ROBERT SIEGEL, host:
You're listening to ALL THINGS CONSIDERED from NPR News.
It's an important day for millions of Americans who take medicine to control their cholesterol. The pharmaceutical company Merck has lost patent protection for its cholesterol-lowering drug, Zocor, and that opens the market to less-expensive, generic versions of the drug.
The first was approved today. Until now, the little orange pills cost about $3 per dose. Merck says it plans to lower that price. Pfizer, which makes the best-selling cholesterol drug, Lipitor, may have to make some adjustments as well. And for doctors, all this means new decisions about what to prescribe.
MICHELE NORRIS, host:
Stuart Seides is a cardiologist in Washington, D.C. He's also the associate director of cardiology at Washington Hospital Center. He joins us now. Doctor, thanks for being with us.
Dr. STUART SEIDES (Washington Hospital Center): My pleasure.
NORRIS: Now that three other companies will be allowed to sell drugs containing the active ingredient in Zocor, what does that mean for the parent company, Merck, and also for the broader market for cholesterol-lowering drugs?
Dr. SEIDES: Well, it's a complicated question because it has both medical and business implications. From the medical point of view, Zocor is one brand of a class of drugs known as statins. All of the statin drugs are in many ways equivalent and are easily substituted for one another, particularly at lower doses.
And so the presence of a generic version of one of the statins will provide an opportunity for consumers and their doctors to potentially obtain the therapeutic benefit of this drug at a lower price. And Merck has to face the reality that it's going to have generic competitors.
On the other hand, my understanding is that they're taking a rather proactive approach with many insurance companies so that, in fact, their version of this drug will become the preferred version for those particular insurance companies. So Merck will continue to sell Zocor, but they will do it at a much lower price.
NORRIS: Now, for years Zocor has basically lorded over this market with its competitor, Lipitor, which is produced by Pfizer. Is this also bad news for Lipitor and Pfizer?
Dr. SEIDES: Well, I think from a business standpoint, clearly the folks who make Lipitor and Crestor are going to have to think through, and I'm sure they have been thinking through, their business strategy. Some of the folks who take Lipitor will be candidates to be reasonably and safely switched to a lower-cost option.
NORRIS: Beyond brand loyalty, is there a danger in switching drugs? You said that they're very similar, but if you switch from one drug to another are there potential problems or complications?
Dr. SEIDES: Well, I think the things to remember, number one, is that although these drugs have a great deal of similarity, they are not equivalent on a milligram basis. For example, Lipitor is approximately twice as potent on a milligram basis as Zocor. So the person taking Lipitor 10 milligram would need to take Zocor 20 milligram or generic Simvastatin 20 milligram to approximate the same beneficial effect.
These drugs tend to have similar side effects, but everybody is different and I certainly have patients who can tolerate Lipitor who can't tolerate Zocor, and vice versa. And so there are certainly going to be people who need to be on Lipitor or Crestor or one of the other statins that are still covered under patent.
NORRIS: Dr. Seides, thanks so much for talking to us.
Dr. SEIDES: My pleasure, Michele. Nice to talk to you.
NORRIS: Dr. Stuart Seides is a cardiologist in Washington. He's also associate director of cardiology at Washington Hospital Center.
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