499:... this often represent(s) advances in safety and efficacy, along with providing new formulations and dosing options that significantly increase patient compliance. From an economic standpoint, expanding drug classes represent the possibility of lower drug prices as competition between manufacturers is increased. Additionally, pharmaceutical companies depend on incremental innovations to provide the revenue that will support the development of more risky “block-buster” drugs. Policies aimed at curbing incremental innovation will ultimately lead to a reduction in the overall quality of existing drug classes and may ultimately curb the creation of novel drugs.
130:, then Senator of Tennessee, led a series of hearings enquiring about the pharmaceutical industry's motive to produce me-too drugs after it was noted that much of their time and resources were spent producing them. Subsequently, the FDA required drug companies to prove their drugs were safe and effective. In 1964,
453:
For example, Celexa is a mixture of a left-handed and right-handed version of the same compound ("citalopram"), but only the left-handed version ("es-citalopram") is biologically active. Lexapro, the "me too" drug released several years after Celexa thus extending the patent life, is a purified form
474:
that metabolize into the same active compound. Gilead has been accused in lawsuits of "slow walking" the development of the me-too drug; however, such lawsuits further a market perception the me-too drug is "safer." This drives sales of the more expensive me-too drug when both drugs have virtually
525:
under clinical development were “me-too” drugs. At the beginning of 2020, the WHO stated that only two of the 50 antibiotics in clinical development are active against serious drug resistant gram-negative bacteria, and most are not significant "upgrades" of drugs.
51:, and used to treat conditions for which drugs already exist. While pharmaceutical companies have justified the development of me-toos as offering incremental improvements in efficacy, side-effects, compliance and cost, critics have questioned the increasing
114:, referred to “the problem of the introduction of ‘me too’ drugs, that is, drugs without signal advantage of any sort”. Once a new drug class was discovered, other major drug companies made efforts to produce their own similar versions. Pharmacologist
122:
noted "the great drug therapy era was marked not only by the introduction of new drugs in great profusion and by the launching of large promotional campaigns but also by the introduction of what are known as 'duplicative' or 'me-too' products".
363:(FDA) in 1987, the understanding of the link between cholesterol and heart disease was improving, and the potential market for the drug became significant. Subsequently, several other companies developed similar drugs: Merck developed Zocor (
506:
Many physicians are unaware that me-toos are compared to placebos rather than pre-existing drugs. Me-toos are seen as patentable new drugs and therefore substantial profit makers, where innovative drugs may be more risky to develop.
72:, referred to “the problem of the introduction of ‘me too’ drugs, that is, drugs without signal advantage of any sort”. However, me-too drugs can be novel compounds themselves. They are commonly used and include several
110:
68:
1277:"Pharmacokinetics of acyclovir and its metabolites in cerebrospinal fluid and systemic circulation after administration of high-dose valacyclovir in subjects with normal and impaired renal function"
296:. It was shown to preserve revenues of Prilosec, whose U.S. patent expired in 2001. Considered a new drug by the FDA, Nexium was patented separately, sold for eight times the cost of its
515:
Between 1998 and 2003, the U.S. Food and Drug
Administration (FDA) approved 487 drugs, of which 78 per cent appeared to have similar characteristics to pre-existing marketed drugs.
303:
and advertised as significantly better than its predecessor, a move the company received much criticism for, with a subsequent class action lawsuit filed against them.
483:, first FDA approved in the mid-1980s. Valtrex metabolizes into acyclovir in the liver, but when it first entered the market, it cost many times than the generic.
1143:
427:
134:
described me-too drugs as being “hard to justify putting into man at all, let alone on the market”. Three years later, the term appeared in the
1397:
1370:
1126:
1096:
1014:
984:
904:
877:
97:
816:
Patterson, Julie A.; Carroll, Norman V. (May 2020). "Should the United States government regulate prescription prices? A critical review".
1507:
1341:
292:
is a me-too which was granted its patent by showing that it was effective for heartburn, not that it was better than its precursor,
165:
588:"Me‐too pharmaceutical products: History, definitions, examples, and relevance to drug shortages and essential medicines lists"
184:"drugs that are chemically related to the prototype, or other chemical compounds which have an identical mechanism of action"
495:
defended me-toos, describing their development as "incremental improvements on already existing drugs". The report stated:
755:
Mazzucato, Mariana; Li, Henry Lishi; Darzi, Ara (4 March 2020). "Is it time to nationalise the pharmaceutical industry?".
1583:
492:
360:
230:
226:
1526:
535:
1413:
1328:
1573:
261:. Successive differences between β-blockers have had a combined cumulative effect and are seen as "innovative".
136:
56:
52:
190:"a drug with a similar chemical structure or the same mechanism of action as a drug that is already marketed".
1257:
730:
1181:
Oldani, Michael (2009). "Understanding the 'Therapeutic
Embrace' between Big Pharma and Modern Medicine".
153:
81:
43:, usually by making minor modifications to the prototype, reflected in slight changes in the profiles of
798:
463:
282:
48:
347:
being its first me-too. Most were as efficient as each other and had similar adverse effect profiles.
518:
More than 60% of medicines listed on the World Health
Organization's essential list are me‐too drugs.
160:
1363:
Patents for
Development: Improved Patent Information Disclosure and Access for Incremental Innovation
380:
920:
Mason, Jonathan (5 October 2013). "Introduction of biosimilars: not to be confused with generics".
470:, a popular Antiretroviral also used to prevent HIV infection in healthy people. Both versions are
36:
1541:
1190:
937:
841:
790:
737:
708:
1336:. International Policy Network; Working Papers on Intellectual Property, Innovation and Health.
1159:
1434:
Buccafusco, Christopher; Masur, Jonathan S. (31 March 2020). "Drugs, Patents, and Well-Being".
1553:
1549:
1488:
1443:
1439:
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1366:
1358:
1337:
1306:
1239:
1163:
1122:
1116:
1092:
1061:
1010:
980:
968:
956:
900:
894:
873:
865:
833:
782:
700:
670:
619:
1086:
1004:
1478:
1470:
1296:
1288:
1229:
1221:
1155:
1051:
1043:
972:
964:
929:
825:
772:
764:
660:
650:
609:
599:
115:
105:
63:
430:
have been developed for maintenance treatment in chronic depression. These include Paxil (
270:
77:
1578:
1301:
1276:
1056:
1031:
665:
638:
614:
587:
145:
141:
127:
40:
1483:
1458:
1234:
1209:
1144:"'For Me There Is No Substitute'—Authenticity, Uniqueness, and the Lessons of Lipitor"
273:
were marketed in the UK between 1960 and 1982, of which seven were produced by Roche.
1567:
1082:
845:
794:
415:
411:
336:
131:
119:
73:
941:
741:
712:
476:
443:
396:
376:
368:
300:
297:
96:
1030:
Jena, Anupam B.; Calfee, John E.; Mansley, Edward C.; Philipson, Tomas J. (2009).
829:
503:
This incremental innovation has led to some referring to me-toos as "me-betters".
479:, first FDA approved in 2001 to treat persistent herpes outbreaks is a prodrug of
802:
187:"drugs which have more or less identical clinical outcomes to pre‐existing drugs"
522:
392:
384:
364:
289:
234:
149:
44:
1088:
The Truth About the Drug
Companies: How They Deceive Us and What to Do About It
177:
There is no agreed definition, however, several have been proposed, including:
17:
1389:
The
Influence of the Pharmaceutical Industry: Fourth Report of Session 2004-05
655:
447:
439:
435:
431:
407:
356:
316:
258:
254:
246:
214:
210:
194:
480:
419:
344:
340:
250:
242:
140:. In the early 1970s, Silverman and Lee reported that there were almost 100
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1310:
1243:
1167:
1065:
1047:
837:
786:
777:
674:
623:
704:
1474:
1292:
1225:
976:
388:
293:
206:
1545:
1194:
471:
467:
423:
312:
238:
85:
1386:
Great
Britain: Parliament: House of Commons: Health Committee (2005).
604:
1258:"How a Drugmaker Profited by Slow-Walking a Promising H.I.V. Therapy"
933:
768:
372:
320:
285:
896:
197:
are compared with other biosimilars and are therefore not me-toos.
1416:. House of Commons, Select Committee on Health Minutes of Evidence
319:'s prices increased following the arrival of further me-too drugs
95:
324:
59:
resources and their impact on the innovation of new treatments.
454:
of just the left-handed version (the "es" in "es-citalopram").
870:
The $ 800 Million Pill: The Truth Behind the Cost of New Drugs
1359:"6.4. Transferring patent information by means of imitation"
1330:
Pharmacoevolution: the advantages of incremental innovation
639:"The high cost of prescription drugs: causes and solutions"
225:
The first-in-class β-blocker pronethalol was developed by
104:
The term "me‐too drugs" was coined in the 1950s. In 1956,
691:
Garattini, Silvio (1997). "Are me-too drugs justified?".
410:
was the first-in-class of the tricyclic antidepressants.
1508:"A Market Failure for Antimicrobial Resistant Medicines"
1210:"Stereoisomers in Psychiatry: The Case of Escitalopram"
586:
Aronson, Jeffrey K.; Green, A. Richard (13 May 2020).
426:
are some of the me-toos that followed. Several me-too
893:
Gutka, Hiten J.; Yang, Harry; Kakar, Shefali (2018).
1365:. Cheltenham: Edward Elgar Publishing. p. 150.
959:. In Brenkert, George G.; Beauchamp, Tom L. (eds.).
872:. University of California Press. pp. 209–230.
1414:"Memorandum by Professor Patrick Vallance (PI 106)"
1327:Wertheimer, Albert I.; Santella, Thomas M. (2005).
355:When Merck's cholesterol-lowering statin Mevacor (
181:"multiple drugs within the same therapeutic class"
1322:
1320:
1506:O'Brien, Michael K.; Chu, Philip (8 July 2020).
957:"Just Access to Health Care and Pharmaceuticals"
1032:"'Me-Too' Innovation in Pharmaceutical Markets"
998:
996:
686:
684:
1110:
1108:
1077:
1075:
818:Research in Social and Administrative Pharmacy
335:Several me-toos followed the prototype of the
1091:. Random House Publishing Group. p. 80.
724:
722:
100:Louis Goodman, who coined the phrase "me-too"
8:
1160:10.1001/virtualmentor.2010.12.10.msoc2-1010
581:
579:
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664:
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613:
603:
569:
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563:
561:
559:
557:
555:
553:
551:
592:British Journal of Clinical Pharmacology
1459:"Excess in the pharmaceutical industry"
1036:Forum for Health Economics & Policy
969:10.1093/oxfordhb/9780195307955.003.0008
547:
428:Selective serotonin reuptake inhibitors
1392:. The Stationery Office. p. 204.
1118:An Introduction to Medicinal Chemistry
961:The Oxford Handbook of Business Ethics
475:identical safety profiles. Similarly,
1214:Prim Care Companion J Clin Psychiatry
637:Vincent Rajkumar, S. (23 June 2020).
7:
1463:Canadian Medical Association Journal
1142:Greene, Jeremy A. (1 October 2010).
731:"Me-too drugs: is there a problem"
729:Hollis, Aidan (13 December 2004).
169:referred to me-too as "me-again".
25:
35:" refers to a medication that is
1436:Washington University Law Review
55:of me-toos, their absorption of
1512:Applied Clinical Trials Online
1457:Angell, M. (7 December 2004).
1:
1006:Business Ethics of Innovation
963:. OUP USA. pp. 202–232.
830:10.1016/j.sapharm.2019.06.010
736:. World Health Organization.
1525:Price, W. Nicholson (2020).
493:International Policy Network
361:Food and Drug Administration
1281:Antimicrob Agents Chemother
1121:. OUP Oxford. p. 181.
1115:Patrick, Graham L. (2013).
521:In September 2019, half of
359:) was approved by the U.S.
1600:
1357:Nefissa Chakroun (2016).
1264:. No. July 23, 2023.
899:. Springer. p. 129.
864:Goozner, Merrill (2005).
656:10.1038/s41408-020-0338-x
491:In 2005, a report by the
137:Oxford English Dictionary
1009:. Springer. p. 44.
955:Menzel, Paul T. (2012).
57:research and development
1208:Burke, William (2002).
1003:Hanekamp, Gerd (2007).
126:Between 1960 and 1962,
1048:10.2202/1558-9544.1138
501:
277:Proton pump inhibitors
101:
1527:"The Cost of Novelty"
1275:Smith, James (2010).
1148:AMA Journal of Ethics
693:Journal of Nephrology
497:
383:developed Pravachol (
283:proton-pump inhibitor
233:. It was followed by
205:Me-too drugs include
166:Clinical Pharmacology
99:
82:stomach acid reducing
1475:10.1503/cmaj.1041594
1293:10.1128/AAC.00729-09
1226:10.4088/pcc.v04n0107
643:Blood Cancer Journal
536:Unique selling point
466:is a me-too drug of
381:Bristol-Myers Squibb
86:cholesterol lowering
1584:Medical terminology
1534:Columbia Law Review
1183:Pharmacy in History
375:developed Lipitor (
231:ICI Pharmaceuticals
148:, greater than 270
395:). Others include
391:developed Lescol (
161:Desmond Laurence's
152:and more than 200
111:Goodman and Gilman
102:
69:Goodman and Gilman
1469:(12): 1451–1453.
1399:978-0-215-02457-2
1372:978-1-78536-860-8
1128:978-0-19-969739-7
1098:978-1-58836-211-7
1016:978-3-540-72309-7
986:978-0-19-991622-1
906:978-3-319-99679-0
879:978-0-520-24670-6
605:10.1111/bcp.14327
598:(11): 2114–2122.
462:Gilead Science's
41:pre-existing drug
16:(Redirected from
1591:
1574:Drug development
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1557:
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1383:
1377:
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1354:
1348:
1347:
1335:
1324:
1315:
1314:
1304:
1287:(3): 1146–1151.
1272:
1266:
1265:
1254:
1248:
1247:
1237:
1205:
1199:
1198:
1178:
1172:
1171:
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934:10.1002/psb.1108
917:
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769:10.1136/bmj.m769
752:
746:
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688:
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634:
628:
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583:
116:Milton Silverman
106:Louis S. Goodman
64:Louis S. Goodman
21:
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1273:
1269:
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1206:
1202:
1180:
1179:
1175:
1154:(10): 818–823.
1141:
1140:
1136:
1129:
1114:
1113:
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1099:
1081:
1080:
1073:
1029:
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532:
513:
489:
460:
405:
403:Antidepressants
367:) and Crestor (
353:
333:
309:
279:
271:benzodiazepines
267:
265:Benzodiazepines
223:
203:
175:
108:, co‐editor of
94:
78:antidepressants
66:, co‐editor of
23:
22:
18:Me-too compound
15:
12:
11:
5:
1597:
1595:
1587:
1586:
1581:
1576:
1566:
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1560:
1559:
1540:(3): 769–835.
1517:
1498:
1449:
1426:
1405:
1398:
1378:
1371:
1349:
1342:
1316:
1267:
1262:New York Times
1249:
1200:
1173:
1134:
1127:
1104:
1097:
1083:Angell, Marcia
1071:
1022:
1015:
992:
985:
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912:
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885:
878:
851:
824:(5): 717–723.
808:
747:
718:
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629:
546:
545:
543:
540:
539:
538:
531:
528:
512:
509:
488:
485:
459:
456:
446:) and Prozac (
404:
401:
352:
349:
332:
331:ACE inhibitors
329:
308:
307:H2 antagonists
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275:
266:
263:
222:
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192:
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185:
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174:
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146:antihistamines
142:tranquillisers
128:Estes Kefauver
118:and physician
93:
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33:follow-on drug
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1343:1-905041-05-5
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1111:
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748:
743:
739:
732:
725:
723:
719:
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706:
702:
699:(6): 283–94.
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416:Nortriptyline
413:
412:Amitriptyline
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337:ace inhibitor
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132:Louis Lasagna
129:
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120:Philip R. Lee
117:
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89:
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83:
79:
75:
74:beta blockers
71:
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1418:. Retrieved
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