Lexapro Psychiatric Drug

An article in the NY Times highlights how the pharmaceutical industry has gone to great lengths to maintain its profit margins by continuing to market brand name drugs over their generic counterparts.
The article points to Lexapro as an example of this practice. Lexapro, sold by Forest Laboratories, was developed as a way to continue to market a brand name psychiatric drug after its Celexa brand’s patent expired. Forest Laboratories did this by slightly adjusting the molecular structure found in Celexa so that it could introduce a new drug (Lexapro) to the market. In their marketing materials, Forest Lab officials touted Lexapro as superior to Celexa in fighting depression even though no such evidence is available to make such a claim. In fact, the FDA quickly approved Lexapro because it considered the new brand name drug as practically interchangeable with the older version Celexa.
So, what’s the difference? It’s price and profits. According to the NY Times article, a month’s supply of Lexapro sells for $87.99 while a generic version of Prozac goes for $14,99 That’s quite a difference in price and profit.
Drug companies make huge profits on their brand name drugs. Once the patent expires and the drug becomes available as a generic, the profit margin is lost. So, the marketing plan seems to be to continue to churn out “newer, superior” forms of the same drug to keep the profit margins. In order to do this, doctors must be convinced that the brand drug is superior. This requires a substantial marketing effort for the pharmaceutical companies.
While it’s not illegal to educate healthcare professionals about the benefits of a drug, it is illegal to pay doctors to prescribe a particular drug. In recent years, prosecutors have been arguing that some companies have crossed the line. The Times cites a recent lawsuit as a case in point.
“In February, federal prosecutors in Boston announced a civil lawsuit against Forest claiming that the company illegally marketed both Lexapro and a closely related antidepressant, Celexa, for use in children and paid kickbacks to doctors to induce them to prescribe the medicines to children.”
One could argue that the fine line is crossed when doctors are inundated with free lunches provided by drug companies as well as huge consulting fees for promoting the industry’s products. In politics, there are stringent rules concerning what lobbyists can provide elected officials. Such rules are much looser or non-existent when it comes to the relationship between the pharmaceutical industry and doctors.
The NY Times notes the following, “t is impossible to unpack all of the reasons for these prescriptions, but some industry critics say one reason could be the money doctors make from Forest. Psychiatrists make more money from drug makers than any other medical specialty, according to analyses of payment data. And Forest gives more money and food to doctors than many of its far larger rivals. Vermont officials found that Forest’s payments to doctors in 2008 were surpassed only by those of Eli Lilly, Pfizer, Novartis and Merck — companies with annual sales that are five to 10 times larger than Forest’s.
Forest’s 2004 plan for marketing Lexapro offers detailed information about how the company planned to direct this money to doctors.
Under “Rep Promotional Programs,” the document said the company planned to spend $34.7 million to pay 2,000 psychiatrists and primary care doctors to deliver 15,000 marketing lectures to their peers in one year.”
Isn’t it time these relationships are regulated? Isn’t it time doctors’ prescription decisions are based solely on sound science rather than a paycheck or other forms of remuneration?