As Lipitor's Patent Expires, Is Era of 'Blockbuster Drugs' Over?

bjbjLULU JEFFREY BROWN: And finally tonight, a blockbuster drug goes generic, and patients,
doctors and the pharmaceutical industry all have an interest. Margaret Warner has the
story. MARGARET WARNER: It's been the most profitable prescription drug in history, with
many millions of people taking it over the last 14 years. But, today, Lipitor, a so-called
statin that lowers cholesterol levels, lost its patent protection, opening the door to
low-cost generics. Lipitor accounted for more than $10 billion in worldwide sales last year
for its manufacturer, Pfizer, and more than $130 billion over the patent's life. It's
the first of several blockbuster drugs due to lose their patents in the next year. We
look at the implications of all this now with Dr. Jerry Avorn, a professor at Harvard Medical
School and a senior physician at Brigham and Women's Hospital in Boston. He's also the
author of the book "Powerful Medicines." And, Dr. Avorn, thank you so much for being with
us. How big a change is this for the world of pharmaceuticals and for consumers to have
Lipitor going off patent today? DR. JERRY AVORN, Harvard Medical School: Well, for consumers,
it's welcome news for those who are on Lipitor, because they will be able to switch to the
generic drug, which is called atorvastatin, and it's the exact same molecule. It will
work every bit as well, and it's going to cost a fraction of what they have been paying
thus far. So, from that perspective... MARGARET WARNER: How small a fraction? DR. JERRY AVORN:
Well, Lipitor is now selling for about $5 a pill. It probably costs about a dime a pill
to make. So it's a nice business to be in with that kind of a markup. And probably the
rate will drop down to maybe about half as much initially, and then even lower than that.
There are statins that are now available at discount stores for $4 a month, as opposed
to $5 a pill. So it could well get down into that $4- to $10-a-month category, certainly
after six months, when there will be many more generic manufacturers selling it. MARGARET
WARNER: Now, Pfizer, though, is fighting back against generic competitors. DR. JERRY AVORN:
Yes, they are. It's really kind of like trying to hold back the tide, because, in six months,
because of a variety of legal reasons, there will be many generic manufacturers. And, at
that point, Pfizer can't keep fighting them all back. I think what it's trying to do is
just preserve whatever franchise it can in the waning months of its availability on the
market. And, frankly, I would rather that all of that enormous creativity that they're
showing in ways of dealing with this legally and through deals and economically were being
spent on developing new products, rather than trying to figure out other ways to get people
not to use the generic. MARGARET WARNER: But explain what they're trying to do. It's quite
a novel approach. DR. JERRY AVORN: It involves arranging deals with prescription benefit
management companies to not make the generic available. It involves making coupons available
to patients to bring down the co-pay to get them to stay on Lipitor, as opposed to the
generic. It involves a variety of kind of side deals with insurers, with druggists,
with anybody who's a player to try to desperately hang on to a couple more months of Lipitor
use. MARGARET WARNER: Now, is there not a debate about whether generics are -- quote
-- "as good" or at least as reliably good as the brand name manufacturer, or do you
consider that a settled point? DR. JERRY AVORN: It's not subtle. And it should not be a debate.
And it should not have been a debate for decades. Generics are every bit as good as the brand
name drugs. There's a lot of disinformation that gets spewed out there. It's not scientifically
accurate information. All the data we have is that generics are every bit as good as
the brand name products. They're held to the same high standards by FDA. They contain the
exact same molecules in the exact same strength. And I really wish that that old canard about
generics don't work as well could be put to bed, because it hasn't been true, and it isn't
true. MARGARET WARNER: So, now, as I said in the introduction, there are other blockbuster
drugs like Lipitor, for instance, Plavix, the blood thinner, that have been a hefty
chunk of the sales of the company, of the manufacturer. Are there other such drugs in
the -- either on the market or in the pipeline, or are we seeing a turning point in the industry?
DR. JERRY AVORN: Well, there are people who have said the era of the blockbuster drug
is over. And when I think of blockbusters like Vioxx or Avandia, both of which cause
heart attacks, maybe those blockbusters, we won't miss so much. But there could be new
blockbusters coming along. There's a variety of new drugs for treating -- anticoagulants,
or blood thinners, for treating a condition called atrial fibrillation that are just coming
to market. Some of them could be blockbuster, if, by that, I mean billion-dollar-a-year
drugs. But we may see fewer of them than we have in the past, in part because people are
looking much more carefully at how we spend every health care dollar. And a lot of the
blockbusters of recent years probably, if they had been subjected to the kind of scrutiny
that drugs are going to get from here on out -- and, again, I'm thinking of Avandia and
Vioxx -- may never have been blockbusters in the period that we're living in, in the
first place. MARGARET WARNER: And is it also the case that the blockbuster drugs, as we
call them, apply to just such a huge class of people, and that now the whole nature of
the research and the formulas for various drugs has become more refined, more targeted?
DR. JERRY AVORN: Well, I wouldn't dismiss the possibility that there is going to be
some wonderful new drug that we can't even imagine. I think nobody saw Google or Facebook
coming a few years before they hit the streets, and they were in a sense blockbusters of their
own. There's a lot of exciting science going on. And I wouldn't rule out the possibility
of some really exciting major drugs for huge numbers of people coming down the road. It's
just a little hard to know what they might be sitting here in 2011. MARGARET WARNER:
Well, Dr. Jerry Avorn, Harvard Medical School, thank you so much. DR. JERRY AVORN: You're
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