Why I’ve lost respect for the pharmaceutical industry

6 Jun
2002

Today’s Wall Street Journal has a wonderful front page article titled ‘As a Patent Expires, Drug Firm Lines Up Pricey Alternative’. Since the Wall Street Journal web version requires a paid subscription I won’t link to the article. Rather I will summarize the issues.

Prilosec’s patent expiration date was April 2001. As of today we still have no generic competition.

The reason? Seven years of planning by a group of marketeers, lawyers and scientists within the drug’s maker. The group called itself the Shark Fin project after the dismal shape the sales chart would trace if they did nothing: an inverted-V.

Beginning its work in 1995, the team came up with a list of nearly 50 possible solutions to the patent-expiration disaster facing the company. …

I was at dinner Saturday night with a lawyer, a VA administrator and a gastroenterologist. We were discussing proton pump inhibitors. The gastroenterologist mentioned his disgust with AstraZeneca, primarily over the release of Nexium. The lawyer opined that Nexium was supposed to be great. He had seen the ads. He knew nothing about the drug, the indications or what it was replacing. He did know that it was purple.

AstraZeneca has released Nexium solely to capture a significant portion of the PPI market, despite no clinical significant advantage over Prilosec (omeprazole). The drug is a derivative of Prilosec. But the new patent exists on Nexium. There is really no good clinical reason for this drug – there are several other very good PPIs already on the market. There is nothing wrong with Prilosec. It is still a great drug.

Prilosec costs $4.47 per pill. This is the driving force. Prilosec is still the cash cow for AstraZeneca. They are trying to convert patients and physicians to Nexium at a similar price.

But that still doesn’t explain the lack of generics. AstraZeneca’s lawyers have filed suit after suit to delay the patent expiration. These suits are a bargain for the company, since each day without competition brings $10,000,000 in sales to AstraZeneca. Given this amount of money, which far exceeds any investment in research, the company will consider any trick to delay the release of generic competition (which would probably decrease the patient’s cost significantly). Meanwhile Nexium is the most heavily marketed drug in the U.S – $478 million last year. I almost choked while typing that number.

Reading the entire article will only make you angrier. This story is not about recouping investment costs. It is not about improving medical care. It is about money. Obscene amounts of money which come from patients who use that money to improve their quality of life, but who can’t always really afford to buy the drug.

This is why 29 state attorneys are suing Bristol-Myers Squibb. I’m continously impressed by the advances the pharmaceutical industry brings to medical care. I’m increasingly distraught by their business tactics.