488:... 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.
119:, 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,
442:
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
463:
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
514:
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.
40:, 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
103:, 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
111:
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".
352:(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 (
495:
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.
61:, 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
154:
1266:"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"
285:. 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
86:
99:
57:
504:
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.
292:
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.
472:, 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.
1132:
149:
123:
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
805:
Patterson, Julie A.; Carroll, Norman V. (May 2020). "Should the United States government regulate prescription prices? A critical review".
1496:
281:
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,
416:
577:"Me‐too pharmaceutical products: History, definitions, examples, and relevance to drug shortages and essential medicines lists"
1386:
1359:
1115:
1085:
1003:
973:
893:
866:
173:"drugs that are chemically related to the prototype, or other chemical compounds which have an identical mechanism of action"
484:
defended me-toos, describing their development as "incremental improvements on already existing drugs". The report stated:
744:
Mazzucato, Mariana; Li, Henry Lishi; Darzi, Ara (4 March 2020). "Is it time to nationalise the pharmaceutical industry?".
1515:
1330:
1402:
1317:
250:. Successive differences between β-blockers have had a combined cumulative effect and are seen as "innovative".
179:"a drug with a similar chemical structure or the same mechanism of action as a drug that is already marketed".
1246:
719:
1572:
481:
349:
219:
215:
1170:
Oldani, Michael (2009). "Understanding the 'Therapeutic
Embrace' between Big Pharma and Modern Medicine".
32:, usually by making minor modifications to the prototype, reflected in slight changes in the profiles of
524:
336:
being its first me-too. Most were as efficient as each other and had similar adverse effect profiles.
507:
More than 60% of medicines listed on the World Health
Organization's essential list are me‐too drugs.
1562:
1352:
Patents for
Development: Improved Patent Information Disclosure and Access for Incremental Innovation
125:
909:
Mason, Jonathan (5 October 2013). "Introduction of biosimilars: not to be confused with generics".
459:, a popular Antiretroviral also used to prevent HIV infection in healthy people. Both versions are
45:
41:
1325:. International Policy Network; Working Papers on Intellectual Property, Innovation and Health.
1148:
1423:
Buccafusco, Christopher; Masur, Jonathan S. (31 March 2020). "Drugs, Patents, and Well-Being".
142:
70:
1542:
1432:
1376:
1347:
1105:
957:
945:
883:
854:
1374:
1075:
993:
787:
452:
271:
37:
369:
419:
have been developed for maintenance treatment in chronic depression. These include Paxil (
8:
25:
1530:
1290:
1265:
1179:
1045:
1020:
926:
830:
779:
726:
697:
654:
627:
603:
576:
1472:
1447:
1223:
1198:
1133:"'For Me There Is No Substitute'—Authenticity, Uniqueness, and the Lessons of Lipitor"
262:
were marketed in the UK between 1960 and 1982, of which seven were produced by Roche.
1538:
1477:
1428:
1382:
1355:
1326:
1295:
1228:
1152:
1111:
1081:
1050:
999:
969:
889:
862:
834:
822:
783:
771:
689:
659:
608:
930:
1467:
1459:
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1277:
1218:
1210:
1144:
1040:
1032:
961:
953:
918:
814:
761:
753:
730:
701:
649:
639:
598:
588:
104:
94:
52:
1019:
Jena, Anupam B.; Calfee, John E.; Mansley, Edward C.; Philipson, Tomas J. (2009).
818:
492:
This incremental innovation has led to some referring to me-toos as "me-betters".
468:, first FDA approved in 2001 to treat persistent herpes outbreaks is a prodrug of
791:
259:
176:"drugs which have more or less identical clinical outcomes to pre‐existing drugs"
66:
1567:
1077:
The Truth About the Drug
Companies: How They Deceive Us and What to Do About It
166:
There is no agreed definition, however, several have been proposed, including:
134:
130:
116:
29:
1378:
The
Influence of the Pharmaceutical Industry: Fourth Report of Session 2004-05
644:
1556:
1071:
404:
400:
325:
120:
108:
62:
129:. In the early 1970s, Silverman and Lee reported that there were almost 100
1481:
1299:
1232:
1156:
1054:
1036:
826:
775:
766:
663:
612:
465:
432:
385:
365:
357:
289:
286:
693:
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511:
381:
373:
353:
278:
223:
138:
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428:
424:
420:
396:
345:
305:
247:
243:
235:
203:
199:
183:
1375:
Great
Britain: Parliament: House of Commons: Health Committee (2005).
593:
85:
1247:"How a Drugmaker Profited by Slow-Walking a Promising H.I.V. Therapy"
922:
757:
469:
408:
333:
329:
239:
231:
885:
377:
282:
195:
186:
are compared with other biosimilars and are therefore not me-toos.
1405:. House of Commons, Select Committee on Health Minutes of Evidence
308:'s prices increased following the arrival of further me-too drugs
460:
456:
412:
301:
227:
74:
48:
resources and their impact on the innovation of new treatments.
443:
of just the left-handed version (the "es" in "es-citalopram").
361:
309:
274:
859:
The $ 800 Million Pill: The Truth Behind the Cost of New Drugs
1348:"6.4. Transferring patent information by means of imitation"
1319:
Pharmacoevolution: the advantages of incremental innovation
628:"The high cost of prescription drugs: causes and solutions"
313:
1018:
214:
The first-in-class β-blocker pronethalol was developed by
93:
The term "me‐too drugs" was coined in the 1950s. In 1956,
680:
Garattini, Silvio (1997). "Are me-too drugs justified?".
399:
was the first-in-class of the tricyclic antidepressants.
1497:"A Market Failure for Antimicrobial Resistant Medicines"
1199:"Stereoisomers in Psychiatry: The Case of Escitalopram"
575:
Aronson, Jeffrey K.; Green, A. Richard (13 May 2020).
415:
are some of the me-toos that followed. Several me-too
937:
882:
Gutka, Hiten J.; Yang, Harry; Kakar, Shefali (2018).
1354:. Cheltenham: Edward Elgar Publishing. p. 150.
948:. In Brenkert, George G.; Beauchamp, Tom L. (eds.).
861:. University of California Press. pp. 209–230.
1403:"Memorandum by Professor Patrick Vallance (PI 106)"
1316:Wertheimer, Albert I.; Santella, Thomas M. (2005).
1315:
344:When Merck's cholesterol-lowering statin Mevacor (
170:"multiple drugs within the same therapeutic class"
1311:
1309:
1554:
1495:O'Brien, Michael K.; Chu, Philip (8 July 2020).
1345:
946:"Just Access to Health Care and Pharmaceuticals"
804:
743:
625:
1422:
1021:"'Me-Too' Innovation in Pharmaceutical Markets"
987:
985:
675:
673:
1494:
1416:
1306:
1099:
1097:
1066:
1064:
881:
807:Research in Social and Administrative Pharmacy
324:Several me-toos followed the prototype of the
1368:
1080:. Random House Publishing Group. p. 80.
713:
711:
89:Louis Goodman, who coined the phrase "me-too"
1339:
982:
737:
670:
574:
1395:
1149:10.1001/virtualmentor.2010.12.10.msoc2-1010
1094:
1061:
619:
1439:
1124:
708:
570:
568:
566:
564:
562:
560:
1507:
1471:
1289:
1222:
1044:
848:
846:
844:
765:
679:
653:
643:
602:
592:
558:
556:
554:
552:
550:
548:
546:
544:
542:
540:
265:
991:
902:
875:
798:
581:British Journal of Clinical Pharmacology
84:
1488:
1448:"Excess in the pharmaceutical industry"
1103:
1025:Forum for Health Economics & Policy
958:10.1093/oxfordhb/9780195307955.003.0008
852:
417:Selective serotonin reuptake inhibitors
1555:
1445:
1381:. The Stationery Office. p. 204.
1169:
1163:
1130:
1107:An Introduction to Medicinal Chemistry
1070:
950:The Oxford Handbook of Business Ethics
943:
841:
717:
537:
464:identical safety profiles. Similarly,
1513:
1263:
1203:Prim Care Companion J Clin Psychiatry
1196:
908:
626:Vincent Rajkumar, S. (23 June 2020).
1452:Canadian Medical Association Journal
1131:Greene, Jeremy A. (1 October 2010).
13:
720:"Me-too drugs: is there a problem"
718:Hollis, Aidan (13 December 2004).
391:
253:
158:referred to me-too as "me-again".
14:
1584:
319:
295:
24:" refers to a medication that is
1425:Washington University Law Review
209:
44:of me-toos, their absorption of
1257:
1239:
1190:
1012:
1501:Applied Clinical Trials Online
1446:Angell, M. (7 December 2004).
1:
995:Business Ethics of Innovation
952:. OUP USA. pp. 202–232.
819:10.1016/j.sapharm.2019.06.010
725:. World Health Organization.
530:
499:
446:
161:
1514:Price, W. Nicholson (2020).
482:International Policy Network
350:Food and Drug Administration
7:
1270:Antimicrob Agents Chemother
1110:. OUP Oxford. p. 181.
1104:Patrick, Graham L. (2013).
518:
510:In September 2019, half of
348:) was approved by the U.S.
189:
10:
1589:
339:
80:
1346:Nefissa Chakroun (2016).
1253:. No. July 23, 2023.
888:. Springer. p. 129.
853:Goozner, Merrill (2005).
645:10.1038/s41408-020-0338-x
480:In 2005, a report by the
475:
126:Oxford English Dictionary
998:. Springer. p. 44.
944:Menzel, Paul T. (2012).
46:research and development
1197:Burke, William (2002).
992:Hanekamp, Gerd (2007).
115:Between 1960 and 1962,
1037:10.2202/1558-9544.1138
490:
266:Proton pump inhibitors
90:
1516:"The Cost of Novelty"
1264:Smith, James (2010).
1137:AMA Journal of Ethics
682:Journal of Nephrology
486:
372:developed Pravachol (
272:proton-pump inhibitor
222:. It was followed by
194:Me-too drugs include
155:Clinical Pharmacology
88:
71:stomach acid reducing
1464:10.1503/cmaj.1041594
1282:10.1128/AAC.00729-09
1215:10.4088/pcc.v04n0107
632:Blood Cancer Journal
525:Unique selling point
455:is a me-too drug of
370:Bristol-Myers Squibb
75:cholesterol lowering
1573:Medical terminology
1523:Columbia Law Review
1172:Pharmacy in History
364:developed Lipitor (
220:ICI Pharmaceuticals
137:, greater than 270
384:). Others include
380:developed Lescol (
150:Desmond Laurence's
141:and more than 200
100:Goodman and Gilman
91:
58:Goodman and Gilman
1458:(12): 1451–1453.
1388:978-0-215-02457-2
1361:978-1-78536-860-8
1117:978-0-19-969739-7
1087:978-1-58836-211-7
1005:978-3-540-72309-7
975:978-0-19-991622-1
895:978-3-319-99679-0
868:978-0-520-24670-6
594:10.1111/bcp.14327
587:(11): 2114–2122.
451:Gilead Science's
30:pre-existing drug
1580:
1563:Drug development
1547:
1546:
1520:
1511:
1505:
1504:
1492:
1486:
1485:
1475:
1443:
1437:
1436:
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1413:
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1393:
1392:
1372:
1366:
1365:
1343:
1337:
1336:
1324:
1313:
1304:
1303:
1293:
1276:(3): 1146–1151.
1261:
1255:
1254:
1243:
1237:
1236:
1226:
1194:
1188:
1187:
1167:
1161:
1160:
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1122:
1121:
1101:
1092:
1091:
1068:
1059:
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1048:
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923:10.1002/psb.1108
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900:
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879:
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872:
850:
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838:
802:
796:
795:
769:
758:10.1136/bmj.m769
741:
735:
734:
724:
715:
706:
705:
677:
668:
667:
657:
647:
623:
617:
616:
606:
596:
572:
105:Milton Silverman
95:Louis S. Goodman
53:Louis S. Goodman
1588:
1587:
1583:
1582:
1581:
1579:
1578:
1577:
1553:
1552:
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1262:
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1164:
1143:(10): 818–823.
1129:
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1102:
1095:
1088:
1069:
1062:
1017:
1013:
1006:
990:
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502:
478:
449:
394:
392:Antidepressants
356:) and Crestor (
342:
322:
298:
268:
260:benzodiazepines
256:
254:Benzodiazepines
212:
192:
164:
97:, co‐editor of
83:
67:antidepressants
55:, co‐editor of
12:
11:
5:
1586:
1576:
1575:
1570:
1565:
1549:
1548:
1529:(3): 769–835.
1506:
1487:
1438:
1415:
1394:
1387:
1367:
1360:
1338:
1331:
1305:
1256:
1251:New York Times
1238:
1189:
1162:
1123:
1116:
1093:
1086:
1072:Angell, Marcia
1060:
1011:
1004:
981:
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936:
901:
894:
874:
867:
840:
813:(5): 717–723.
797:
736:
707:
669:
618:
535:
534:
532:
529:
528:
527:
520:
517:
501:
498:
477:
474:
448:
445:
435:) and Prozac (
393:
390:
341:
338:
321:
320:ACE inhibitors
318:
297:
296:H2 antagonists
294:
267:
264:
255:
252:
211:
208:
191:
188:
181:
180:
177:
174:
171:
163:
160:
135:antihistamines
131:tranquillisers
117:Estes Kefauver
107:and physician
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22:follow-on drug
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1380:
1379:
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1301:
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1279:
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1108:
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847:
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812:
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801:
793:
789:
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768:
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759:
755:
751:
747:
740:
732:
728:
721:
714:
712:
703:
699:
695:
691:
688:(6): 283–94.
687:
683:
676:
674:
665:
661:
656:
651:
646:
641:
637:
633:
629:
622:
614:
610:
605:
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586:
582:
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569:
567:
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563:
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541:
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523:
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516:
513:
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497:
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489:
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473:
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467:
462:
458:
454:
444:
440:
438:
434:
430:
426:
422:
418:
414:
410:
406:
405:Nortriptyline
402:
401:Amitriptyline
398:
389:
387:
383:
379:
375:
371:
367:
363:
359:
355:
351:
347:
337:
335:
331:
327:
326:ace inhibitor
317:
315:
311:
307:
303:
293:
291:
288:
284:
280:
276:
273:
263:
261:
251:
249:
245:
241:
237:
233:
229:
225:
221:
217:
210:Beta blockers
207:
205:
201:
197:
187:
185:
178:
175:
172:
169:
168:
167:
159:
157:
156:
151:
146:
144:
140:
136:
132:
128:
127:
122:
121:Louis Lasagna
118:
113:
110:
109:Philip R. Lee
106:
102:
101:
96:
87:
78:
76:
72:
68:
64:
63:beta blockers
60:
59:
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49:
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39:
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1490:
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1407:. Retrieved
1397:
1377:
1370:
1351:
1341:
1318:
1273:
1269:
1259:
1250:
1241:
1209:(1): 20–24.
1206:
1202:
1192:
1178:(2): 75–86.
1175:
1171:
1165:
1140:
1136:
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