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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

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