Friday, April 23, 2010

Lipitor - another sign of a completely borken market

Atorvastatin, a.k.a Lipitor, is the best-selling drug in history.  Annual sales are nearly $13B.

Lipitor is a great drug, and it probably saves a lot of lives.  The patent expires next June, so expect to hear how a slightly reformulated Lipitor is actually much better for you over the next year.

Since I'm paying my own health insurance costs these days, I got quite the shock in January when I had to meet the deductible for my meds.  For the first time in ten years of taking Lipitor, I actually tried to find out how much it cost.

Walgreens wasn't allowed to tell me how much it cost.  But they wanted to!  And since I already knew the scam, no harm was done.

You can look this up yourself, on  100 Lipitor pills @ 20mg costs $415.  Guess how much 100 pills @ 40mg costs?  $415.  And the 80mg?  Yup, $415.  I could have been saving about $1200/year by chopping 80mg pills into 10 or 20mg pills.  (Since the half-life of atorvastatin is only about 24 hours, it would probably be a bad idea to take a larger dose every other day).

The kind folks at Walgreens pointed out that some insurance companies actually require their customers to get the higher dose pills and chop them up.  But nobody designs a pill to be chopped into 8 pieces.

Pfizer considers chopping up the pills to be a form of 'cheating'.  From their point of view (and I have some sympathy with it), they are renting you their intellectual property, and in a way that doesn't discriminate against people who need higher doses.

Understand, my complaint here isn't about Pfizer's pricing strategy.  My complaint is that the vast majority of people taking Lipitor have no idea how wildly expensive it is, and that there's a simple way to cut the price down to a small fraction.  Most of those people just don't care.  And that is what is broken in the health care market.  That simple problem explains most of the unsustainable rise in health care costs.

Now for the kicker... you can buy generic atorvastatin from overseas pharmacies for a fraction of the cost of Pfizer's product.  A sample price - $75 for 100@20mg.  That's actually less than my co-payment through my insurance company.  Prices will plummet further by next year.

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