I'm writing this from the point of view of retail pharmacy because that's what I know about....
Does anyone know if there are any potential blockbuster drugs in development for the big pharmaceutical companies? I admit that I've fallen a little behind when it comes to recent developments in the pharmaceutical industry.
The other day, I was thinking about what pharmacy will be like in 10 years, and I got to thinking about how just about all the drugs out right now will be off-patent with generic versions available. Lipitor will be generic. Plavix will be generic (again!). Pretty much all the blockbuster brand name drugs will be generic.
If this is the case, what are the pharmaceutical companies developing to replace these drugs? I know in many cases, they'll just make an XR version or a single enantiomer version (i.e. Zyrtec to Xyzal), but insurance companies tend to limit the use of those drugs.
I've touch on this before when I mentioned how treatment guidelines for the major longterm diseases (hypertension, hyperlipidemia, chronic heart failure, diabetes) haven't changed all that much in quite some time. Statins are still the drug of choice for high cholesterol. Heart failure and post-MI patients still use beta-blockers and ACE Inhibitors. Type II diabetics still use mainly Metformin and/or a sulfonylurea.
I haven't heard of anything coming out in the near future that will completely change our guidelines for those diseases. Therefore, if no big advances come out in the next 10 years, we'll be looking at the majority of chronic illnesses being treated pretty much entirely with generic drugs. This will be great for the patients, great for the insurance companies, and great for pharmacies. However, the big pharmaceutical companies won't be too happy about this.
The pharmaceutical companies will have to respond to this in some way, and I don't think making products like Ambien CR or Xyzal will be sufficient. Will they be forced to drop their prices in order to compete with generics? More likely, they'll spend tons of money trying to convince doctors that their latest and greatest "me too" drug is a HUGE improvement over the less costly generic.
I think it will be interesting to see how this all plays out. I suppose we'll get a really good glimpse when we see how Pfizer responds to Lipitor coming off-patent. All I know is that if I were in charge of one of those big companies, I'd cut my enormous direct-to-consumer advertising budget and start spending a lot more cash on drug research and development. Without a revolutionary new drug, these companies could be in a lot of trouble.