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Expand chart
Data: Company filings; Note: First nine months of 2019 shown; Chart: Naema Ahmed/Axios

Lipitor, the cholesterol-lowering medication that has become the gold standard of statins, continues to generate roughly $2 billion per year in sales for Pfizer, even though its patent expired eight years ago.

The big picture: Almost all of Pfizer's Lipitor sales now come from China and other emerging markets. But Lipitor's ability to remain a blockbuster drug, even with so many generic competitors that cost pennies per pill, shows how distorted the global pharmaceutical system can be.

By the numbers: Worldwide Lipitor sales peaked in 2006, at almost $13 billion, with more than 60% coming from the U.S.

  • After Lipitor's patent lapsed in late 2011, sales started declining precipitously in the U.S. as numerous generic atorvastatin pills hit the market.
  • But since 2014, annual sales have hovered around $2 billion thanks to the gigantic Chinese market.
  • Pfizer has frequently won bids to sell Lipitor in Chinese hospitals, "as they could more easily offer quality assurances for their higher-cost medicines," Bloomberg reported earlier this year.
  • But after losing a large hospital bid last year, Pfizer lowered Lipitor's price in China by 30% "in the hope patients would buy it privately," the Financial Times reported.

Between the lines: Lipitor is mostly bought overseas but holds a small pulse domestically. Pfizer is on pace to sell roughly $100 million of the statin in the U.S. this year.

  • That isn't a lot of money broadly speaking. But it still means patients, health insurance programs and taxpayers are paying upwards of $14 per Lipitor pill when generic equivalents cost less than a dime per pill.
  • Pfizer advertises a Lipitor coupon card for the uninsured and those with commercial insurance — the type of card that is outlawed in Medicare and Medicaid because it's viewed as a kickback.
  • Pfizer didn't immediately respond to questions.

The bottom line: Lipitor remains a global money-maker for Pfizer despite generic competition.

Go deeper: Generic drugs aren't always favored

Go deeper

Social media's "in-kind contribution to Biden"

Photo illustration: Annelise Capossela/Axios. Photo: Mark Wilson/Getty Images

Facebook's continued suspension of Donald Trump's account extends the silencing of Joe Biden's most potent critic — and the current president's control over the national political narrative into his second 100 days.

Why it matters: Biden has been able to successfully focus on COVID-19 relief, his infrastructure plan and fielding his new administration, in part, because Trump hasn't been able to shake his social media muzzle and bray about the migration crisis or any White House misstep.

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Rep. Liz Cheney (R-Wyo.) is all but rolling out the red carpet for her own ouster as House GOP conference chair next week and her expected replacement with Trump defender Rep. Elise Stefanik (R-N.Y.).

Why it matters: Cheney’s political falling out with House Minority Leader Kevin McCarthy (R-Calif.) is the ultimate proxy war between Republicans who remain beholden to a former president who falsely claims the election was stolen from him, or breaking free from Donald Trump to refocus on traditional conservative values.

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Biden's plan to work with — or bail on — the GOP

President Biden, after remarks on Wednesday. Photo: Alex Wong/Getty Images

President Biden plans to test Republicans’ appetite to pay for any part of his proposed $4.1 trillion in infrastructure and social spending before deciding whether to pursue one big tax-and-spend package or two smaller ones, Axios has learned.

Driving the news: Biden is wary of boxing himself in, since it would dictate whether he seeks a bipartisan or all-Democratic approach. He told reporters on Wednesday, "I'm willing to compromise. But I'm not willing to not pay for what we're talking about. I'm not willing to deficit-spend."