Heartburn remedy soon will be cheaper

By Bruce Japsen

Chicago Tribune

Coming soon to a drugstore near you: prescription-strength heartburn pills that won't burn a hole in your wallet.

Every day, more than 2 million Americans take the ubiquitous $4 "purple pill" called Prilosec, making it the No. 2-selling drug in America after the cholesterol drug Lipitor.

Introduced in 1989, Prilosec was hailed for its quick relief of heartburn and other digestive ailments. And it proved a healthy addition to its manufacturer's fortunes, raking in some $4.6 billion in U.S. sales annually by 2001.


But in the very near future -- possibly this fall -- generic alternatives are expected to debut at savings of up to 60 percent. And for those with insurance, co-payments will be cut in half, to $10 or less for a month's supply.

Besides being a welcome development for consumers, a generic alternative also is winning fans from corporate America, insurers and doctors, who say the nation's prescription bill is out of control -- rising 17 percent annually.

Of course the generic rush isn't such good news for Prilosec's maker, AstraZeneca PLC, which last year launched a slightly improved successor heartburn drug, Nexium. Neither is it welcomed by Prilosec's rivals, including TAP Pharmaceutical Products Inc., which makes Prevacid, a pill not expected to have generic competition until 2009.

To protect their market share, drugmakers are blitzing consumers with television ads and free promotional items at food festivals.

But it may not be easy to persuade consumers to pay more for a brand name. Even the drug companies' own studies show there's little reason for patients to continue taking rival brand names of heartburn drugs that have no generic alternative because there's minimal clinical difference, experts said.

"When Prilosec goes generic, I look for physicians who are sensitive about the cost of these drugs to encourage patients to take the generics," said Dr. Ronald Ruecker, a Decatur, Ill., gastroenterologist and chairman of the Illinois State Medical Society. "They all work significantly to reduce acids."

Prilosec, Nexium and Prevacid are part of a blockbuster class of heartburn treatments known as proton-pump inhibitors. Combined, the three had more than $8 billion in sales last year.

Prilosec and Prevacid have also been key contributors to employer and consumer health insurance premiums, costing General Motors Corp. alone more than $80 million last year. When generic Prilosec is available, employers expect millions of dollars in savings.


"All of us who are responsible for protecting the affordability of the prescription drug benefit will encourage the utilization of the gold-standard generic, Prilosec," said Robert Seidman, chief pharmacy officer for managed-care giant Wellpoint Health Networks Inc., the California-based parent of Unicare Health Plans of Illinois. "Generic Prilosec will become the first-line therapy for most doctors."

While drugmakers are asking consumers to remain loyal to the brand names, their own head-to-head studies and federal court records indicate there is little clinical difference between the current industry leaders: Prilosec and Prevacid.

Insurers and employers are countering the brand-name manufacturers with unprecedented campaigns of their own to encourage generic use. GM, for example, has regular newsletters for its 1.2 million retirees, employees and their families, while AARP, the nation's senior citizen lobby, and insurers have television ads promoting generics.

The aggressive push for generics can work. Eli Lilly &; Co. saw sales for once top-selling antidepressant Prozac fall dramatically with the advent of generic competition.

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