There are several
different types of drugs to treat high cholesterol.
Statins are by far the most popular type of cholesterol
lowering drug. Other types include bile acid resins,
nicotinic acid (niacin), and fibrates.
Statins prevent the
body from making cholesterol. Statins are considered to
be the first treatment for people with high cholesterol
if making lifestyle changes doesn't cause cholesterol
levels to decrease. Statins have been shown to reduce
cholesterol levels 25 to 40 percent.
Cholesterol drugs have
experienced double digit growth over the last five
years. Much of that growth can be attributed to the
increased usage of statins.
The first statin was
introduced by Merck in September 1987. The drug was
called Mevacor, which is now available as lovastatin in
a generic form. Promotional efforts were targeted to
The second statin on
the market was Pravachol, which became available in
November of 1991. Pravachol was priced 5 to 10 percent
less than Mevacor. Zocor, which is now the second best
selling drug in the United States, started being sold in
January of 1992. Within five years, Smith-Kline Beecham
was spending nearly $265 million to promote Zocor.
Nearly two-thirds of those promotion dollars were for
Statin number four
started being sold in April 1994 by the name of Lescol.
It wasn't until February of 1997 that Lipitor became
available. In just two years, Lipitor had gained a 30
percent market share, largely because of heavy physician
promotions and samples.
In 2000, for example,
sampling accounted for nearly $175 million of the $285
million that was spent on promotion Lipitor.
Direct-to-consumer advertising accounted for only $60
A sixth statin, Baycol,
started being sold in December 1997. Baycol was taken
off of the market, however, in August of 2001 after
there were reports that 31 patients died from severe
muscle weakness from taking the drug. Crestor, another
stain, is awaiting FDA approval.
There are currently no
over-the-counter drugs for reducing cholesterol.
Drug companies have
found it very effective to distribute samples of
statins to doctors to increase usage.
This chart shows
how five popular statins were promoted in 2000:
Sampling is the
largest single expense for promoting drugs. In 2000,
nearly one-half of the $16 billion that was spent
for promoting drugs – all drugs – was for samples.
One billion samples were distributed in 2000.
Drug companies have
found samples to be an effective way to increase statin
usage. With cholesterol-lowering drugs, patients often
start by taking “free” samples. If the drug helps to
lower cholesterol, they start getting prescriptions
filled. Since most people who start taking a cholesterol
drug remain on it, it is easy to see the influence of
The average price
of a 30-day cholesterol-lowering prescription drug
has remained relatively flat over the last four