Shares of AstraZeneca, a major pharmaceutical company, dropped this morning in the wake of the news that Crestor, their cholesterol-lowering drug, was not a better performer than old standby Lipitor. Lipitor is produced by Pfizer, and has been a known-name in the drug industry for a while. The hope (from AstraZeneca’s standpoint) was that a recent, exhaustive study of the relative benefits of the two cholesterol-fighting drugs would bear out that Crestor was the superior treatment. However, the numbers are in, and the results don’t tell the story that AstraZeneca wanted to hear – and investors are reacting.
The study couldn’t have been much more thorough. It lasted two years (104 weeks), featured full randomization, parallel groups, and multiple different locations. The 1,300 patients involved in the study were evaluated with 40 milligrams of Crestor (the max dosage) vs. 80 mg of Lipitor (the same max dose). Investigators gathered data on arterial plaque buildup by using a catheter to insert an ultrasound device into a heart artery. Then the doctors took internal images and compared the results. Groups were double-blind as well, meaning that neither patients nor researchers knew who were in the experimental and control groups. This is one of the most stringent testing methodologies available and it is used to eliminate bias during information gathering. Granted, it’s hard to be biased with something as straightforward as pictures, but knowing that one patient was in the intervention group may influence a doctor to interpret an image as showing less plaque than another patient with the same amount of plaque who was not taking the medication in question.
So after all the data had been collected and analyzed, the results are in, and Crestor was not the big winner that AstraZeneca wanted it to be. Their fear now is that when cheaper generic versions of Lipitor hit the market, that doctors will start prescribing them instead of AstraZeneca’s product. Apparently they were hoping for this to be a big payoff – as most pharmaceutical companies do when they develop a new product. No one wants to hear that the thing they poured so much time and effort into is just as good as something that’s been on the market for years, has name recognition, and an established track record of success and of being prescribed to many patients.
Frankly, an established name and track record can be one of the biggest obstacles to getting a new drug accepted or rehabilitating the name of an old drug or drug company. If a company or drug has been subject to a lot of drug recalls, patients may be hesitant to take their products, even if tests prove that their drugs work better than others. Public opinion and news stories can have heavy influences on the way patients react. More and more patients are coming to doctors with ideas in their heads about which drugs they may or may not need. This has proven to be a double-edged sword for practitioners, who are used to prescribing their choices, not being forced to argue with their patients because they’ve seen a commercial on television and decided that the drugs pitched there are the ones that they need.
