Sales of cholesterol blockbuster Lipitor plunged by half barely a week after the world's top-selling drug got its first U.S. generic competition, new data show.
That's despite a very aggressive effort by Lipitor maker Pfizer Inc. to keep patients on its pill, which generated peak sales of $13 billion a year, through patient subsidies and big rebates to insurers.
Lipitor lost patent protection on Nov. 30 in the U.S., where the drug was still generating about $7.9 billion in annual sales. Two generic versions costing about a third less hit the market right away, one made by India's Ranbaxy Laboratories Ltd. and the other an authorized generic, made by Pfizer and sold by its partner, Watson Pharmaceuticals Inc.
Lipitor's patent loss has been closely watched across the pharmaceutical industry, where most companies face generic competition, and a big revenue hit, for at least some of their top drugs over the next few years.
Figures from data firm IMS Health on prescriptions for Lipitor and competing drugs that lower LDL or bad cholesterol, the class called statins, show the number of Lipitor prescriptions filled in the seven days ended Dec. 9, the first full week when generic rivals were available, plunged to 359,235. That's down from the 724,799 Lipitor prescriptions filled a month earlier, in the week ended Nov. 11.
Lipitor's share of statin prescriptions dropped to 9.7 percent from 20.9 percent over that period. Its biggest rival among brand-name cholesterol drugs is a newer one, Crestor from Britain's AstraZeneca PLC, which saw market share hold steady at 12.3 percent amid a new Crestor ad campaign.
The IMS data, released Monday, show nearly 476,000 new prescriptions for generic Lipitor, called atorvastatin, were filled the week ended Dec. 9. Just under 80 percent were for Watson's generic version.
The figures cover retail prescriptions, those filled at independent pharmacies, chain drug stores and pharmacies in supermarkets and discounters such as Target. Not included are prescriptions filled by mail order, where any shifts are likely to take longer to appear.
Miller Tabak analyst Les Funtleyder said Monday the drop in Lipitor prescriptions is less than he expected.
"It's already done better than we thought it would, (but) it's a little early in the game to declare this a successful strategy," Funtleyder, portfolio manager for the Miller Tabak Health Care Transformation Fund, said of Pfizer's rebates and discounts.
For months, New York-based Pfizer has been heavily advertising its "Lipitor For You" program, which offers insured patients a card to get Lipitor for a monthly $4 copayment. Pfizer will pay the difference between that and an insurance plan's normal brand-name co-pay, up to $50.
Uninsured patients could get the same savings using the card but would have to pay the rest of the cost, which ranges from about $115 a month for the lowest Lipitor dose to $160 a month for three higher doses. The new generics cost roughly $80 and $100 a month, respectively.
Spokesman MacKay Jimeson said Pfizer estimates about 5 percent of current Lipitor patients in the U.S. and Puerto Rico will enroll in the program.
Many of the roughly 3 million Americans who were taking Lipitor have not gotten a refill since generic Lipitor arrived. For some, their insurance plan may not give them a choice -- either automatically switching them to generic Lipitor or keeping them on the brand name and taking Pfizer's rebates for the next six months.
After that, multiple generic versions will hit the market. Their prices should dip as low as about 20 percent of brand-name Lipitor, and the Pfizer discounts will end.
Any market share retained until then is worth a lot to Pfizer, Funtleyder said, noting the low cost of making the pills -- about a dime each.
"It wouldn't surprise me to see similar things from other companies," he said, if Pfizer's program continues to retain some patients.
While Lipitor and Crestor generate most of the money from cholesterol medicines, much-cheaper generic versions of three older statins -- Zocor, Pravachol and Mevacor -- account for almost two-thirds of statin prescriptions. Those three generics saw a slight increase in the number of prescriptions filled from Nov. 11 to Dec. 9.
According to IMS, about 167,000 of the prescriptions filled for atorvastatin were from patients who had been on Lipitor, another 118,000 were from people on simvastatin (generic Zocor) and about 20,000 were from patients on Crestor. The rest were from the other existing generic statins and seven other brand-name statins that have very low sales, most because they have a generic rival.
Overall, the number of people taking a statin drug increased slightly right after generic Lipitor arrived. The number of prescriptions filled for statins jumped from about 3.48 million in the week ended Nov. 11, to 3.7 million in the week ended Dec. 9.
Jason Mazzarella, a product manager at IMS Health, thinks that's partly because patients with tight budgets are more likely to go without cholesterol pills than drugs for conditions with obvious symptoms, and generic Lipitor would be more affordable for them.
Also, some of the new atorvastatin prescriptions are for patients adding it to another statin or one of the eight other types of drugs for cholesterol problems.
Besides Pfizer, AstraZeneca stands to lose most from generic Lipitor. It started a new Crestor advertising campaign in November, with broadcast, print, Internet and other ads. It will continue into 2012, AstraZeneca spokeswoman Elizabeth Renz said.