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Where are all the miracle medicines?

Tue., Jan. 20, 2009

Drug companies justify the high cost of prescription medicines to help pay for breakthroughs of the future. One company even advertises: “Today’s medicines finance tomorrow’s miracles.”

The implication is that if we want wonderful medications to cure Alzheimer’s disease, cancer or diabetes, we should be happy to pay whatever they charge us for drugs to control heartburn, depression or high cholesterol.

The trouble is, there have been relatively few miracles in recent years. To date, there is nothing very exciting to slow the progression of Alzheimer’s, let alone cure this dreadful disease. Even unbelievably expensive cancer therapies may prolong life for only a few months.

When you look at last year’s crop of Food and Drug Administration drug approvals, there are few breakthroughs. A new antidepressant was approved called Pristiq. The generic name for this medicine is desvenlafaxine. If that sounds familiar, there’s a good reason. The generic name for the antidepressant Effexor, introduced in 1993, is venlafaxine. In other words, these drugs are chemically related.

The same company makes both Effexor and Pristiq. Why would Wyeth spend countless millions to develop a similar antidepressant? Effexor went off patent in 2006, and a long-acting version, Effexor XR, will lose its patent protection next year.

This type of drug development, whether done by the same company or a competitor, is known in the trade as a “me-too” medicine. It certainly doesn’t represent a major advance in the treatment of depression. Quite a few other antidepressants are already available, including Celexa, Cymbalta, Lexapro, Paxil, Prozac and Zoloft.

A similar situation occurred some years ago when the highly successful acid-suppressing drug Prilosec (omeprazole) lost its patent. Facing a huge loss in revenue due to generic competition, the company brought out a chemical cousin, esomeprazole. It was (and still is) sold under the name Nexium and was widely promoted as “The Purple Pill.”

Although Nexium doubtless has made billions for the company, it was hardly a miraculous development in heartburn treatment. There are now several acid-suppressing drugs on the market that all work in a similar manner. There is little data to suggest than Nexium is head and shoulders above Aciphex, Prevacid, Prilosec or Protonix.

Another product the FDA approved in 2008 is even harder to label as a miracle breakthrough. The glaucoma drug Lumigan may have represented an advance in the treatment of glaucoma when the eyedrops were approved in 2001. But should Americans really celebrate approval of the exact same medicine under the name Latisse to lengthen eyelashes?

We will never know how many millions of dollars were spent on the development of Latisse, as that sort of information is usually kept secret. But it will be expensive to use. A month’s prescription is expected to cost consumers $120. It may take two to four months to see significant results. Once the topical treatment is discontinued, eyelashes are likely to return to their original state.

If the pharmaceutical industry expects Americans to continue spending billions for pricey prescriptions, it will have to come up with more miraculous medicines than me-too drugs and eyelash lengtheners.

Contact Joe and Teresa Graedon by e-mail them via their Web site:

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