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The moment I saw the title of the “research” article comparing the effectiveness of the non-generic statin Lipitor to the generic version of the statin Zocor on the cover of Mayo Clinic Proceedings, I knew its conclusion without reading it. My first thought had to do with the research participants being little better than Illinois politicians, money-wise.
Let’s start with the facts: A three-month supply of Lipitor costs about $250, compared to a three-month supply of generic Zocor, called simvastatin, at $13. Yes, you read that right–Lipitor costs $237 more than simvastatin, and that couple hundred dollars buys you essentially the same drug.
Lipitor is probably the most profitable drug in medical history, netting Pfizer billions of dollars since its launch a decade ago. It was due to go generic, but Pfizer, not wanting to lose the cash cow that keeps it afloat, has tried every maneuver to extend its patent and keep the price high (“for the health and safety of the consumer,” crowed their CEO). Three years ago, Pfizer funded a British study that attempted to show switching from Lipitor to a generic increased a person’s risk for heart attacks. Cardiologists on both sides of the Atlantic found so many flaws in the study that it received the minimal publicity it deserved. When that didn’t work, Pfizer cut a sweetheart deal with generic manufacturer Ranbaxy Pharmaceuticals to hold off generic production a year beyond Lipitor’s patent expiration date so Pfizer could reap an additional year’s profits. These people are unbelievable.
As a consumer of health care, you should know that Pfizer is unstoppable in its quest to get doctors to keep writing Lipitor prescriptions. So they approached the august and revered Mayo Clinic. Here’s a make-believe conversation regarding the study published by Mayo. This is not a wiretapped exchange, but based on what I know about how drug companies work, I’m pretty sure it’s not far from the truth.
Doctor #1: We got a proposal from Pfizer to show their brand-name Lipitor is better than the generic.
Doctor #2: Are they still on that old horse? Doesn’t everyone know it’s not lowering cholesterol that saves people? It’s lifestyle, it’s reducing inflammation…
Doctor #1: Do you want to see the size of the check? (shows check to Doctor #2)
Doctor #2: Jeez! I don’t think I’ve ever seen that many zeroes on a check in my life.
Doctor #1: Plus a donation to the Clinic. Plus lots of full-page ads in the journal. It’s a big study and we really don’t have to work. Just have lackeys go over the records of 170,000 patients who took Lipitor and 50,000 patients who took Zocor and show the Lipitor patients had fewer heart attacks. We can get a team together. Even if we get a dozen doctors on this, there’s more than enough bucks to go around.
Doctor #2: I don’t know. I’m real busy these days. These studies can be time consuming.
Doctor #1: Not for us. It’s just a review of records. Computers and such. Pfizer pays for nurses and data analysts to do all the hard work. We just massage the results. They’ve got professional writers to put the final article together and a huge team of publicists in place when we get the results together. We publish in Mayo Clinic Proceedings. Heck, the Mayo name is worth more than an Illinois senate seat.
Doctor #2: But there are so many factors involved that will foul up the data. For example, generic Zocor goes to Medicaid patients who generally have unhealthier lifestyles. Lipitor is prescribed to people with good health insurance. Nobody can unravel all these factors and get coherent results.
Doctor #1: You want in or out?
Doctor #2: So all I have to do is put my name on the study?
Doctor #1: That’s it, pal. Little ski chalet in Aspen look good? Take the family on an African safari? Get all your kids through college?
Doctor #2: What if our analysis shows Lipitor coming out just the same or even worse than the generic?
Doctor #1: You aren’t serious! You’ve got the livelihood of doctors, nurses, writers, and Pfizer executive bonuses all riding on this study. And if Pfizer likes it, there’ll be more to follow. Mmm. I can sure smell that meat a-cookin’…
Doctor #2: Come to think if it, my Lipitor patients are doing better than my Zocor patients.
Doctor #1: That’s the spirit! Welcome aboard!
Be well,
David Edelberg, MD