June 20, 2013

Big Changes in the Drug Patent World Are Good News for People with Diabetes

Several days ago the Supreme Court of the U.S. issued a decision saying that the FDA could sue drug companies that paid off generic drug makers to keep them from releasing generic versions of drugs that had gone off patent.

A second decision that may be just as important for controlling the costs of drugs for people with diabetes occurred on June 18, 2013. A U.S. appeals court found the patent on Novo Nordisk's Prandin diabetes drug Prandimet, a combination of Prandin with metformin to be invalid, paving the way for introduction of a generic version of the medicine.

MedCity Newsletter: Novo Nordisk’s diabetes drug patent ruled invalid, door open for generic version

Drug companies have been creating combination drugs with two off patent drugs claiming they are new drugs that deserve new patents. Then they convince doctors to only prescribe the expensive, patented combination drug rather than the separate generics. ("So much more convenient." "More effective!" Both lies, of course.)

This is good news not only because it makes the combo drug cheaper, but because if upheld it will dissuade drug makers from marketing these combo drugs, which are a very poor choice for consumers because they make it impossible to dose the individual components correctly.

Some people need 1000 mg of metformin a day for it to be effective. Some need 1500, and some need 2000. However, if you put 1000 mg of metformin in the same pill with a full dose of Prandin, an insulin secretion stimulator, you have to double the Prandin to double the metformin dose. Doubling Prandin can cause hypos in people who are sensitive to it. So with a combo pill the person is likely to end up with an optimal dose of only one component of the pill.

Two generic prescriptions should be the same cost or, more commonly, cheaper than one patented pill, except for people who have top tier health  insurance whose co-pays are low enough that this shouldn't be an issue. Most people with diabetes can handle opening two pill containers and taking two pills if that means they are a) paying less and b) getting more effective doses.

The drug companies are likely to lobby and appeal this one to the top, too, since their failure to come up with effective new drugs drives them to more and more tricks, like bribing generic drug makers or creating these combo pills to keep their expiring patent moneymakers profitable.