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Invited Commentary
September 2016

Prescription of Brand-Name Medications When Generic Alternatives Are Available—Patently Unfair

Author Affiliations
  • 1Division of General Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 2Center for Pharmaceutical Policy and Prescribing, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 3Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
  • 4Pharmacy Benefits Management Services, US Department of Veterans Affairs, Hines, Illinois
  • 5Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania
JAMA Intern Med. 2016;176(9):1323-1324. doi:10.1001/jamainternmed.2016.3389

In December 1996, 8 days before Christmas, the US Food and Drug Administration (FDA) approved Lipitor (atorvastatin; Pfizer) for the treatment of hyperlipidemia. Lipitor would become one of the most profitable prescription drugs in history, bringing in $130 billion in sales during its lifetime as a brand-name product and peaking at nearly $13 billion in sales in 2006 alone.1-3 Lipitor was far from the first statin in its class (simvastatin, pravastatin, and fluvastatin were already on the market), but 1996 was also the year that the FDA began allowing direct-to-consumer broadcast advertising. Lipitor was aggressively marketed based on its more potent lowering of cholesterol levels compared with other statins.1

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