Doctors in the US are wasting hundreds of millions of dollars a year prescribing expensive branded medicines even when cheaper generic alternatives are available, according to an analysis by the Financial Times.
Large drugmakers including Pfizer, GlaxoSmithKline and Eli Lilly made more than $ 1bn in the first six months of the year selling expensive branded versions of popular drugs that have lost patent protection such as Lipitor, the cholesterol-lowering statin, anti-epileptic drug Lamictal, and Prozac, the antidepressant.
The price of medicine in the US, the world’s largest and most profitable healthcare market, has become a central issue in the presidential campaign following the furore over Martin Shkreli’s decision to raise the price of an Aids medicine by 5,000 per cent.
Big pharma has countered criticism of high drug prices by arguing that its products have a limited shelf-life, after which cheaper generic versions flood the market — but many companies are still generating significant revenues from ageing medicines.
Pfizer sold more than $ 2bn worth of “legacy established products” in the US in the first half of the year, most of which were off-patent branded drugs with generic alternatives. In most cases the price of the brand is significantly higher than the copycat alternatives.
Eli Lilly’s Prozac, which went on sale in 1987, costs $ 11.39 per pill compared with 3 cents for the generic version, while Pfizer’s Lipitor is $ 10.59 per tablet compared with 13 cents for the alternative, according to the National Average Drug Acquisition Cost database.
A generic version of Prozac, fluoxetine, has been on sale in the US since 2001, while Lipitor generic atorvastatin has been available for five years.
In the UK, generics are automatically dispensed by pharmacists, but in the US doctors can insist that a patient is given the brand by writing “dispensed as written” on the prescription.
Some US doctors say they are reluctant to shift patients to generics after they are settled on a drug, especially when they are suffering from a mental illness or life-threatening condition.
Valeant, a Canadian drugmaker that has drawn ire for its sharp price increases, made $ 151m from sales of antidepressant Wellbutrin in the first six months of the year. The drug costs $ 36 per pill versus 46 cents for the generic.
Hillary Clinton, the Democratic presidential nominee, has attacked Valeant for “gouging American consumers and patients” and said she would be “going after them” if elected to the White House.
Dr Sidney Wolfe, a physician and founder of the Public Citizen’s Health Research Group, said: “Given the rapidly increasing price of drugs, this is just money over the dam, and there is no evidence that this is anything other than a wash for big pharma.”
He added: “No one is getting anything out of this other than the likes of Pfizer and Eli Lilly.”
Pfizer said: “There is a segment of the patient population that prefers to use branded medicines rather than their generic equivalents and these patients should have access. More than 99 per cent of prescriptions for Lipitor today are for the generic.
“In the US, where there are strong intellectual property protections for medicines which allow for a period of return on innovation, when a medicine loses that patent the rate of switching to the generic version is much higher than it is in many other countries.”
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