This is a story about the games that the pharmaceutical industry play.
In this case, they are playing a shell game that costs you thousands of dollars.
Take an agent already in the public domain and classified as a nutritional supplement, perform a clinical trial to treat some condition, and then declare that this new agent is a drug. This is how prescription fish oil, Lovaza (called Omacor in Europe), got its start, when the drug company Reliant spotted the opportunity. It’s been known for decades that supplements of omega-3 fatty acids from fish oil reduce the level of triglycerides in the bloodstream, a risk for cardiovascular disease and other conditions. A clinical trial of the “drug” was performed, demonstrating its effectiveness for reducing triglyceride levels, just as over-the-counter fish oil does. The FDA approved Lovaza for treatment of hypertriglyceridemia, or high triglyceride blood levels.
Pharmaceutical giant GlaxoSmithKline purchased the rights from Reliant and has since built the Lovaza franchise into a $1 billion-per-year business. Marketing for Lovaza uses clever wording like, “Lovaza is the only FDA-approved medication made from omega-3 fish oil. It’s purified. It’s concentrated. And you can’t get it at a health food store.” The wording is meant to persuade doctors and the public that Lovaza is somehow different from its low-cost competitors: purer, more concentrated, so powerful you can’t get it on your own. Doctors, being as poorly informed about nutritional supplements as they are, jumped on the prescription form.
Lovaza costs about $60 per capsule per month. Most people take four capsules per day: $240 per month, or $2,880 per year, to obtain 3,360 milligrams of EPA and DHA omega-3 fatty acids per day.
What if I instead went to Costco and bought its high-potency fish oil?
This version is in the same common ethyl ester form as Lovaza. The Costco form of omega-3 fatty acids costs $14.99 for 180 capsules, or $2.50 per capsule per month; each capsule contains 684 milligrams EPA + DHA. I would therefore have to take five capsules per day to obtain the same 3,360 milligrams EPA and DHA per day as with Lovaza. This would cost me 5 x $2.50 = $12.50 per month, or $150 per year to achieve the same effect, or 95 percent less than the cost of the prescription form. High-grade fish oil that is pure (contains essentially no contaminants such as mercury) and has a similar or greater omega-3 fatty acid content than the prescription form is widely available over the counter at a fraction of the price of Lovaza. You can even purchase another form of fish oil, the triglyceride form (as opposed to the ethyl ester form in Lovaza and most other brands), which has been put through additional steps that concentrate the omega-3 fatty acids further and reduce contaminants to even lower levels than the ethyl ester form. The triglyceride form is more potent than prescription fish oil and better absorbed, yet still at a tiny fraction of the price of Lovaza.
Oddly, few physicians advised patients to take fish oil until Lovaza appeared on the market and persuasive sales representatives started dropping off samples with smiles. While doctors could have easily advised patients to supplement over-the-counter fish oil before the “drug” form came on the market, they instead opted to prescribe Lovaza, reflecting the effectiveness of marketing hocus-pocus and adding several thousand dollars of cost per person under the guise of FDA approval. Of course, the $1 billion in Lovaza sales ends up in the pockets of the drug company, while we all bear the burden of increased costs whether or not the drug was prescribed to us. And all of this from something that you could have taken on your own, easily and inexpensively.