Feb 27 2021 • 19 mins

We have allowed our patent drugmakers to gouge us so thoroughly that we can no longer afford their products. The result is that ninety percent of America’s medications are now generics. Until recently, I believed that these were practically equivalent to the brand names, but it stunned me to learn I was wrong.

Generics are not exact copies of trade-name drugs. The manufacturers do not have the original recipe, and production outside the brand factories tends to be less careful. Overseas, there might be hygiene problems or extra ingredients added. These can change the way a drug works or even be harmful.

We permit new companies to manufacture drugs after the patent expires. Other companies make generics in foreign countries where patent laws are ignored. The drug’s chemical name is used to market generics rather than the original trade name, and sometimes the generic drugmaker makes up their own trade name.

Lipitor generics illustrate how it works. Richard Mason (Harvard), collected thirty-six samples of this statin drug from fifteen countries and two dozen manufacturers between 2011 to 2013. Analysis proved that thirty-three had impurities that thoroughly compromised them. This is beyond atrocious, but the backstory is worse.

When the patented version of Lipitor was originally studied during its approval process, only two small groups lived longer: those who had a previous heart attack and (possibly) those with hereditary high cholesterol. This alleged success was used to support marketing to nearly anyone with slightly high cholesterol. There are now 35 million US citizens taking Lipitor. It is not just the bestselling statin, but in 2011, it was the bestselling medication of all time.

Lipitor was an ideal drug for fraudulent generic copies because the genuine item was nearly worthless. Neither the doctors, the public, the study authors, nor the writers of the two otherwise excellent resource books I used for this chapter ever understood the irony.


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