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Except that the problem doesn't take care of itself. By 2019, the same company will likely have on the market a new patented drug in the same family, with roughly the same efficacy as the other two. They can do this pretty much indefinitely.


I'll bet Dr. Reddy is already on the case if you don't mind the occasional moldy smell:

http://en.wikipedia.org/wiki/Dr._Reddy%27s_Laboratories

With up to 10M cases in the US alone, it seems like an excellent target for competition.

http://www.blindness.org/index.php?option=com_content&view=a...


Wrong. Pharmacy doesn't work that way.


Yes it does. For example, look at Clarinex. This drug is in no way advantageous over Claritin, and in fact is metabolized into Claritin in vivo. The only reason that it exists is because Schering-Plough's patent ran out on Claritin.

Or look at Vyvanse, a prodrug of Adderall. Shire Plc has been intentionally manipulating the market (using government amphetamine quotas) for years in order to push patients away from cheaper generic Adderall (despite the fact that many people find Vyvanse to be substantially inferior).

Or take the case of adrafinil, which metabolizes into modafinil (provigil). Adrafinil is just fine (not quite as effective, but nearly so), but its patent ran out. At that point, Cephalon pulled strings to get its approval revoked (this was in France; adrafinil is unapproved and unregulated in the US), so that people would have to move to their newer, patented drug. (And yes, adrafinil does tax the liver some, but no more so than plenty of other drugs).


Yes, it does. They add something like calcium carbonate (tums) to an existing med and patent the combo, or they find an isomer of the drug. Happens all the time.


No, it doesn't. Generic companies can make replicates of the original drug easily when the original patent expires.


Drug companies have tackled that in a variety of ways.

Outright bribery of generic companies to hold off on production (http://www.usatoday.com/story/news/nation/2013/06/17/supreme...), scaremongering over safety of the generic (the article being discussed in this thread), paying doctors for prescribing the more expensive versions, etc.


Yes, but those generics will be cheap, whereas the new drug will be expensive. Since the doctors are reimbursed based on a percentage of the cost of the drug, they will choose the more expensive one, just like they do now. A cheap competitor already exists. Adding another cheap competitor won't help when doctors are incentivized to use the most expensive option.


You're forgettingabout the incentives of the insurers. They will be the ones to require the cheaper alternative, similar to the way many insurers require the use of Avastin for AMD unless there is a good reason to use Lucentis.


> They will be the ones to require the cheaper alternative

They likely can't in this situation, as the cheaper alternative is off-label.


Informative replies to this in another comment thread:

https://news.ycombinator.com/item?id=6870036


Yes, it works exactly that way. Marketing and bribery ensures that both doctors and patients will prefer the "new" and expensive drug.




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