds, including the new Dulera, from Singulair’s manufacturer, Merck.

http://www.glgroup.com/News/Will-Mercks-New-Asthma-Drug-Make-the-Big-Time--49337.html

This prediction is not as wild as it might seem. Way back in the day, when the nation’s only nonsedating antihistamine Seldane was about to generic to the relief of millions of allergy sufferers on a budget, Seldane’s own parent company petitioned the FDA to have it taken off the market because of a rare side effect that occurred when it was taken with other prescription medication. The same company then launched its brand new Allegra---patent, of course.

Lexapro I am not even sure why this drug is on the list. There are so many anti-depressants in its class---some of them generic---I am frankly surprised that this one sees much use. Maybe it had something to do with its manufacturer’s aggressive marketing strategy.

http://www.nytimes.com/packages/pdf/politics/20090831MEDICARE/20090831_MEDICARE.pdf

Prediction Once its parent company stops paying docs money (in the from of lectures etc) to prescribe it, Lexapro will sink to the bottom along with all the other generic SSRI’s.

The biggest declines we see are drugs that have gone off-patent, including Wellbutrin (a decline of 73 percent in prescriptions) and Paxil (which didn’t even make it on this year’s list). Strattera — prescribed for ADHD — lost 42 percent of the prescriptions it had in 2005. And despite Zoloft’s strong showing in 4th place — down from 2nd place four years ago — it also lost 28 percent of its previous prescriptions.

http://psychcentral.com/blog/archives/2010/04/26/top-25-psychiatric-drugs-in-2009/

Seroquel Huge selling drug that leads to some huge patients, because of the weight gain it causes which can lead to diabetes with coma etc. Huge problem for its manufacturer, Astra-Zeneca, which has been charged with using deceptive practices to increase its market share by encouraging physicians to use it for diseases besides those which the FDA approved it to treat.

http://www.sfgate.com/cgi-bin/article.cgi?f=/g/a/2011/07/18/bloomberg1376-LOJWTV6JTSE901-5JUTRA7D7KSS99PAU8THIAAQMG.DTL

Prediction Astra-Zeneca will continue to make big money off its Seroquel XR (patented until 2017) a sustained release preparation of Seroquel. We will by told (by Astra-Zeneca) that Seroquel XR is sooo much better than plain Seroquel that it would be medical malpractice for doctors to continue to prescribe it. Bonus points if they can get the FDA to agree.

Addendum: If you always suspected that the FDA cares more about drug companies than you, you might be interested in this:

http://www.ahrp.org/cms/index2.php?option=com_content&do_pdf=1&id=629

[dixiegrrrrl]

1. another link here for the complete list of drugs going off patent soon

http://seattletimes.nwsource.com/html/health/2015720110_generics25.html

[benld74]

2. They change 1 Molecule in their Formula - and POOF! New drug that does the same thing!!

[HuckleB]

12. Can you list the drugs where one molecule was changed, leading to a new name brand drug?

[damntexdem]

3. So ask your doctor about what is being prescribed, ...

especially a brand name rather than a generic. Tell your doctor that where there is a generic, you want the script written to allow use of the generic.

And when you are filling a prescription, ask whether or not there is a generic equivalent, and if there is, ask that it be used.

The difference is cost is very often tremendous. And the drug is required to be equivalent.

[truedelphi]

4. I have heard that they will be going after Benadryl too.

The PTB are saying it is not as safe as it was believed.

Of course, it also is now obtainable for a mere $ 6 to $ 8 bucks.

My dad used it routinely for decades, and died in his sleep at the ripe old age of ninety.

[HuckleB]

10. You've "heard."

:rofl:

[swilton]

5. This is why I don't trust research done in universities

anymore - the conclusions are influenced by the research funding.

[A Simple Game]

6. I switched from Lipitor to Crestor a couple of years ago.

While on Lipitor I would wake up in the morning and have to take 5 minutes to get out of bed. It felt just like someone had pounded on my buttocks all night long, and not in a good way. I have no problems with Crestor.

For me there is a big difference. I doubt I could take a Lipitor generic.

A lot of people I discuss this with admit to similar or other bad experiences with Lipitor. One person said they had to quit taking it because they became so miserable.

[Flatulo]

8. I had no problems with Lipitor. In fact, it was the only statin

that actually improved both my HDL and LDL numbers. My insurers kept putting me on generics, but my numbers always went to hell. My doctor and I tracked this for years and the conclusion was the Lipitor was best for me. I've had no side effects, but I'm on the lowest dosage.

[PatrynXX]

7. a general FU to thinking too many anti depression meds on the market

I take Lexapro. so far works alot better than zoloft without the fucking side affects frankly someone should sue the makers of Zoloft. Why? You go off it, and your very dizzy. Luvox was worse though. Lexapro not so bad. Been having a tough time getting it free because it's going generic.

Lipitor, too dangerous. Take the zocor generic.

Long story short, if you want to spend the fucking money go ahead, but if you want generic's, my dr is just fine with the generic equiv. and he's somewhat a tea party dr. We have a nice laugh debate every time :P But not much offends me but that one did.

[HuckleB]

11. I agree with your post title.

However, different people react differently to different SSRIs. You are having good luck with Lexapro. Others have good luck with Zoloft, and others with Luvox. Many who do well on Lexapro do just as well on Celexa. Lexapro and Celexa are quite closely related, and they were developed by the same company. The company let Celexa go to generic when it chose to push Lexapro as an SSRI with fewer side effects. That marketing proved to be false, however. Still, it doesn't mean that Lexapro is not a good medication for many individuals.

Cheers!

[pauljulian]

18. Lexapro saved my life

It's killed my wallet, but still has made life worth living.

Would be very nice to not have to spend $116.00 every month along with the $80 for Mirtazapine (which, thankfully, went generic) and $50 for Gabapentin.

Paxil was too "leveling" and Wellbutrin caused ... well, let's just say I think I understand autistics a little better.

[Overseas]

9. I didn't realize this. Although I knew that somehow many decent medicines

had been obsoleted over time, and superceded by meds that weren't that great.

Thanks for the insights.

[hedgehog]

15. I went through this with my son. When first diagnosed with

asthma as a toddler, there were only two drugs: theophylline, which made his heart beat like a hammer, and prednisone, which has a multitude of side effects, especially in a growing child. Over the years, we went through five or six drug regimens as different drugs came on the market. Each drug worked better with fewer side effects. Things pretty much stabilized when he was in high school. He hasn't had any problems in years, and the drugs he takes now are starting to come off patent.

[HuckleB]

13. Paxil is not used because it's not a good drug, overall.

Unfortunately, it took docs too long to figure that out. Strattera has also proven to be of little benefit to many people, which explains its decline. As for Zoloft, saying that it's in "4th place, down from 2nd place" is meaningless.

I'm not going to bother to address the rest of a post that seems to ignore such basic information to push a clear agenda.

[trotsky]

14. +1

Unfortunate that the OP takes a positive development and dumps tons of Debbie Downerism on it. I am no fan of big pharma, but the world is not as black-and-white as the pharma-haters wish it was.

[voteearlyvoteoften]

16. Prilosec morphs to Nexium

Nexium is pretty much just Prilosec with magnesium added. But it has a patent.

[Smilo]

17. One of the things

they like to do is suddenly introduce extended release, or a different coating and what you know - a whole "new" drug.

Just tried to get some drug - "new" brand name extended version $481.00, old version generic $14.00

There is no wonder the big pharmaceuticals spend so much on advertising and give-aways for doctors - it works and they make billions.