Comments on: Dear Doctor: A Union Shills For Pfizer And Lipitor http://www.pharmalot.com/2008/03/a-union-shills-for-pfizer-and-lipitor/ News, Comment and Conversation Fri, 10 Feb 2012 18:58:00 +0000 http://wordpress.org/?v=2.6.2 By: Atlex http://www.pharmalot.com/2008/03/a-union-shills-for-pfizer-and-lipitor/#comment-225627 Atlex Tue, 25 Mar 2008 11:52:38 +0000 http://www.pharmalot.com/2008/03/a-union-shills-for-pfizer-and-lipitor/#comment-225627 JiM, Call me skeptical, but are you sure it was a 2.5mg dose? Were you really taking just 1/4 of a 10mg pill? Must of been a hell of an effort to split the pills! M Helm, I think you miss the point regarding price. Lipitor, even with a rebate or discount, is unlikely to approach the price of simvastatin. However, for patients needing reduction of LDL >45%, a level that simvastin rarely achieves without a significant increase in side effects, Lipitor, if contracted for by the union's PBM, might be a lower cost alternative to Crestor and Vytorin. Atlex JiM,

Call me skeptical, but are you sure it was a 2.5mg dose? Were you really taking just 1/4 of a 10mg pill? Must of been a hell of an effort to split the pills!

M Helm,

I think you miss the point regarding price. Lipitor, even with a rebate or discount, is unlikely to approach the price of simvastatin. However, for patients needing reduction of LDL >45%, a level that simvastin rarely achieves without a significant increase in side effects, Lipitor, if contracted for by the union’s PBM, might be a lower cost alternative to Crestor and Vytorin.

Atlex

]]> By: Justice in Michigan http://www.pharmalot.com/2008/03/a-union-shills-for-pfizer-and-lipitor/#comment-225254 Justice in Michigan Tue, 25 Mar 2008 04:24:24 +0000 http://www.pharmalot.com/2008/03/a-union-shills-for-pfizer-and-lipitor/#comment-225254 Many thanks to all for providing info and reflections. This is beside the point, but I had a _60%_ reduction in LDL on 2.5 mg! Obviously, the folks behind all of this don't want anyone to "miss out." Many thanks to all for providing info and reflections. This is beside the point, but I had a _60%_ reduction in LDL on 2.5 mg! Obviously, the folks behind all of this don’t want anyone to “miss out.”

]]> By: Bingo http://www.pharmalot.com/2008/03/a-union-shills-for-pfizer-and-lipitor/#comment-224817 Bingo Mon, 24 Mar 2008 20:40:30 +0000 http://www.pharmalot.com/2008/03/a-union-shills-for-pfizer-and-lipitor/#comment-224817 Here is some approximate market share data for Lipitor doses 10mg:42% 20mg:35% 40mg:18% 80mg: 5% Make of that what you will... Here is some approximate market share data for Lipitor doses

10mg:42%
20mg:35%
40mg:18%
80mg: 5%

Make of that what you will…

]]> By: M Helm, MD http://www.pharmalot.com/2008/03/a-union-shills-for-pfizer-and-lipitor/#comment-224802 M Helm, MD Mon, 24 Mar 2008 20:30:47 +0000 http://www.pharmalot.com/2008/03/a-union-shills-for-pfizer-and-lipitor/#comment-224802 Jack2, you may be buying the hype. No question atorvastatin is a good drug, but it is hard to argue that aside from being half as potent, simvastatin does not have the same advantages. A 40mg "starting" dose is very high. Some of the data I had laying around showed that more than 80% received 10mg or 20mg atorvastatin prior to simvastatin being selected as the preferred agent. It is unlikely that the union can get atorvastatin for less than simvastatin. More likely some "rebate" money is involved. Pfizer has developed some good outcomes data on the 80mg dose, but hardly anyone prescribes it. I don't know if there just aren't that many people whose physicians feel they need >50% reduction, or if there is just healthy caution about playing at the higher end of the dose range of a potent statin. On a certain level, the research focus on 80mg atorvastatin seems to imply that Pfizer knows they can't really compete with simvastatin 20mg or 40mg for the former 10mg and 20mg atorvastatin patients. The only thing certain: the letter was NOT a public service announcement. Jack2, you may be buying the hype. No question atorvastatin is a good drug, but it is hard to argue that aside from being half as potent, simvastatin does not have the same advantages.

A 40mg “starting” dose is very high. Some of the data I had laying around showed that more than 80% received 10mg or 20mg atorvastatin prior to simvastatin being selected as the preferred agent.

It is unlikely that the union can get atorvastatin for less than simvastatin. More likely some “rebate” money is involved.

Pfizer has developed some good outcomes data on the 80mg dose, but hardly anyone prescribes it. I don’t know if there just aren’t that many people whose physicians feel they need >50% reduction, or if there is just healthy caution about playing at the higher end of the dose range of a potent statin. On a certain level, the research focus on 80mg atorvastatin seems to imply that Pfizer knows they can’t really compete with simvastatin 20mg or 40mg for the former 10mg and 20mg atorvastatin patients.

The only thing certain: the letter was NOT a public service announcement.

]]> By: Atlex http://www.pharmalot.com/2008/03/a-union-shills-for-pfizer-and-lipitor/#comment-224735 Atlex Mon, 24 Mar 2008 19:05:23 +0000 http://www.pharmalot.com/2008/03/a-union-shills-for-pfizer-and-lipitor/#comment-224735 JiM, As the letter states, the 40mg starting dose is appropriate for patients who need an LDL-C reduction of >45%. That would be a minority of the patients with high LDL. My guess that there are two purposes to this letter: 1)assuming that Lipitor is the preferred branded agent on the formulary, this letter would lead more physicians to prescribe Lipitor instead of Crestor or Vytorin; 2) Since simvastatin is not as potent as Lipitor, this letter will subtedly remind prescribers that patients who need >45% LDL reduction probably won't benefit from simva but will benefit from Lipitor. In the first instance, Lipitor may cost the union less than the branded alternatives due to a contract. In the second case, the union may believe that Lipitor's ability to impact very high LDL as opposed to simva, makes it a better value for the targeted segment of patients. Health plans (as opposed to unions) send these type letters out all of the time when they are at risk. Atlex JiM,

As the letter states, the 40mg starting dose is appropriate for patients who need an LDL-C reduction of >45%. That would be a minority of the patients with high LDL.

My guess that there are two purposes to this letter: 1)assuming that Lipitor is the preferred branded agent on the formulary, this letter would lead more physicians to prescribe Lipitor instead of Crestor or Vytorin; 2) Since simvastatin is not as potent as Lipitor, this letter will subtedly remind prescribers that patients who need >45% LDL reduction probably won’t benefit from simva but will benefit from Lipitor. In the first instance, Lipitor may cost the union less than the branded alternatives due to a contract. In the second case, the union may believe that Lipitor’s ability to impact very high LDL as opposed to simva, makes it a better value for the targeted segment of patients.

Health plans (as opposed to unions) send these type letters out all of the time when they are at risk.

Atlex

]]> By: Justice in Michigan http://www.pharmalot.com/2008/03/a-union-shills-for-pfizer-and-lipitor/#comment-224622 Justice in Michigan Mon, 24 Mar 2008 16:43:45 +0000 http://www.pharmalot.com/2008/03/a-union-shills-for-pfizer-and-lipitor/#comment-224622 40 mg. starting dose? How typical is that? (Anyone have the actual numbers re: proportion of Lipitor rx's at that level?) 40 mg. starting dose? How typical is that? (Anyone have the actual numbers re: proportion of Lipitor rx’s at that level?)

]]> By: Jack2 http://www.pharmalot.com/2008/03/a-union-shills-for-pfizer-and-lipitor/#comment-224541 Jack2 Mon, 24 Mar 2008 15:28:52 +0000 http://www.pharmalot.com/2008/03/a-union-shills-for-pfizer-and-lipitor/#comment-224541 It's a plus for Pfizer and the patients. Lipitor is the best. It's proven to lower cholesterol more than other statins that went generic. The same generics that insurance companies will pay doctors to switch pts from Lipitor to. ...and no I don't work for Pfizer. Maybe I'm just buying the hype, but I think Lipitor's the greatest recent achievement of the pharmaceutical industry, and I think Pfizer deserves to make a bundle off of Lipitor. It’s a plus for Pfizer and the patients.

Lipitor is the best. It’s proven to lower cholesterol more than other statins that went generic. The same generics that insurance companies will pay doctors to switch pts from Lipitor to.

…and no I don’t work for Pfizer. Maybe I’m just buying the hype, but I think Lipitor’s the greatest recent achievement of the pharmaceutical industry, and I think Pfizer deserves to make a bundle off of Lipitor.

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