One frequently cited example of a best-in-class late entrant that achieved major commercial success is atorvastatin (Lipitor; Pfizer). Although it was the fifth statin on the market, trailing lovastatin (Mevacor; Merck), the first, by more than 9 years, it went on to capture nearly double the peak annual sales of other drugs in the class, reaching US$13 billion. This example suggests that there could be merit in the common assumption that as long as a drug has a proven therapeutic advantage over its rivals, it does not have to be first. But what would a more systematic review tell us about the relative value of speed and therapeutic advantage? And how do these dynamics play out in different therapeutic areas and mechanistic classes?

Basis of analysis

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