Pfizer is promoting data supporting the cost-effectiveness of atorvastatin versus simvastatin in an effort to counter patient switches from Lipitor ahead of the launch of generic Merck's Zocor .

Lipitor is more cost-effective for payers than Zocor, even when the latter is discounted by 50% from its current price, according to a Pfizer-sponsored economic analysis of data from the Incremental Decrease in Endpoints Through Aggressive Lipid Lowering trial (IDEAL).

IDEAL, published in November in the Journal of the American Medical Association, compared high-dose Lipitor (80 mg) to moderate doses of simvastatin (20 mg-40 mg) for lowering LDL cholesterol and a range of CV outcomes.

Patients on Lipitor had greater reductions in heart attacks, strokes and cardiovascular procedures, which "provides a cost savings for payers in long-term hospitalizations and surgical costs," Pfizer said in a May 15 release.

The economic study compared the total cost per patient for 4.8 years in each treatment group in the Swedish IDEAL trial "by calculating medication costs, the cost of hospitalizations associated with cardiovascular events and lost work days for the U.S. and for Sweden."

The study results were presented at the annual American Heart Association Quality of Care & Outcomes Research meeting in Washington, D.C. May 7-9.

Teva holds 180-day exclusivity for three doses of simvastatin (10 mg, 20 mg, 40 mg) and Ranbaxy holds exclusivity rights to the 80 mg dose. In addition, Merck has signed an authorized generic agreement for Zocor with Dr. Reddy's (¹ Also see "Statin Prices Likely To Remain High After Zocor Exclusivity Win" - Pink Sheet, 1 May, 2006.).

With three generic players, it is unlikely that the price of simvastatin would drop below 50% of Zocor's current price in the immediate future. However, as more players enter the market following the expiration of Teva's and Ranbaxy's exclusivity, the price could drop below the 50% threshold.

IDEAL also evaluated the cost-effectiveness of Lipitor compared to a 75% reduction in the current U.S. price of Zocor. "Even if the current U.S. price of Zocor were reduced by 75%, Lipitor patients could still achieve better cardiovascular outcomes at an increase to payers of less than one dollar a day," Pfizer said.

Promotion of the economic study is consistent with Pfizer's stated strategy for staving off competition from generic statins.

Pharmacy benefit manager Express Scripts removed Lipitor from its preferred formulary status last fall in order to promote adoption of Zocor in anticipation of the availability of generic simvastatin. The firm said recently that patients have been switching to Zocor faster than expected (² Also see "Express Scripts Sees Rapid Switching to Zocor" - Pink Sheet, 1 May, 2006.).

During an analyst conference in January, Pfizer CEO Hank McKinnell said the firm would emphasize the savings resulting from superior cardiovascular event prevention demonstrated in IDEAL and other trials, calling the approach of switching patients to simvastatin "penny-wise but pound-foolish."

Switching patients could have "negative health implications for patients," Pfizer said May 15. "The IDEAL economic analysis makes the case that drug cost savings from use of generic statins may be largely offset by higher patient care and indirect costs."

-Christopher Walker

Lipitor Is Pound-Wise Versus Generic Zocor, Pfizer IDEAL Cost Study Says

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