The nation's top-selling drug, Lipitor, goes generic on Wednesday, and that's good news for patients, experts say.
"The fact that Lipitor is going generic should make it available to a wider group of patients," said Dr. Robert Kloner, professor of medicine at the University of Southern California in Los Angeles.
In particular, people who have been prescribed Lipitor (atorvastatin) but haven't been taking it as regularly as they should or have been cutting pills in half to make their prescriptions last longer may be able to better adhere to their medication regimens, said Kloner, who was involved in some of the clinical studies on Lipitor and who takes the drug himself.
"Atorvastatin is a very good medication and quite effective at lowering LDL cholesterol," said Dr. Robert Ostfeld, attending cardiologist at Montefiore Medical Center in New York City. "I think that having a generic will be a wonderful addition because, unfortunately, some of our patients have to make the very painful decision between paying the rent and taking their medication and any time we can reduce the cost without sacrificing efficacy, that's a wonderful thing."
Lipitor sales were nearly $4 billion from January to June, with 21 million prescriptions dispensed, according to IMS Health. In 2010, sales reached $7.2 billion for its manufacturer, Pfizer.
According to Kaiser Family Foundation figures cited in the Wall Street Journal, copays for branded drugs average $29 or $49, versus only $10 for generics, which should mean more savings for patients.
Several other statins have already gone generic, namely Zocor (simvastatin), Pravachol (pravastatin) and Mevacor (lovastatin), but "they're not as potent as Lipitor," said Dr. Howard Weintraub, clinical director of the Center for the Prevention of Cardiovascular Disease at NYU Langone Medical Center in New York City.
As of Dec. 1, the statin Crestor (rosuvastatin) will still be branded.
But Lipitor does seem to offer advantages over the other generic statins, said Ostfeld.
"The other generic statins are excellent and are very effective at lowering the LDL ["bad"] cholesterol, but atorvastatin tends to be a little more potent than the current generic statins, so in patients whose bad cholesterol levels are particularly high despite a healthy lifestyle, having the ability to also prescribe generic atorvastatin may help us get more patients to their LDL cholesterol goals," Ostfeld added.
Of course interactions with other drugs and the fact that many patients who are on Lipitor or who need Lipitor are also on other multiple medications needs to be taken into account when prescribing, Weintraub cautioned.
And, as always, lifestyle considerations should be paramount, Ostfeld noted.
"It's critically important to ensure that the patient has a healthy lifestyle," he said. "That means eating a whole-food, plant-based diet and regular exercise." And there are times, Ostfeld added, that despite having a healthy lifestyle, medications are still needed.
The American Heart Association has more on cholesterol.
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