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Believe it: Vytorin is all about Big Pharma reaping profits

The pharmaceutical industry may not be “evil,” as some have suggested, but it is just as dedicated to profit-making as any other business, and consumers should never forget it.

The drug Vytorin has hit the headlines today because a new study in the New England Journal of Medicine shows it is no more effective at reducing LDL (“bad” cholesterol) and arterial plaque than older, cheaper drugs. This should come as no surprise, since study results released in early January showed that Zetia, one of the components of Vytorin, is ineffective.

Vytorin is a combination of Zetia (ezetimibe), a Merck/Schering-Plough Pharmaceuticals product and Zocor (simvastatin), an older Merck & Co. product that is now available in cheaper generic form.

There are several important points to be made here. The first is that doctors could have saved their patients some money by prescribing generic simvastatin and Zetia, rather than Vytorin, the newer, more expensive, but no more effective combo drug. The only difference is taking two pills instead of one. Got that? Same drugs, same effect, but you pay more for Vytorin. Vytorin doesn’t benefit patients any more than the older drugs, but it puts a lot more money into the pockets of the pharmaceutical companies.

The second point has just been illustrated. When a drug company introduces a new drug, it gets to charge big bucks for it. That company is, after all, entitled to recoup its research and development costs. However, the timer is running on its patent and its exclusive right to market that drug. As soon as the drug goes “off-patent,” generic companies can and do start producing it and selling it more cheaply, usually under the drug’s chemical name.

Knowing this, the drug company tries to extend its profit-taking by introducing new forms of the original drug; each of these forms can be patented and marketed as a “new” drug. Combining the older off-patent drug with another drug and marketing the result as “new” (e.g.,Vytorin) is one technique. Another is producing the old drug in a new form; an old 4-hour drug is now available in a new, long-acting 12-hour form. A liquid form of what was once available only in tablets can be marketed as new. An adult drug comes out in “new” child-size doses. These new forms of existing drugs may offer certain conveniences to consumers, but they are also a way to keep the profits rolling in for the pharmaceutical companies that have lost their patents on the original drugs.

Be aware that these same marketing techniques are applied to over-the-counter (available without prescription) drugs. For example, Actifed, a cold and allergy medicine, is simply a combination of Sudafed (pseudoephedrine HCl), a decongestant, and Chlor-Trimeton (chlorpheniramine maleate), an antihistamine. Convenient when both an antihistamine and a decongestant are needed; undesirable if the consumer wants to avoid or doesn’t need one of the two drugs. Why pay for two drugs if one is all you need?

Smart consumers should read labels. Know, or at least read, the chemical/generic names of drugs, both prescription and OTC. Look at the chemical names, not just the brand names, when comparing drugs. Know when a “new” drug is just a combination of existing drugs. Do you need or want everything in that combo? Read labels. Read package enclosures. Read online.

Yes, those chemical names are long, intimidating, and often unpronounceable. But they are what tells you the difference between Brand A and Brand B, or if there even is a difference. Talk to your doctor or pharmacist if you have questions, and remember, they are human too. Rarely, they can make mistakes or be unaware of new or reformulated drugs.

It’s not uncommon for doctors to learn about new drugs from pharmaceutical reps who visit them in their offices. The reps hype the drugs and leave literature and samples. It can be a valuable service to doctors, or it can be nothing more than blatant lobbying that includes, say, lunch for all the employees. Most doctors know the reps are just there to sell a product and take that into account when evaluating a drug. On the other hand, a lot of doctors refuse to see reps at all because it takes time away from patients.

Pharmaceutical companies contribute tremendously to the welfare of the world, and they cannot be commended enough for the good things they do. That said, consumers should never forget that Big Pharma, like any other business, never takes its eye off the bottom line — profits.

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