The Wonders of WikiPedia. And Drugs.

[shannon_a]

If you haven't used wikipedia, you should. It's an absolutely amazing community-built online encyclopedia that has great, great content. In the last couple of months I've used it to learn tons about Pope John Paul I, Pope John Paul II, and Benedict XVI. I've researched some legal precedents for a Skotos article. And I've learned more about various drugs.

It was the drug research that really impressed me. You see, K. had received a prescription for Lexapro, but the insurance company refused that, and then she got a prescription instead for an alternative drug called Celexa.

So, in trying to figure out what was going on, I looked up both drugs in the wikipedia, and got entries on each. There were even molecular diagrams of each drug. I've included them at right, with Lexapro on the top and Celexa below it.

It turns out that Celexa, the original drug, is made up of a pair of mirrored isomers (that's different molecules which have the same atoms, but in different orders, in this case mirror images of each other), and that it's suspected that only one of the two isomers has a theurapeutic effect.

In 2003 Lundbeck's 20-year patent on Celexa was running out, so someone in corporate headquarters said, "How can we continue flogging this cash horse?" So they clipped out the useless isomer from Celexa and, poof, had a new drug. Lexapro. Just months before Celexa could go generic, and start notably dropping the price.

Lundbeck says that the new drug has a faster onset and is more easily tolerated. The faster onset does show up in their trials, but with no statistical weight (meaning it was within the margin of error). I didn't see any additional info on the tolerability.

This is apparently one of the ways that drug companies get around the patent system, and I'm sure that once in a while it does result in something that's very new and exciting, but for the most case I bet it's moving around an atom here or there to produce a newly patentable product that's not very different.

And with all of that said, I can actually understand why the insurance company refused the Lexapro.

Comments

[jbru.livejournal.com]

Coolness! Ericka, my sweetie, has already discovered the reformulate-to-repatent game for some of her meds. One oddness is that she's found that brand-name Ritalin works well for her but that the generic has no effect. I'll be sure to recommend Wikipedia to her for the next time our health care "system" does something weird to her meds.