Shortages, particularly of cheaper generics, have become so endemic that some patients say they worry almost constantly about availability.

But SmithKline lost its patent protection for the drug last May, and sales have since plummeted because cheaper generics have come onto the market.

That added time can allow companies to rake in hundreds of millions of dollars more before the way is open for cheaper generics to drive prices down.

The reason, critics say, is that Lipitor will lose patent protection in 2010, opening the way for cheap generics to take away its market.

Astonishingly, the country spends most of its scarce AIDS money on brand-name drugs rather than cheaper generics, which could treat three times as many people.

Nevertheless, some branded products may offer only marginal advantages over much cheaper generics.

Or to sell brand-name drugs with high markups when cheaper generics are available?

They are virtually saying "no" to cheap, affordable generics for very sick people in poor countries.

Several of its best-selling drugs are losing their patent protection and will face competition from cheaper generics.

He pointed to drugs that lower blood pressure, where expensive branded medicines dominate cheaper generics despite extensive research showing the generics work as well.