Angus Hepburn, of Beacon, N.Y., has been taking Lipitor, a cholesterol-lowering drug, since 2009, after he had a heart attack. He credits the drug with helping him bring his cholesterol level down to a healthy level.
"I had blood work done yesterday, and my cholesterol levels are looking good," he said. "I'm on the drug for life."
Lifesaving as Lipitor may be, it's expensive. Hepburn, who has an employer-based health plan with pharmacy benefits manager MedCo Health Solutions, said he pays about $200 every three months in co-payments and deductibles to take the brand-name drug.
But Hepburn and the 8.7 million Americans who take Lipitor, which is in a class of drugs called statins, for their high cholesterol are in for a pleasant change. On Wednesday, the drug's patent expires, opening the market for cheaper, generic versions of Lipitor, which should lower costs for consumers by about 50 percent.
Lipitor has been a moneymaker for its manufacturer, Pfizer. In 2010 alone, the drug earned the company more than $5.3 billion in U.S. sales. Many patients have been eagerly awaiting the patent's expiration and the money it will save them on their prescriptions.
Dr. Nieca Goldberg, medical director of the New York University Women's Heart Program, said many of her patients have asked about the release of a generic Lipitor.
"They ask if the drug will be the same and are concerned about side effects," she said. "The side effects of the generic should be similar to Lipitor."
Hepburn said Lipitor's going generic is the best news he's heard in a while.
"If I want to stay alive, I've got to keep taking these things," he said. "You've just got to bite the bullet and pay the charges until something like this happens."
For patients currently taking Lipitor, here are answers to the questions that will inevitably arise when the Lipitor patent expires and the drug goes generic:
Will the generic version be the same as Lipitor? Although the new pill may look different and will cost less, doctors say the generic version of the drug, called atorvastatin calcium, will be basically the same as the brand version.
"The active component of the medication is atorvastatin and should give the same lipid lowering as Lipitor," said Goldberg. "The pill will look different due to the inactive components in the pill that are responsible for its shape and color."
To receive approval from the U.S. Food and Drug Administration, generic drugs must contain the same active ingredients as their original patented counterparts. Edith Rosato, a pharmacist and chief executive officer of the Academy of Managed Care Pharmacy, said consumers should remember that the lower cost of a generic drug doesn't mean that its quality is inferior to brand-name drugs.
"Generics are also FDA-approved and are safe and effective and are equivalent to the brand name products," she said.
When it comes to prescribing the drug, many doctors say it won't matter to them whether their patients want to switch to the generic or continue taking Lipitor. Some doctors report that patients taking Crestor, a statin made by Astra Zeneca, have requested to switch to the generic Lipitor.
"Whatever is the lowest cost and gets the LDL ["bad cholesterol"] down is OK," said Dr. Christopher Cannon, a cardiologists at Brigham and Women's Hospital in Boston.
What will happen when I need to refill my Lipitor prescription? Consumers can still get a Lipitor prescription filled at their pharmacies once the drug's patent expires. But whether they get the brand name drug or the generic will depend on what kind of health insurance plan they have. Some plans automatically require consumers to get less-expensive generic drugs, if they exist, while other plans leave it to consumers to decide if they want to pay higher co-payments for the brand-name drugs.
Tim Wentworth, group president of employer and key accounts for MedCo, said starting Wednesday, most of MedCo's clients will get the generic version of Lipitor. He said most other major health plans will likely have a similar strategy.
A spokesman for Medicare declined to comment on what patients under the Part D prescription drug plan can expect.
Another question remains about whether initial supplies of atorvastatin will be sufficient to meet demand from consumers who want to switch to the generic right away. Ranbaxy Laboratories, the manufacturer with exclusive rights to sell atorvastatin for the first 180 days of the patent expiration, did not respond to requests for comment about its initial supply of the drug.
Rosato said it often takes time for pharmacies to fill their shelves with generics, but consumers shouldn't worry about a major shortage of atorvastatin.
"The supply and demand issue is always hard to judge for a drug like Lipitor," Rosato said. "But it will get to a steady state eventually."
Experts say patients should check with their pharmacists about whether atorvastatin is available and covered by their health plans. They should also check with their doctors to learn if their prescriptions specify that they take Lipitor, and ask if a switch to the generic is possible.
How much money will I save by switching? Most experts say consumers can expect to pay about 50 percent less for atrovastatin as they did for Lipitor. Co-payments for Lipitor range from $25 to about $50, depending on a patient's health plan. Co-payments for the generic form of the drug will drop to $10.
"It's going to save a lot of people a lot of money," said Wentworth, noting that MedCo estimates that the generic version of Lipitor will save its clients and members a total of nearly $1 billion.
After the next 180 days, Ranbaxy's exclusive rights to sell the generic drug will expire, opening the door to even more manufacturers, which could drive prices down even further. But many experts say consumers will see the biggest price differences as soon as the drug goes generic on Wednesday.
What if I want to keep taking Lipitor? Some health plans allow patients to choose to stay on Lipitor and pay the difference between the brand and generic cost. Consumers should check on the policies of their health plans and their state regarding mandatory prescriptions of generic drugs.
Patients can get Lipitor directly from Pfizer. The company has set up a discount program called Lipitor for You, which will allow participants to sign up and receive a discount card to get Lipitor for $4 a month. Pfizer has negotiated with health plans to make the drug available at or lower than the rate of generic drugs for the next 180 days. The Associated Press reports that the company is also paying pharmacies to mail Lipitor patients offers for the $4 co-pay card and to counsel them that Lipitor lowers cholesterol more than other drugs.