THERAPEUTIC SUBSTITUTION POST-PATENT EXPIRY: THE CASES OF ACE INHIBITORS AND PROTON PUMP INHIBITORS
تعليق: إقتصاديات هذه الأدوية تصل حجم مكسب 40 مليار سنوياً. يا ترى كم مريض إستفادوا فعليا وكم مريض تضرروا. --احمد شوقي محمدين 20:52، 22 أكتوبر 2016 (ت ع م)
شرح مجلة الإيكونوميست للموضوع:A second strategy nudges customers towards newer drugs that are still protected by patent. Omeprazole, a drug to reduce stomach acid developed by AstraZeneca in the 1980s, shows how it works. Branded as Losec in Britain and Prilosec in America, it became one of the world’s bestselling drugs in the mid-1990s. With the patent set to expire in 2001 AstraZeneca faced a drop in profits. So the company took its drug and adapted it, creating a closely related compound, esomeprazole, which it sold as Nexium. Though a clear offshoot of the original medicine, this counted as a new drug and was given a patent. A big marketing campaign and attractive pricing helped shift demand away from Losec and towards Nexium. With the help of this strategy, sales between 2006 and 2013 amounted to almost $40 billion.
This sort of “follow on” patenting is common. In a new paper Sotiris Vandoros of the London School of Economics looks at what happens when patents expire in two important classes of drugs: ACE inhibitors, used to treat blood pressure, and proton-pump inhibitors, such as omeprazole. He tracked sales of these drugs after patents expired in six European countries between 1991 and 2006, measuring the switch both to generic drugs and to related but still patented compounds. Mr Vandoros’s findings are worrying. When patents expired on Captopril, a leading ACE inhibitor, cheap generic versions became available. But the total volume of sales of all versions of the drug went down rather than up as demand shifted to more expensive patented products. Other drugs showed similar patterns, meaning that competition from generics was failing to cut costs.
Even more troubling than fending off competition with marketing nous and chemical tinkering is drug companies’ third option: pay the makers of generics not to compete. Since the early 2000s “pay for delay” agreements have become more common. A company with a patent due to expire strikes a deal: it pays potential entrants a fee not to compete, preserving its monopoly. A pay-for-delay deal between AstraZeneca and three big generic manufacturers helped to protect Nexium from competition between 2008 and May 2014.
The economic costs of these three strategies vary hugely. Marketing is a decent way to compete. Purists may wish that firms would try to outdo each other by devoting more cash to genuine research and economists may bemoan the irrationality of those who buy branded drugs at ten times the price of an identical generic. But despite the quibbles, the market works: there is a choice, including a low-cost option.
Health Economics
Volume 23, Issue 5 May 2014 Pages 621–630 Health Economics Letter
THERAPEUTIC SUBSTITUTION POST-PATENT EXPIRY: THE CASES OF ACE INHIBITORS AND PROTON PUMP INHIBITORS
Sotiris Vandoros
DOI: 10.1002/hec.2935
Abstract
This paper examines whether there is a switch in total (originator and generic) consumption after generic entry from molecules that face generic competition towards other molecules of the same class, which are still in-patent. Data from six European countries for the time period 1991 to 2006 are used to study the cases of angiotensin-converting enzyme inhibitors and proton pump inhibitors. Empirical evidence shows that patent expiry of captopril and enalapril led to a switch in total (off-patent originator and generic) consumption towards other in-patent angiotensin-converting enzyme inhibitors, whereas patent expiry of omeprazole led to a switch in consumption towards other proton pump inhibitors. This phenomenon makes generic policies ineffective and results in an increase in pharmaceutical expenditure due to the absence of generic alternatives in the market of in-patent molecules.
http://onlinelibrary.wiley.com/doi/10.1002/hec.2935/abstract
