The Rev. Eddie Martin was willing to take two drugs, a diuretic and a calcium channel blocker, to get his blood pressure down. But when his doctor decided to add a third pill, a cholesterol-lowering medication, to Martin's daily medicine regimen, the reverend balked. "I just hate taking pills," Martin says, "and what's more, with each extra drug, that's another co-pay I've got to shell out." Then, the Woodland, Ohio, resident heard a TV ad for Caduet, which combines the blood-pressure-lowering drug Norvasc with the cholesterol-reducing medicine Lipitor, Martin's doctor agreed that Caduet could take care of his patient's blood pressure and cholesterol-lowering needs and prescribed the drug, leaving the reverend's drug count at a total of two per day. "Now, I'm getting the drugs I need without extra pills or extra cost," Martin says.
That doesn't mean the drugs are the best choice for everyone. If a patient is already taking Norvasc and Lipitor — and having two insurance copays — taking the drugs as a single Caduet pill will reduce the number of pills he or she has to take, and, for many people, will bring the two copays down to one, Fisler says.
Several factors are behind the recent push to introduce new combination products.
Companies facing patent expirations and lowered revenues from generic competition can reap at least some of the cash back by patenting a combination drug. For example, the patent for Norvasc, one of the two drugs in Caduet, expires this year, and the patent for the other drug, Lipitor, expires in 2010. Pfizer, which makes both Norvasc and Lipitor, has already seen annual sales of Lipitor drop by billions because of competition from generic versions of Merck's cholesterol medication Zocor, which lost its patent this year. Annual sales for Norvasc, approved in 1992, are currently $5 billion.