top 100 drugs in canada
DESCRIPTION
Prescription volume continued to increase in 2012, fueled by increasedaccess to generics, an aging population, and the prevalence of chronicdiseases (Figure 1). As they did last year, specialty and niche prescriptionproducts are having an impact on the market. In the 12 months endingOctober 2012, community pharmacies across Canada dispensed almost 557million prescriptions, an increase of 3.3% over 2011. The growingpenetration of lower-cost generics continues to drive today’s deflationarymarket. For the fifth consecutive year, generic prescription productscontinued to dominate the prescription market, comprising 62.6% of thetotal market. Brand prescriptions’ share continued to fall (at 37.4% of thetotal market, down from 40.2% last year). That’s a decrease of 3.5%, afurther slowdown from last year’s -1.6%. Generic prescription volume grewby 8.2%, down 2.4 percentage points from the rate posted in theprior-year period—10.6%. (See Tables 1, 2, and 3 for the top 100prescription drugs of 2012.)TRANSCRIPT
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About IMS Brogan
The information for this article
was obtained from three of IMS
Brogans databases: Canadian
CompuScript Audit (CS),
Canadian Drugstore and Hospital
Purchases Audit (CDH), and
Canadian Disease and
Therapeutic Index (CDTI), as
well as from the PharmaFocus
2016 update, published
November 2012. IMS Brogan is
a unit of IMS, the worlds leading
provider of market intelligence
to the pharmaceutical and
healthcare industries.
Top 100 Drugs
on March 4, 2013 for Pharmacy Practice
witnessed a year of increased prescription volume fueled by generic prescription growth and brand patent
expiries
Prescription volume continued to increase in 2012, fueled by increased
access to generics, an aging population, and the prevalence of chronic
diseases (Figure 1). As they did last year, specialty and niche prescription
products are having an impact on the market. In the 12 months ending
October 2012, community pharmacies across Canada dispensed almost 557
million prescriptions, an increase of 3.3% over 2011. The growing
penetration of lower-cost generics continues to drive todays deflationary
market. For the fifth consecutive year, generic prescription products
continued to dominate the prescription market, comprising 62.6% of the
total market. Brand prescriptions share continued to fall (at 37.4% of the
total market, down from 40.2% last year). Thats a decrease of 3.5%, a
further slowdown from last years -1.6%. Generic prescription volume grew
by 8.2%, down 2.4 percentage points from the rate posted in the
prior-year period10.6%. (See Tables 1, 2, and 3 for the top 100
prescription drugs of 2012.)
The continuing gains in generic prescription market share can be attributed
to patent expiries and to public- and private-sector policies reimbursing
lower-cost drug alternatives.
For example, Crestor lost its patent exclusivity to seven generic copies in April 2012. The market started to feel
the impact in June, and Crestors prescription share continued to tumble all year. Other major brands that lost
exclusivity, contributing to a slower brand performance, included Plavix (December 2011), Singulair (October
2011), Micardis and Micardis Plus (January 2012), Cellcept (November 2011), Cozaar (January 2012), Cesamet
(March 2012), and Hyzaar and Hyzaar DS (January 2012).
Generic substitution erodes brand prescription share
The generic price reductions implemented in most provinces will continue to be phased in between 2012 and
2014, further dampening potential brand growth.
On the private-payer side, two major insurance companies, Sun Life and Great-West Life, instituted new policies
in 2012 to reject claims for brand medicines when a generic is available. Together, these insurers administer
about half of Canadas private drug plans. Other companies, such as Manulife, are planning on adopting similar
programs.
Top therapeutic classes
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For the 19th consecutive year, cardiovascular medications were the most prescribed class, with a total of 83.4
million prescriptions dispensed, valued at $2.6 billion. This corresponds well to the top reason for patients to
visit a family physician (see sidebar on page 41). Unchanged from last year, the top 10 drug classes represent
69.7% of total dispensed prescriptions and 63.3% of total prescription dollar value (Table 4).
In each of the top 10 therapeutic categories, significantly more prescriptions were written for generic
medications than for brand medicines, most notably in the cardiovasculars, psychotherapeutics, anti-infectives,
and diuretics classes. The fastest-growing (35.7%) prescription drug class is anti-EGFR (anti-epidermal growth
factor receptor) agents, used in the treatment of advanced cancers. Anti-EGFRs bumped ophthalmologic
preparations out of the top spot after three years as the highest growth class, with total purchases of at least
$10 million annually made by community and hospital pharmacies. The EGFR class of drugs has become a
foundation in the treatment of many common cancers, targeting the specific type of cancer. Targeted agents are
the foundation for the future of cancer treatment as they provide a less toxic treatment regimen, allowing
patients to have a chance of receiving the optimal doses over longer periods of time.
Conversely, cytostatic antibiotics used in cancer therapy experienced the largest decrease in purchases for the
12 months ending October 2012 (-41.7%). The reason for the decline of this group of drugs may in fact be due
to novel classes of newer, targeted anticancer drugs that are more efficient, less toxic, and cause less severe
side effects.
Most prescribed products
Looking at the top 100 Rx Drugs, the top four products remain unchanged from last year (Table 1). Synthroid
retained the top spot for a third year with 14.7 million prescriptions dispensed for the 12 months ending
October 2012. Crestor stayed in second place, despite a 24.3% drop due to generic competition.
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Cipralex, the selective serotonin reuptake inhibitor, jumped up from 22nd position in 2011 to seventh in 2012
due to formulary listing in major provinces such as British Columbia, Alberta, and Ontario. Elavil also moved
into the top 10, up from 16th place. After losing patent protection, Plavix dropped from 7th spot to 48th.
Of the top 100 products, 63 are generic and 37 are brand. Those 63 generics represent 47.4% of total
prescriptions dispensed for the top 100 products. Twenty-two of these products are manufactured by Apotex,
16 by Teva, nine by Pharmascience, and four by Pro Doc. Seven other manufacturers produce the remaining 12
generics.
Prescription sales dollars
The top 100 products based on prescription dollars represented 45.3% of all prescription expenditures for the
12 months ending October 2012 (Table 5). Crestor remains at the top of the list in spite of a 27.3% drop. Brand
purchases totaled $13.95 billion for the 12 months ending October 2012 and accounted for 75.9% of the
market, up a bit from last years 75.7%. Brand sales grew by 0.6%, a positive change from the 0.4% decrease
noted a year ago. The generic sector accounted for the remaining 24.1% of market sales, down slightly from
24.3% a year ago, at $4.4 billion. Generic purchases posted negative growth of -0.5%, a noted improvement
over the -5.3% pace recorded a year ago.
Figure 2 highlights percentage growth of drugstore and hospital drug purchases over the past five years.
A history of the top five products
The top five Rx products provide further evidence of the impact that our aging population
has, and will continue to have, on prescription medications. Four out of the top five treat
various cardiovascular conditions, while the top drug, Synthroid treats hypothyroidism.
Abbott EPDs Synthroid (levothyroxine) is a prescription synthetic thyroid hormone that
was introduced in 1957. It is typically taken for life.
Crestor (rosuvastatin), produced by AstraZeneca, is a member of the statin class for
the treatment of dyslipidemia. It reduces LDL-C and raises HDL-C. Crestor was initially
developed by the Japanese pharmaceutical company Shionogi and in-licensed to
AstraZeneca in April 1998. It was launched in Canada in 2003.
The first of Apotexs two products in the overall top five, Apo-atorvastatin launched in
2010 as a lower-cost alternative to Pfizers Lipitor.
The second, Apo-furosemide launched in 1976 as a diuretic primarily used for the treatment
of hypertension and edema associated with congestive heart failure and kidney or
liver disease.
In 1994, Servier launched the ACE inhibitor Coversyl (perindopril) in Canada. It is indicated
to treat mild to moderate hypertension, mild to moderate congestive heart failure,
and to reduce cardiovascular risk in patients with hypertension and/or those who have
suffered a myocardial infarction.
Top generic products
Looking at the top 100 generic products only, Apo-atorvastatin is again the top product in terms of volume,
with close to 5.5 million prescriptions (Table 2). Figure 3a reveals the breakdown of brand versus generic sales
for the drug oxycodone. In February 2012, Purdue launched OxyNEO, a new abuse-deterrent formulation of
oxycodone to replace Purdues OxyContin. OxyNEO is leading the way in oxycodone sales with just over $1
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million due in part to public formulary listings in British Columbia, Alberta, Saskatchewan, Manitoba, Ontario
(except for 60 mg strength), and Quebec. OxyNEO is funded through the Special or Exceptional Access Program
in the majority of provinces, except in Alberta where it is funded as a full benefit. (Market share data for
esomeprazole, rosuvastatin, atorvastatin, and pantoprazole are available online [Figure 3be]). Apotex claimed
30 of the top 100 generic products, with Teva close behind at 25 products.
Diagnosis
*Estimated number
of diagnosed
patient visits (000s)
HYPERTENSION 19,773
routine general medical exam 10,369
diabetes 9,759
depression 8,324
anxiety 6,313
normal pregnancy supervision 5,357
acute upper respiratory
infection 5,302
hyperlipidemia 4,370
esophagitis 3,831
otitis media 3,415
Most prescribed by generic name
Atorvastatin and levothyroxine retain the top two spots, with some shuffling among the rest of the top 10
(Table 3). The only new entrant, moving up from 11th to 10th place is lorazepam. The top 100 drugs (by
generic name) represent 70.6% of the total dispensed prescriptions.
table 1. Top 100 Rx drugs
2012 2011 PRODUCT MANUFACTURER
12
months
ending
Oct.
2012
%
CHANGE
vs 12
months
ending
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TRx*
(000s)
Oct.
2011
1 1 Synthroid ABBOTT EPD 14,709 7.6
2 2 Crestor ASTRAZENECA 8,423 -24.3
3 3 Apo-atorvastatin APOTEX 5,485 0.4
4 4 Apo-furosemide APOTEX 4,084 3.6
5 9 Coversyl SERVIER LAB 3,759 16.5
6 8 Apo-hydro APOTEX 3,197 -6.5
7 22 CipralexLUNDBECK
CANADA3,151 29.3
8 6 Teva-amoxicillin TEVA CANADA 3,134 -14.9
9 5 Nexium ASTRAZENECA 3,107 -18.6
10 16 Elavil AA PHARMA 3,007 14.6
11 15 Taro-warfarin TARO PHARM 2,855 6.2
12 11 Ativan PFIZER 2,854 1.4
13 23 Lyrica PFIZER 2,848 17.3
14 13 Celebrex PFIZER 2,699 -1.4
15 32 Zyloprim AA PHARMA 2,675 25.9
16 47 Teva-venlafaxine XR TEVA CANADA 2,670 51.9
17 12 Ventolin HFA GLAXOSMITHKLINE 2,663 -5.2
18 57 D-tabs RIVA 2,605 59.9
19 27 Apo-salvent CFC FR APOTEX 2,475 11
20 10 Apo-ramipril APOTEX 2,475 -15.7
21 18 Eltroxin TRITON PHARMA 2,441 -3.3
22 19 Apo-lorazepam APOTEX INC 2,391 -3.9
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23 26 Nasonex MERCK CANADA 2,274 1.4
24 24 Ratio-lenoltec TEVA CANADA 2,250 -2.1
25 34 Ezetrol MERCK CANADA 2,215 9
26 21 Ran-atorvastatin RANBAXY PHARMA 2,211 -10.1
27 25 Ratio-oxycocet TEVA CANADA 2,164 -4.4
28 37 Ratio-metformin TEVA CANADA 2,154 11.3
29 128 Ratio-atorvastatin TEVA CANADA 2,136 124.7
30 33 Pro-AAS EC-80 PRO DOC 2,132 4.6
31 40 Apo-metformin APOTEX 2,096 12.7
32 31 Flovent HFA GLAXOSMITHKLINE 2,090 -1.7
33 29 Tylenol w/cod #3 JANSSEN PHARMA 2,027 -7
34 20 Teva-rabeprazole TEVA CANADA 1,995 -19.5
35 36 Adalat XLBAYER
HEALTHCARE1,992 1.7
36 35 Teva-furosemide TEVA CANADA 1,987 -1.8
37 107 Tecta NYCOMED CANADA 1,962 86.3
38 41 Spiriva BOEHRINGER ING 1,937 5.2
39 63 Ran-ramiprilRANBAXY PHARMA
CAN1,907 24.5
40 39 Apo-metoprolol APOTEX 1,903 0.5
41 131 Apo-bisoprolol APOTEX 1,902 102.1
42 49 Aricept PFIZER 1,887 8.6
43 48 Alesse PFIZER 1,857 6.4
44 60 Wellbutrin XL VALEANT PHARMA 1,852 16.3
45 56 pms-Clonazepam-R PHARMASCIENCE 1,846 11.3
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46 69 Atorvastatin PRO DOC 1,841 25
47 14 Sandoz-bisoprolol SANDOZ CANADA 1,810 -32.8
48 7 Plavix BMS-SANOFI 1,808 -50.7
49 72 pms-Amlodipine PHARMASCIENCE 1,808 25.5
50 45 Apo-oxazepam APOTEX 1,796 -0.4
51 44 pms-Hydrochlorothiazide PHARMASCIENCE 1,768 -2.3
52 30 Teva-hydrochlorothiazide TEVA CANADA 1,716 -20.1
53 50 Toloxin PENDOPHARM 1,704 -1.5
54 61 Ran-pantoprazoleRANBAXY PHARMA
CAN1,652 5.2
55 38 Apo-citalopram APOTEX 1,643 -13.4
56 71 Teva-pantoprazole TEVA CANADA 1,587 10
57 91 Apo-amoxi APOTEX 1,581 30.5
58 66 Apo-amlodipine APOTEX 1,575 5.3
59 55 Apo-lansoprazole APOTEX 1,559 -6.1
60 52 Coumadin BMS PHARMA 1,557 -9.1
61 70 Symbicort ASTRAZENECA 1,544 5.3
62 67 One Touch Ultra LIFESCAN 1,511 1.1
63 101 Cymbalta LILLY 1,500 31.4
64 65 Apo-naproxen APOTEX 1,495 -0.6
65 87 pms-Citalopram PHARMASCIENCE 1,467 14.1
66 97 Seroquel XR ASTRAZENECA 1,457 23.3
67 43 Teva-risedronate TEVA CANADA 1,452 -20.1
68 83 Pro-metformin PRO DOC 1,427 6.9
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69 79 Teva-amlodipine TEVA CANADA 1,417 3.8
70 122 pms-Ramipril PHARMASCIENCE 1,393 43.2
71 68 Co Metformin COBALT PHARMA 1,383 -6.9
72 82 Ascensia microfillBAYER
HEALTHCARE1,382 3
73 76 Advair diskus GLAXOSMITHKLINE 1,381 -0.6
74 104 Teva-trazodone TEVA CANADA 1,364 27.6
75 46 Lipitor PFIZER 1,361 -23.5
76 222 Sandoz-valsartan SANDOZ CANADA 1,353 131.2
77 62 Teva-lorazepam TEVA CANADA 1,345 -12.4
78 5568 Apo-clopidogrel APOTEX 1,335 ******
79 75 Teva-metoprolol TEVA CANADA 1,335 -4.6
80 81 Apo-pantoprazole APOTEX 1,326 -1.2
81 77 Teva-olanzapine TEVA CANADA 1,324 -3.5
82 73 Apo-prednisone APOTEX 1,312 -7.9
83 80 Diamicron MR SERVIER LAB 1,312 -2.5
84 86 Apo-metoprolol-L APOTEX 1,288 -1.1
85 84 Mylan-nifedipine MYLAN PHARMA 1,271 -4.3
86 92 Atorvastatin SANIS HEALTH 1,264 6.5
87 98 pms-Clonazepam PHARMASCIENCE 1,263 6.9
88 334 Apo-esomeprazole APOTEX 1,262 231.2
89 274 Sandoz-tamsulosin SANDOZ CANADA 1,262 168.7
90 114 Apo-trazodone APOTEX 1,255 22.3
91 94 Premarin PFIZER 1,254 5.9
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92 127 pms-Atenolol PHARMASCIENCE 1,251 30.8
93 105 Avodart GLAXOSMITHKLINE 1,251 18.5
94 64 YasminBAYER
HEALTHCARE1,243 -18.7
95 100 pms-Zopiclone PHARMASCIENCE 1,235 7.9
96 117 pms-Metoprolol-L PHARMASCIENCE 1,232 21.9
97 78 Apo-omeprazole APOTEX 1,230 -10
98 149 Januvia MERCK CANADA 1,226 42.2
99 96 Estrace SHIRE CANADA 1,218 3
100 112 Amlodipine PRO DOC 1,201 15.7
*Estimated volume of prescriptions dispensed from Canadian retail pharmacies. Source: IMS Brogan, Canadian
CompuScript,12 months ending October 2012.
Due to routine data history corrections completed in 2012, certain product rankings listed in the Feb/March
2012 issue of Pharmacy Practice may differ from those listed above.
table 2. Top 100 generic Rx products
RANK PRODUCT MANUFACTURER
12
months
ending
Oct.
2012
TRx*
(000s)
%
CHANGE
vs 12
months
ending
Oct. 2011
1 Apo-atorvastatin APOTEX 5,485 0.4
2 Apo-furosemide APOTEX 4,084 3.6
3 Apo-hydro APOTEX 3,197 -6.5
4 Teva-amoxicillin TEVA CANADA 3,134 -14.9
5 Elavil AA PHARMA 3,007 14.6
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6 Taro-warfarinTARO
PHARMACEUTICA2,855 6.2
7 Zyloprim AA PHARMA 2,675 25.9
8 Teva-venlafaxine TEVA CANADA 2,670 51.9
9 D-tabs RIVA 2,605 59.9
10 Apo-salvent CFC FR APOTEX 2,475 11
11 Apo-ramipril APOTEX 2,475 -15.7
12 Apo-lorazepam APOTEX 2,391 -3.9
13 Ratio-lenoltec #3 TEVA CANADA 2,250 -2.1
14 Ran-atorvastatinRANBAXY PHARMA
CAN2,211 -10.1
15 Ratio-oxycocet TEVA CANADA 2,164 -4.4
16 Ratio-metformin TEVA CANADA 2,154 11.3
17 Ratio-atorvastatin TEVA CANADA 2,136 124.7
18 Pro-AAS EC-80 PRO DOC 2,132 4.6
19 Apo-metformin APOTEX 2,096 12.7
20 Teva-rabeprazole TEVA CANADA 1,995 -19.5
21 Teva-furosemide TEVA CANADA 1,987 -1.8
22 Ran-ramiprilRANBAXY PHARMA
CAN1,907 24.5
23 Apo-metoprolol APOTEX 1,903 0.5
24 Apo-bisoprolol APOTEX 1,902 102.1
25 pms-Clonazepam-R PHARMASCIENCE 1,846 11.3
26 Atorvastatin PRO DOC 1,841 25
27 Sandoz-bisoprolol SANDOZ CANADA 1,810 -32.8
28 pms-Amlodipine PHARMASCIENCE 1,808 25.5
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29 Apo-oxazepam APOTEX 1,796 -0.4
30 pms-Hydrochlorothiazide PHARMASCIENCE 1,768 -2.3
31 Teva-hydrochlorothiazide TEVA CANADA 1,716 -20.1
32 Ran-pantoprazoleRANBAXY PHARMA
CAN1,652 5.2
33 Apo-citalopram APOTEX 1,643 -13.4
34 Teva-pantoprazole TEVA CANADA 1,587 10
35 Apo-amoxi APOTEX 1,581 30.5
36 Apo-amlodipine APOTEX 1,575 5.3
37 Apo-lansoprazole APOTEX 1,559 -6.1
38 Apo-naproxen APOTEX 1,495 -0.6
39 pms-Citalopram PHARMASCIENCE 1,467 14.1
40 Teva-risedronate TEVA CANADA 1,452 -20.1
41 Pro-metformin PRO DOC 1,427 6.9
42 Teva-amlodipine TEVA CANADA 1,417 3.8
43 pms-Ramipril PHARMASCIENCE 1,393 43.2
44 Co metformin COBALT PHARMA 1,383 -6.9
45 Teva-trazodone TEVA CANADA 1,364 27.6
46 Sandoz-valsartan SANDOZ CANADA 1,353 131.2
47 Teva-lorazepam TEVA CANADA 1,345 -12.4
48 Apo-clopidogrel APOTEX 1,335 ******
49 Teva-metoprolol TEVA CANADA 1,335 -4.6
50 Apo-pantoprazole APOTEX 1,326 -1.2
51 Teva-olanzapine TEVA CANADA 1,324 -3.5
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52 Apo-prednisone APOTEX 1,312 -7.9
53 Apo-metoprolol-L APOTEX 1,288 -1.1
54 Mylan-nifedipine XR MYLAN PHARMA 1,271 -4.3
55 Atorvastatin SANIS HEALTH 1,264 6.5
56 pms-Clonazepam PHARMASCIENCE 1,263 6.9
57 Apo-esomeprazole APOTEX 1,262 231.2
58 Sandoz-tamsulosin SANDOZ CANADA 1,262 168.7
59 Apo-trazodone APOTEX 1,255 22.3
60 pms-Atenolol PHARMASCIENCE 1,251 30.8
61 pms-Zopiclone PHARMASCIENCE 1,235 7.9
62 pms-Metoprolol-L PHARMASCIENCE 1,232 21.9
63 Apo-omeprazole APOTEX 1,230 -10
64 Amlodipine PRO DOC 1,201 15.7
65 Apo-cephalex APOTEX 1,195 26.2
66 Teva-spironolactone TEVA CANADA 1,169 21
67 pms-Hydromorphone PHARMASCIENCE 1,158 17.6
68 Taro-docusateTARO
PHARMACEUTICA1,148 25.7
69 Apo-rosuvastatin APOTEX 1,133 ******
70 Teva-ramipril TEVA CANADA 1,115 -33
71 Teva-salbutamol HFA TEVA CANADA 1,102 7.8
72 Apo-zopiclone APOTEX 1,094 23.3
73 Pantoprazole PRO DOC 1,078 22.7
74 Sandoz-pantoprazole SANDOZ CANADA 1,077 36.2
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75 Apo-temazepam APOTEX 1,068 21.7
76 Gliclazide MR AA PHARMA 1,059 67.9
77 Calcite 500+D 400 RIVA 1,043 -15.6
78 Ratio-venlafaxine TEVA CANADA 1,029 -53.3
79 pms-Atorvastatin PHARMASCIENCE 1,019 19.1
80 Mylan-metformin MYLAN PHARMA 1,009 -12.3
81 Apo-candesartan APOTEX 1,007 277.2
82 Teva-divalproex TEVA CANADA 993 8
83 Apo-quetiapine APOTEX 986 19.3
84 pms-Docusate sodium PHARMASCIENCE 979 33
85 Apo-ibuprofen APOTEX 939 -2.3
86 pms-Metformin PHARMASCIENCE 939 6.4
87 Ran-rabeprazoleRANBAXY PHARMA
CAN935 -21.1
88 Teva-prednisone TEVA CANADA 922 23.8
89 Teva-rosuvastatin TEVA CANADA 915 ******
90 Sandoz-valsartan HCT SANDOZ CANADA 910 134.3
91 Jamp-vitamin D3 JAMP PHARMA 909 108.7
92 BetadermTARO
PHARMACEUTICA908 40.8
93 Metformin SANIS HEALTH 902 89.3
94 pms-Quetiapine PHARMASCIENCE 897 15.8
95 Sandoz-rabeprazole SANDOZ CANADA 896 77.8
96 Mylan-zopiclone MYLAN PHARMA 882 6.6
97 Teva-glyburide TEVA CANADA 874 -3.5
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98 Euro-fer EUROPHARM 873 10.1
99 Ratio-domperidone TEVA CANADA 864 26.6
100 Apo-acetaminophen APOTEX 861 -11.1
*Estimated volume of prescriptions dispensed from Canadian retail pharmacies. Source: IMS Brogan, Canadian
CompuScript,12 months ending October 2012.
table 3. Top 100 Rx drugs (by generic name)
2012 2011 GENERIC NAME
12 months
ending Oct.
2012
TRx* (000s)
% CHANGE
vs 12 months
ending Oct.
2011
1 1 ATORVASTATIN 17,240 0.7
2 2 LEVOTHYROXINE 17,150 5.9
3 4 ROSUVASTATIN 12,523 12.6
4 3 METFORMIN 12,508 2.7
5 7 PANTOPRAZOLE 11,051 17.3
6 5 AMLODIPINE 10,374 5.6
7 6 RAMIPRIL 9,375 -1.9
8 9 METOPROLOL 7,806 4.2
9 10 FUROSEMIDE 7,711 3.7
10 11 LORAZEPAM 7,331 -1.2
11 12 CITALOPRAM 7,302 0.8
12 8 HYDROCHLOROTHIAZIDE 7,250 -8.5
13 15 QUETIAPINE 6,985 9.9
14 13 VENLAFAXINE 6,706 0
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15 14 SALBUTAMOL 6,641 2.8
16 23 CHOLECALCIFEROL 6,260 38.5
17 16 AMOXICILLIN 5,625 -4.3
18 17 WARFARIN 5,620 -3.1
19 18ACETAMINOPHEN &
CAFFEINE & CODEINE5,319 -4.4
20 20 ZOPICLONE 5,283 6
21 21 DOCUSATE 5,255 7.9
22 19 CLONAZEPAM 5,148 3.3
23 25 BISOPROLOL 4,968 12.8
24 22 RABEPRAZOLE SODIUM 4,550 -5.3
25 26 ESOMEPRAZOLE 4,370 4.1
26 29 TRAZODONE 4,014 8.1
27 30 CLOPIDOGREL 3,795 3.4
28 31 IRON FERROUS 3,774 6.4
29 39 PERINDOPRIL 3,759 16.5
30 34ETHINYL ESTRADIOL &
LEVONORGESTREL3,616 4
31 28 ATENOLOL 3,607 -3.5
32 33 NAPROXEN 3,551 0.4
33 36 FLUTICASONE 3,430 0.4
34 32 RISPERIDONE 3,425 -3.2
35 43 TAMSULOSIN 3,376 8.7
36 24CALCIUM &
ERGOCALCIFEROL3,359 -24.3
37 35 RISEDRONATE 3,334 -3.1
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38 41 ACETAMINOPHEN 3,317 4.6
39 37 NIFEDIPINE 3,273 -0.7
40 57 CALCIUM 3,171 24.2
41 64 ESCITALOPRAM 3,151 29.3
42 38 OMEPRAZOLE 3,134 -4.5
43 45 AMITRIPTYLINE 3,127 2.6
44 40 LANSOPRAZOLE 3,074 -4.2
45 44 DILTIAZEM 3,054 -0.1
46 47 MOMETASONE 3,026 1
47 54 GLICLAZIDE 3,025 15.1
48 42 SIMVASTATIN 2,969 -5.9
49 56 HYDROMORPHONE 2,933 14.8
50 66 PREGABALIN 2,848 17.3
51 61 GABAPENTIN 2,837 15.5
52 46 IRBESARTAN 2,703 -10.5
53 58 ALLOPURINOL 2,700 6.3
54 50 CELECOXIB 2,699 -1.4
55 49ACETAMINOPHEN &
OXYCODONE2,694 -5.3
56 62 BUPROPION 2,680 9.3
57 48 ALENDRONATE 2,642 -7.9
58 52 OXAZEPAM 2,620 -1.1
59 59 ACETYLSALICYLIC ACID 2,562 2.9
60 65 PREDNISONE 2,549 4.9
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61 55 OLANZAPINE 2,542 -3.2
62 53 PAROXETINE 2,524 -4.5
63 73 METHYLPHENIDATE 2,504 9.4
64 68 ESTRADIOL 2,494 4.6
65 51 GLYBURIDE 2,450 -7.7
66 60 VALSARTAN 2,443 -0.5
67 75 SERTRALINE 2,375 7.1
68 63 RANITIDINE 2,363 -3.2
69 76 CANDESARTAN 2,328 7.3
70 71 CIPROFLOXACIN 2,294 -1
71 69 DOMPERIDONE 2,287 -2.9
72 74FLUTICASONE &
SALMETEROL2,264 1.3
73 80 EZETIMIBE 2,215 9
74 67 OXYCODONE 2,213 -7.8
75 72 CLARITHROMYCIN 2,159 -6
76 79 DIVALPROEX 2,107 3
77 77ETHINYL ESTRADIOL &
NORGESTIMATE2,070 -2.8
78 82 POTASSIUM 2,053 2.8
79 70DROSPIRENONE &
ETHINYL ESTRADIOL2,043 -13
80 83 AZITHROMYCIN 2,028 1.8
81 81 DICLOFENAC 2,021 0.9
82 85 MIRTAZAPINE 2,017 9.9
83 78 CYANOCOBALAMIN 1,999 -2.7
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84 84 TIOTROPIUM BROMIDE 1,937 5.2
85 87 DONEPEZIL 1,893 8.7
86 91 HYDROCORTISONE 1,833 9.7
87 93 MORPHINE 1,796 9.2
88 97 SENNOSIDES A&B 1,751 10.8
89 89 CYCLOBENZAPRINE 1,744 2.7
90 94 TELMISARTAN 1,735 7.2
91 95 CEPHALEXIN 1,715 6.5
92 86 DIGOXIN 1,709 -2.7
93 96 BETAMETHASONE 1,676 5.4
94 88HYDROCHLOROTHIAZIDE
& VALSARTAN1,657 -3.1
95 90 TEMAZEPAM 1,638 -2.5
96 92 NITROGLYCERIN 1,582 -4.6
97 102BUDESONIDE &
FORMOTEROL1,544 5.3
98 117 DULOXETINE 1,500 31.4
99 100 FENOFIBRATE 1,491 -1.2
100 98 FOLIC ACID 1,453 -6
*Estimated volume of prescriptions dispensed from Canadian retail pharmacies. Source: IMS Brogan, Canadian
CompuScript,12 months ending October 2012.
Due to routine data history corrections completed in 2012, certain product rankings listed in the Feb/March
2012 issue of Pharmacy Practice may differ from those listed above.
table 4. Top 10 classes
RANK THERAPEUTIC CLAS
TRx* 12
MONTHS
TRx %
Change
TRx $$**
12
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ENDING OCT
RANK
THERAPEUTIC
CLAS 2012
(000s)
Over 12
MONTHS
ENDING
OCT
2011
MONTHS
ENDING
OCT
2012
(000s)
1 CARDIOVASCULARS 83,447 2.7 $2,645,107
2 psychotherapeutics 73,714 4.5 $2,635,579
3 gastrointestinal/genitourinary 41,718 5.3 $1,767,847
4 antihyperlipidemic agents 38,598 4 $1,885,270
5 analgesics 28,622 1.6 $1,109,556
6 hormones 27,129 1.2 $1,018,726
9 anti-infectives 24,628 -1.4 $887,483
7 diabetes therapy 26,166 4.8 $1,211,700
8 neurological disorders 25,123 6.4 $1,252,671
10 diuretics 18,926 -1.9 $194,904
*Estimated volume of prescriptions dispensed in Canadian retail pharmacies.
**Estimated dollar value of prescriptions dispensed from Canadian retail pharmacies (includes professional fees
and mark-ups).
Source: IMS Brogan, Canadian CompuScript
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Click for larger view
table 5. Top 100 products based on prescription dollars
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RANK PRODUCT NAME MANUFACTURER
12
months
ending
Oct. 2012
TRx*
(000s)
%
CHANGE
vs 12
months
ending
Oct. 2011
1 CRESTOR ASTRAZENECA $634,357 -27.3
2 REMICADE JANSSEN PHARMA $541,183 6.5
3 HUMIRA ABBOTT SPD $399,051 23.6
4 ENBREL AMGEN $329,854 8.1
5 CIPRALEX LUNDBECK CANADA $259,878 29.7
6 LYRICA PFIZER $258,602 14.8
7 NEXIUM ASTRAZENECA $257,173 -23.9
8 ADVAIR DISKUS GLAXOSMITHKLINE $226,686 0.6
9 SPIRIVA BOEHRINGER ING $206,320 6.8
10 EZETROL MERCK CANADA $202,061 8.3
11 CYMBALTA LILLY $191,242 30.5
12 APO-ATORVASTATIN APOTEX $188,600 -9.6
13 COVERSYL SERVIER LAB $187,140 17.5
14 SYMBICORT ASTRAZENECA $185,766 8.6
15 CELEBREX PFIZER $185,458 -0.5
16 SYNTHROID ABBOTT EPD $168,886 8.6
17 FLOVENT HFA GLAXOSMITHKLINE $163,658 -1
18 ARICEPT PFIZER $162,936 8.3
19 ONE TOUCH ULTRA LIFESCAN $156,340 1.7
20 JANUVIA MERCK CANADA $153,115 43.4
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21 PLAVIX BMS-SANOFI $153,053 -54.9
22 LUCENTIS NOVARTIS PHARMA $150,073 54.9
23 ADVAIR GLAXOSMITHKLINE $144,477 5.5
24 ASCENSIA MICROFILL BAYER HEALTHCARE $132,020 4.9
25 CONCERTA JANSSEN PHARMA $130,362 13.8
26 APO-ESOMEPRAZOLE APOTEX $122,855 244.4
27 LIPITOR PFIZER $122,769 -12.6
28 CIALIS LILLY $117,492 8.4
29 OXYCONTIN PURDUE PHARMA $114,026 -55.6
30 OXYNEO PURDUE PHARMA $107,644 ******
31 NASONEX MERCK CANADA $105,191 3.2
32 VIAGRA PFIZER $101,228 2.4
33 COPAXONETEVA
NEUROSCIENCE$99,660 4.2
34 ADALAT XL BAYER HEALTHCARE $97,223 3.5
35HYDROMORPH
CONTINPURDUE PHARMA $96,268 15.1
36 REBIF EMD CANADA $94,614 -1.9
37TEVA-VENLAFAXINE
XRTEVA CANADA $93,151 34
38 SEROQUEL XR ASTRAZENECA $92,094 19.1
39 PRADAX BOEHRINGER ING $91,546 156.9
40 TECTA NYCOMED CANADA $88,736 88.3
41 AVODART GLAXOSMITHKLINE $88,005 15.2
42 GLEEVEC NOVARTIS PHARMA $85,527 6.3
43 LANTUS SOLOSTAR SANOFI-AVENTIS $81,406 30.6
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44 NEUPOGEN AMGEN $80,570 13.4
45 RAN-ATORVASTATINRANBAXY PHARMA
CAN$76,454 -8.3
46 WELLBUTRIN XL VALEANT PHARMA $75,079 16.1
47 NOVORAPIDNOVO NORDISK
CDA$74,312 11.6
48 LANTUS SANOFI-AVENTIS $73,472 20.1
49 ATRIPLA BMS-GILEAD $71,981 12.2
50 ACTONEL WARNER CHILCOTT $71,384 -25.7
51 FRAGMIN PFIZER $68,609 16.2
52 ARTHROTEC PFIZER $68,390 -1.1
53 TRUVADA GILEAD SCIENCES $67,897 13.3
54 TEVA-AMOXICILLIN TEVA CANADA $66,155 -13.1
55 ABILIFY BMS PHARMA $65,037 126.5
56 AVONEX BIOGEN IDEC $64,058 10.9
57 LEVEMIRNOVO NORDISK
CDA$63,333 14.2
58 ALESSE PFIZER $62,440 11.2
59RATIO-
ATORVASTATINTEVA CANADA $62,420 90.6
60 EPIPEN PFIZER $62,143 3.9
61 RAN-RAMIPRILRANBAXY PHARMA
CAN$61,331 3.3
62 HUMALOG LILLY $61,315 11.8
63 TEVA-OLANZAPINE TEVA CANADA $61,306 -13.9
64 PROMETRIUM MERCK CANADA $60,630 20.4
65 TIAZAC XC VALEANT PHARMA $58,647 0.4
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66 VICTOZANOVO NORDISK
CDA$58,589 95.3
67 CHAMPIX PFIZER $58,417 1.9
68 ARANESP AMGEN $57,868 0.1
69 TEVA-RABEPRAZOLE TEVA CANADA $57,203 -28.1
70 ACCU-CHEK AVIVAROCHE
DIAGNOSTICS$57,143 104.6
71 BOTOX ALLERGAN $55,377 5.6
72 APO-LANSOPRAZOLE APOTEX $54,965 -15
73 MICARDIS BOEHRINGER ING $54,963 -43.9
74 RISPERDAL CONSTA JANSSEN PHARMA $54,803 -3.4
75MYLAN-NIFEDIPINE
XRMYLAN PHARMA $54,787 -9.9
76 NEULASTA AMGEN $54,008 19.3
77 DETROL LA PFIZER $53,993 -1.4
78 SANDOSTATIN LAR NOVARTIS PHARMA $53,989 14
79 APO-OMEPRAZOLE APOTEX $53,429 -19.2
80 SINGULAIR MERCK CANADA $53,029 -50.1
81 TEVA-PANTOPRAZOLE TEVA CANADA $52,994 -1.8
82 RATIO-FENTANYL TEVA CANADA $52,947 2
83 STELARA JANSSEN PHARMA $52,735 22.7
84 EPREX JANSSEN PHARMA $52,088 -1.1
85 SIMPONI JANSSEN PHARMA $51,165 60
86 APO-RAMIPRIL APOTEX $49,829 -22.1
87 CESAMET VALEANT PHARMA $49,759 -27.9
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88 RAN-PANTOPRAZOLERANBAXY PHARMA
CAN$49,539 -6.2
89 ELAVIL AA PHARMA $49,506 11.6
90 MIRENA BAYER HEALTHCARE $49,476 16
91 VENTOLIN HFA GLAXOSMITHKLINE $48,788 -4.4
92 VYVANSE SHIRE CANADA $48,500 73.6
93 CELLCEPT ROCHE $48,366 -25.3
94 ATACAND PLUS ASTRAZENECA $48,299 -6.5
95 BIAXIN XL ABBOTT EPD $47,953 -10.2
96 KIVEXAVIIV HEALTHCARE
UL$47,461 6.2
97 RATIO-OXYCOCET TEVA CANADA $47,341 -3.7
98ACCU-CHEK
COMPACT
ROCHE
DIAGNOSTICS$47,123 -8.9
99 ADDERALL XR SHIRE CANADA $47,090 4.7
100 APO-AMLODIPINE APOTEX $46,894 -6.8
*Estimated volume of prescriptions dispensed from Canadian retail pharmacies. Source: IMS Brogan, Canadian
CompuScript,12 months ending October 2012.
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