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Reuters Survey Shows Willingness to Switch
Patients from Byetta to Galvus and Januvia

http://yahoo.reuters.com/news/articlehybrid.aspx?storyID=urn:newsml:reuters.com:20061016:MTFH70298_2...

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NEW YORK, Oct 16 (Reuters) - As the first two drugs in a new diabetes-treatment class near U.S. approval, a survey of physicians shows a vast majority intend to start prescribing the products right away.

Merck & Co.'s <MRK.N> Januvia is expected to win clearance any day, while Novartis AG's <NVS> Galvus may be approved next month. Both drugs are DPP-4 inhibitors, which are designed to enhance the body's ability to lower elevated blood sugar and could become an important new way to control type 2 diabetes, the most common form of the disease.

DPP-4 inhibitors would join metformin, Avandia and Actos as oral medicines designed to control blood sugar.

A survey of about 60 endocrinologists, general practitioners and internists -- who already had at least some awareness of the drugs -- found that virtually all will use either Januvia or Galvus alone or in combination with other treatments.

Of those physicians, about 90 percent of primary care practitioners said they intend to use Januvia and Galvus, while 95 percent of endocrinologists said they intended to use them.

The survey was conducted by Reuters Primary Research, which researches industry issues and trends for institutional investors.

"The fact that 90 percent of (surveyed) physicians said that they would use them from the get-go is a big number," said Mara Goldstein, head of health care research for Reuters Primary Research.

The survey found no major difference in how doctors may use Januvia and Galvus, including how they may prefer the new drugs over older therapies. The survey did not ask which the doctors would prefer, Januvia or Galvus.

Some doctors seem willing to use the newer drugs as a replacement for Byetta, which was launched in June 2005 by Eli Lilly and Co. <LLY> and Amylin Pharmaceuticals Inc. <AMLN> and had sales of nearly $100 million in the second quarter.

Of the surveyed doctors who were open to using the new therapies, when asked about the likelihood of switching to either Januvia or Galvus from Byetta, more than 70 percent said they would be somewhat to very likely to change treatments.

Goldstein said those results reinforce the concern among investors that physicians will prescribe other drugs before turning to Byetta.

"That's how it (Byetta) has kind of been viewed, as the last stop before insulin," Goldstein said.
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