Alas, Accutane, you are no more! Economic and legal factors have combined to force pharmaceutical company Hoffman-La Roche to announce that they are discontinuing the acne drug Accutane. This didn’t come as a surprise to dermatologists, as pharmacists have been in the habit for quite some time of filling prescriptions for Accutane with the generic equivalent isotretinoin. Unfortunately for Roche, this has had the effect of lowering their market share drastically, so that their current share is only 3%, leaving the rest of the market to the lower-priced generics Amnesteem, Sotret, and Claravis.

Dermatologists disagree in their perceptions of these generics. Some feel that they are just as good; others have said they might as well give their patients a placebo. One doctor interviewed claimed that it was necessary to prescribe higher doses of the generics, and keep patients on them longer, in order to achieve the same effect as Accutane. Patients want to pay as low a cost or co-pay as possible, and Accutane, like all branded medicines, is more expensive. Bottom line—the wallet rules.

Legal issues have also plagued Roche. Besides the millions of dollars any pharmaceutical company spends to develop, test, and market a new drug, Roche has spent millions on lawsuits defending Accutane. IBD (Inflammatory Bowel Disease), depression, suicide and birth defects have been linked to this drug, resulting in hundreds of lawsuits and FDA warnings on labels. Similar lawsuits have been filed against manufactures of the generic isotretinoin.

With the situation Roche found themselves in–millions spent to bring the drug to market, millions spent defending themselves against lawsuits, market share down to 3%– it’s no wonder they decided to pull the plug. But what does that mean for the future, and the patients who need it?

Dermatologists are concerned that with Accutane out of the picture, the pharmaceutical companies who produce the generics will increase their prices. They have already begun to face the same legal issues as Roche. It would be a shame if this drug, a boon to many people over the years who have severe acne, was pulled off the market entirely.

Tags: accutane, acne treatment, dermatologists, dermatology, isotretinoin