
“New” Drug Vimovo is a $3252 combination of $20 Aleve and $20 Nexium - theprop
https://www.propublica.org/article/horizon-pharma-vimovo-common-medication-455-million-specialty-pill
======
cko
There are many drugs like this. This is definitely not news. Examples of drugs
that came out way later than their similar genetic counterpart:

Namzaric: combination of memantine and donepezil, both of which have been
generic for a while.

Combinations of hydrocodone and acetaminophen in varying strengths: 5/325,
5/300, 7.5/300, 7.5/325, etc.

Fexmid and Amrix, which are both cyclobenzaprine in different doses and
releases.

Moxatag, which is just extended release amoxicillin.

There is one drug that's a capsule form of a drug that was previously a
tablet. (Asacol if I recall.) when you open the capsule, the same exact tablet
is inside.

Naprelan, or extended release naproxen.

That's just off the top of my head. All a company has to do is extend the
release, adjust the dose slightly, add an indication (also treats
fibromyalgia!!) or combine two drugs together and bam, it's technically a new
drug.

Other less questionable tactics yet of dubious clinical benefit include:
isolating a certain enantiomer or creating a "me too" drug - another drug for
the same physiologic target - there are so many ACE inhibitors on the market,
for example.

As pharmacists, when we see such antics, we roll our eyes and say "are you
kidding me."

Most pharmaceutical companies are just marketing companies. Every time I see a
doctor prescribe one of these 'new' drugs I suspect there's some kickback
involved.

~~~
wodenokoto
> Every time I see a doctor prescribe one of these 'new' drugs I suspect
> there's some kickback involved.

In such cases, will you recommend the patient to buy the two separate drugs
instead of the expensive combined drug?

~~~
cko
Yes, it would have similar results. It seems that some of these combo drugs
have shorter patents (and will have a generic equivalent sooner), so in the
first 3 years it would still be cheaper to complain to the prescriber about
cost and have them prescribed separately. There are slight differences in the
release, for example, in the Namzaric example I gave, both ingredients are
extended release (as opposed to immediate).

I know 'kickbacks' are in theory illegal but there is some kind of soft money
/ incentives happening. Pharmaceutical sales reps and medical science liaisons
keep track of what their doctors prescribe.

------
mtgx
This is what happens when the US makes it very difficult for generic drugs to
exist on the market and when it bans importation of generic drugs from other
countries - even from _more_ heavily regulated countries such as Canada.

[http://khn.org/news/government-protected-monopolies-drive-
dr...](http://khn.org/news/government-protected-monopolies-drive-drug-prices-
higher-study-says/)

------
vosper
The latest EconTalk interviews the author of a book on this sort of
anticompetitive behavior, and abuse of the patent system. Well worth a listen.

[http://www.econtalk.org/archives/2017/06/robin_feldman_o.htm...](http://www.econtalk.org/archives/2017/06/robin_feldman_o.html)

