With all the discussion about generic Lipitor this week here’s one thought that deserves some consideration: the saga of Lipitor is the best case yet for the defense of the pharmaceutical industry.
I’ve been as critical as anyone of big pharma over the years, and there’s little doubt that the pharmaceutical industry deserves much of the criticism it has received. But, for once, let’s focus on the positive side of pharma.
Don’t take this to mean that the Lipitor story is a pure and shining example of pharma virtue. It’s not. As with all successful drugs, Pfizer has used every trick in the book, and even written a few new books to add to the library, in its efforts to wring every last dollar out of the Lipitor patent. Most recently, Pfizer’s efforts to blunt the impact of the drug’s patent expiration are a masterful example of corporate ingenuity (or deviousness).
But I’m ok with that. The reason: starting this week, people will pay about half of what they used to pay for the drug, and in six months the cost will drop to pennies a day. We can argue about the relative benefits of Lipitor compared to other blockbuster drugs, but there’s little question that after delivering well over $100 billion to Pfizer (and its predecessors, which the Pfizer leviathan swallowed like so many small fish) for branded atorvastatin over the last dozen years or so, the world will now enjoy the yields of its investment. In the end, the dividend will make even $100 billion seem cheap.
This might provoke howls of protest from some, but isn’t this how capitalism is supposed to work? I suppose we can all imagine more idealistic economic and political systems, in which research would be unsullied by commercial considerations and the pharmaceutical industry would be motivated solely by the desire to help people, but I haven’t seen any evidence that any system radically different from our current one could produce an atorvastatin.
And let’s remember: atorvastatin is not an anomaly. I’ve been covering cardiovascular medicine since the 1980s, and the parade of major blockbuster drugs that have appeared on the scene, raked in billions and billions of dollars, and then gone generic, is breathtaking. When I started out writing about cardiovascular medicine the beta-blocker Inderal (propranolol) was still one of the best-selling drugs in the world, and since then we’ve had more beta-blockers, followed by calcium channel blockers, ACE inhibitors, ARBs, and many others. All of these drugs have come and gone generic. Next year Plavix (clopidogrel) will lose its patent protection, which will mean that the vast majority of people will be able to take cheap generic drugs for nearly every major cardiovascular illness. That’s what I call progress.
Next week I’ll continue my regular coverage of the cardiovascular arena. I have little doubt that new examples of industry excess and malfeasance will turn up as a recurring theme. But it’s good to remember, especially at the end of the week when Lipitor went generic, that there’s another side to the story.