New drugs from old.

The NHS spends over pound10 billion each year on medicines. The use of generic (patent-expired) medicines rather than branded equivalents has a key role in containing this expenditure and ensuring best value for money. On average, 4 years after the patent of a branded medicine has expired in the UK, generic equivalents will account for around half of the drug's market and cost about a quarter as much as the original brand. This represents a potentially large loss of income and, therefore, a major concern for companies that market branded products. Consequently, many use a long-term strategy known as 'lifecycle management' to minimise loss and to maximise returns from such products. This encompasses prioritising products for development, forming strategic alliances with other companies to share resourses, and utilising legal processes to protect products. One part of this strategy is the development and intensive marketing of new formulations or derivatives of existing medicines nearing the end of their patent life. Here we highlight some key examples of the impact the marketing of such products can have on patients, prescribers and the NHS.