A Wall Street Journal article from May 28 takes a closer look at the use of clopidogrel, now that the FDA has approved a generic version of the drug.
The article highlights some of the limitations with clopidogrel, including the fact that "nearly a third of patients prescribed a blood thinner to prevent heart attack or stroke have a genetic variation that limits their response" to the drug. As a result of these limitations more expensive drugs still on patent, such as prasugrel (Effient) or ticagrelor (Brilinta) are currently being prescribed by cardiologists.
However, "absent more definitive evidence, health plans are expected to steer patients away from more expensive strategies in favor of generic [clopidogrel]," the article says – a move that is generating debate among cardiovascular care providers. Some cardiologists are currently using genetic tests or other tests to determine how well patients are responding to the drug. Some say these tests could also be used as justification for more expensive drugs down the road.