Pharmacist Cynthia Jackevicius of Western University of Health Sciences discusses her New England Journal of Medicine article, co-authored by Harlan Krumholz of Yale et al, on the cost savings to the American healthcare system from cheaper generic Lipitor and the strategies Pfizer is using to delay the market share shift to generics.

This is a case study on a larger issue. The generic drug industry has morphed into a hybrid of branded and generic business models and using ever more sophisticated strategies to exploit loopholes in the patent law and FDA regulations. As a result, once cheap generic drugs are often becoming much more expensive. Fewer generic manufacturers exist due to mergers and consolidation, and it is not uncommon to find a single manufacturer of a generic drug charging branded drug prices exerting monopolistic pricing power.