A simple peptic ulcer could have proved life-threatening for sufferers less than five decades ago. That was before scientists at a then-minor pharmaceutical business called Smith, Kline & French discovered the compound cimetidine in the mid-1970s. Marketed under the brand name Tagamet, the drug prevents the excess release of ulcer-causing stomach acids. It became the first pharmaceutical product to surpass $1bn in annual sales in 1986.
The next drugs to reach – and exceed – this milestone were also treatments for very common conditions. The antidepressant Prozac, developed by Eli Lilly (US:LLY), made it big shortly after Tagamet. Pfizer’s (US:PFE) cholesterol medication Lipitor would later become the first mega-blockbuster drug of the 21st century. This first crop of billion-dollar-earning medicines had an important feature in common: they could all be prescribed at a GP’s office, often without referral to a specialist.
The economics underpinning these so-called ‘primary care blockbusters’ is easy to grasp. At the time they arrived on the market, they addressed a widespread unmet medical need. The sheer size of the patient population meant that these drugs didn’t need hefty price tags to make a profit for their developers.