Deal over heartburn drug is enough to give you, well, heartburn

Jan 8, 2010 10:41 AM

The heartburn drug Nexium is one of the most expensive of its kind, and that’s just the way the manufacturer, AstraZeneca, wants to keep it. The company said Thursday it inked a deal with Teva shielding the lucrative esomeprazole (Nexium) from generic competition until 2014. Nexium falls into a class of drugs called proton pump inhibitors that are used to treat severe heartburn and gastroesophageal reflux disease, or GERD.

Generic drugs cost significantly less and save consumers billions of dollars per year, but they can’t be sold until the patent expires on the brand-name drug, usually some 10 to 14 years after they first hit the market. And brand-name manufacturers may try to delay a generic drug’s availability even longer by making deals with generic companies, basically by paying them to not manufacture the drug. Clearly, both drug manufacturers benefit from these arrangements, but it’s consumers who lose out.

AstraZeneca, for example, already made a separate deal with Ranbaxy Laboratories last year to delay the release of its generic version of Nexium. And some financial analysts anticipate AstraZeneca will make yet another deal with a third generic manufacturer, Dr. Reddy’s, to block its generic drug from coming to market, according to a report from the Wall Street Journal.

AstraZeneca has good reason to want to protect Nexium. The drug is the company’s biggest seller, raking in $4.8 billion in U.S. sales in 2008. It is also one of the most widely prescribed proton pump inhibitors, or PPIs, and one of the most expensive, with an average retail price of about $240 per month.

However, when it comes to treating serious heartburn and GERD, Nexium does not carry any clear advantages over less expensive PPIs, according to an analysis in our latest Best Buy Drugs report on these medications.

Our Best Buy picks for people with frequent heartburn or GERD who need a PPI include Prilosec OTC (omeprazole is the generic name), and generic ompeprazole OTC. Both of these drugs are available over-the-counter without a prescription for about $24 per month and possibly less, and are as safe and as effective as Nexium or other PPIs. A third option is Prevacid 24HR, which is also available over-the-counter for about the same price (It had not hit store shelves when our report was finalized).

Before you turn to a PPI, make sure you need one because while these drugs are relatively safe, they can have rare but serious side effects. If you have occasional heartburn and have not been diagnosed with GERD, your first and best bet is to try an inexpensive over-the-counter antacid like Maalox, Mylanta, Rolaids, Tums, or another type of drug like Pepcid AC or Zantac 150 (known as H2 blockers). There are generic versions of both the antacids and the H2 blockers.

But if you suffer from heartburn twice a week or more for weeks or months on end, you should see a doctor because you may have GERD, which is a serious condition that can lead to inflammation and damage to the lining of the esophagus. PPIs are effective at treating GERD.

—Steve Mitchell, associate editor, Consumer Reports Best Buy Drugs

For more on proton pump inhibitors to treat severe heartburn and GERD, check out our free Best Buy Drugs report.