Rise of the Underdog

Generic drugs are playing to their strengths and boldly stepping up to challenges

By Karen Langhauser, Chief Content Director

Although David and Goliath has evolved into an iconic underdog story, many scholars argue that David may not have been at a disadvantage after all.

While there are several translations and iterations, the basic gist is this: Goliath, a Philistines warrior, relentlessly challenges the Israelites to send out their champion in a winner-takes-all battle. For 40 days and nights, Goliath yells, but there are no takers (if only he had Twitter). Finally, David, a young shepherd, accepts the challenge. In the end, David, wearing no armor and using only a slingshot, walks away with Goliath’s head — giving rise to the most popular tale of a weaker opponent squaring off against a stronger adversary and emerging victorious.

Yet many have called attention to a variety of factors that cast doubt on this seemingly clear-cut case for David as the underdog.

Today’s big-ticket fight playing out on the healthcare battlefield is over drug pricing. Generic drugs have stepped up to the challenge, offering a viable solution to combat rising prescription drug costs. Recently, at the Association for Accessible Medicines’ (AAM) annual meeting, AAM president, Chip Davis, even referred to generics as the “underdogs” of the drug industry.

Although at times it may seem that way, the “battle” here is not brand versus generics. Questionable patent life extension “shenanigans” are merely one of many challenges the generics industry is up against. The “Goliath” in this tale is an agglomeration of factors, which also include legislative hurdles, market struggles and public perceptions. (Read more in our recent cover story: Generic But Mighty)

Returning to the tale of David vs. Goliath, scientists have theorized that considering Goliath’s massive height and size, he suffered from gigantism — an over-production of growth hormones — which often causes blurry vision and even, blindness. Dialogue in the biblical story corroborate the theory that perhaps Goliath was struggling to see his challenger clearly. And then there is the issue of strategy. Goliath had decidedly solid equipment — 125 lbs. of bronze armor and a javelin, spear and sword — but all of this proves to be a hindrance, as David knows how to control the fight’s narrative. David rejects the heavy armor and chooses a slingshot — a weapon ideal for a battle fought from a distance.

So, despite being historically heralded as the underdog, David possessed a clear view of the landscape, a strategic position, and a weapon that was better suited for the fight.

Indeed, today’s generics now have the benefit of clearer regulatory pathways to approval, especially when it comes to policies aimed at bringing generic competition to complex drugs. Generics, as an industry, also have begun rewriting their narrative, positioning themselves strategically as the most viable answer to the country’s number one healthcare problem. And further, their “weapons” rise to this challenge — generic drugs have proven themselves to be effective cures at affordable prices, saving patients and payers nearly $5 billion each week.

And yet, the balance between brand innovation and generic access established by the Hatch-Waxman Act is in serious jeopardy and generics must continue to face off against momentous obstacles.

The jury is still out on David’s underdog status. It’s entirely possible he wanted to be underestimated and that was his greatest advantage. What is clear though is that anyone, underdog or not, fighting what they believe to be the good fight has the potential to rise.

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  • Like David, generics will win because they're on the side of the angels.

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