Simvastatin was the third of the currently used statins to lose its patent and become available as a generic drug. First generic was lovastatin Chris Kunitz Lightning Jersey , generic for Mevacor. Mevacor was the first statin medication to gain FDA approval in the U.S. It was somewhat slow to gain widespread use as it took some time for data to become available about the benefits of statin use to lower LDL cholesterol. By the time statin used became widespread statins with bigger effect on LDL reduction became available. Pravachol (Pravastatin) and Zocor (simvastatin) followed Mevacor to market. Shortly after Zocor became available Lipitor came to market. Lipitor zoomed to become the market leader based on a many of factors. One of the factors was the greater LDL reduction available with Lipitor. In head to head comparison of simvastatin vs. Lipitor, Simvastatin has a very much extra modest LDL reduction. See the table below. In addition Lipitor was featured in several high profile studies which vaulted the popularity of statins for both secondary and primary prevention of coronary artery disorder.

Lipitor, a Pfizer product, is the bunch one grossing drug in the world, with over $10 billion in sales in 2010. Simvastatin reclaimed a huge commission of statin sales in 2009 when generic simvastatin became available, in part since at the vanquish dose of 80 mg simvastatin’s LDL reduction approaches the LDL reduction possible with lesser doses of Lipitor. The news this week that the FDA is limiting the use of simvastatin 80 mg is going to make the simvastatin vs. Lipitoratorvastatin choice lean much additional toward Lipitoratorvastatin. On Nov 30, 2011 a generic for atorvastatin is going to become available. Despite this I anticipate another 6 months, when multiple generic companies can market atorvastatin before generic atorvastatin prices drop to the range of the other generic statins. The apparent lack of an abnormally high incidence of myopathy as a lipitor side effect is going to drive this switch.

Still that’s only a year from now, and the simvastatin vs. Lipitor choice is this day one I can realistically entertain, knowing that the price excess of Lipitor is soon to disappear. I’ll consider changing my simvastatin 80 mg patients to Lipitor now, and generic atorvastatin when it becomes available unless they carry on been stable and symptom free for a long period of time. The FDA recommends change unless a patient has tolerated simvastatin 80 mg for over a year. This is since most cases of myopathy and rhabdomyolysis from simvastatin 80 mg happen in the first year of use. I’ll still consider paltry dose simvastatin for patients who need only an extra modest reduction in LDL reduction, but I expect atorvastatin to quickly become the most widely used statin after it competes in price with simvastatin.

In the long run the simvastatin vs. Lipitor choice looks like one that Lipitor, soon to be generic atorvastatin, is going to win by a runaway. I’ll report back in a couple of years to let you know if I’m right.

Additional information about simvastatin can be found at Simvastatin Side Effects

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