Part B (10 points)
[A] If such pills catch on, they could generate significant revenues for drug companies. In Pfizer's case, the goal is to transfer as many qualified patients as possible to the combo pill. Norvasc's patents expire in 2007, but Pfizer could avoid losing all its revenues from the drug at once if it were part of a superpill. Sena Lund, an analyst at Cathay Financial, sees Pfizer selling ＄4.2 billion worth of Norvasc-Lipitor by 2007. That would help take up the slack for falling sales of Lipitor, which he projects will drop to ＄5 billion in 2007, down from ＄8 billion last year.
[B] As usual, economics could tip the scales. Patients now taking both Lipitor and Norvasc "could cut their insurance co-pay in half" by switching to the combo drug, Gavris notes. That's a key advantage. Controlling hypertension, for instance, can require three or more drugs, and the fi- nancial burden on patients mounts quickly. If patients also benefit—as Pfizer and other drug companies contend—making the switch to superpills could be advantageous for everyone.
[C] Multifunction superpills aren't nearly as farfetched as they may sound. And reducing such serious risks to heart health as soaring cholesterol, diabetes, and high blood pressure potentially could save many lives and be highly lucrative for drug companies. A combo pill from Pfizer (PFE) of its hypertension drug Norvasc and cholesterol-lowering agent Lipitor "could have huge potential," says Shaojing Tong, analyst at Mehta Partners. "Offering two functions in one pill itself is a huge convenience. "
[D] Some other physicians are more skeptical. "If you want to change dosage on one of the new pill's two drugs, you're stuck," fears Dr. Irene Gavris, professor of medicine at Boston University School of Medicine. She says she would feel most comfortable trying the combination pill on patients who "have been on the drugs for a while" and are thus unlikely to need changes in dosage.
[E] Combining treatments would challenge doctors to approach heart disease differently. But better patient compliance is important enough, says Rockson, that he expects doctors to be open to trying the combined pill.
[F] Doctors also may be quick to adopt Norvasc-Lipitor, Pfizer figures, because it's made up of two well-studied drugs, which many physicians are already familiar with. But Dr. Stanley Rockson, chief of consultative cardiology at Stanford University Medical Center, says fixed-dose combination pills represent "an interesting crossroads" for physicians, who are typically trained to "approach each individual problem with care. "
[G] Pfizer argues that addressing two distinct and serious cardiovascular risk factors in one pill has advantages. People with both hypertension and high LDL cholesterol (the "bad" kind) number around 27 million in the U. S. , notes Craig Hopkinson, medical director for dual therapy at Pfizer, and only 2% of that population reaches adequate treatment goals. Taking two treatments in one will increase the number of patients who take the medications properly and "assist in getting patients to goal," he says.
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