Biotech Values

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Eli Lilly Pitches Blood Test to Aid Sales of Blood Thinner [Effient]

http://prescriptions.blogs.nytimes.com/2010/07/12/eli-lilly-pitches-blood-test-to-aid-sales-of-blood-thinner/

By ANDREW POLLACK, July 12, 2010, 3:11 pm

Eli Lilly is about to try a new tack to help flagging sales of its new anti-clotting drug, Effient. It will urge doctors to test patients taking a rival drug, Plavix, to see if it is working. If it isn’t, doctors would presumably switch patients to Effient.

Lilly said on Monday that its sales representatives would tell doctors about a blood test offered by Accumetrics that physically measures clotting ability after patients take anti-platelet drugs like Effient and Plavix. Daiichi Sankyo, Lilly’s partner on Effient, will also participate in the effort.

The collaboration is an example of how pharmaceutical companies and diagnostics companies can work together for mutual advantage.

“We’ve had a mutual interest in promoting the fact that many patients don’t get the appropriate level of platelet inhibition,’’ said Steve Schaefer, senior director of marketing for Lilly’s cardiovascular business unit.

Effient was expected to be a blockbuster, but in its first three quarters on the market sales have totaled just $35 million. By contrast, Plavix, sold by Bristol-Myers Squibb and Sanofi Aventis, has billions of dollars in annual sales.

Both drugs prevent platelets from clumping together to form a clot. The drugs are used by patients who have undergone artery-opening procedures like stenting. Effient was better at preventing heart attacks and strokes than Plavix in its main clinical trial, but it also caused more bleeding incidents, including fatal ones. There is also some suggestion, disputed by Lilly, that Effient is associated with a higher cancer risk than Plavix.

Timothy I. Still, president of Accumetrics, a privately held company in San Diego, said that the use of his company’s test suggests that one-third of the people taking Plavix might not be getting the full benefit of the drug in preventing heart attacks and strokes.

However, Accumetrics is only now doing a study aiming to demonstrate that patient outcomes are improved if its test is used to guide therapy. The tests, called VerifyNow, cost about $60 each, though laboratories also need a machine to run them on, which costs at least $8,000.

Mr. Schaefer of Lilly, who said Effient sales were improving, said the collaboration was not aimed at Plavix and would also urge doctors to test patients receiving Effient.

Still, since Plavix has the dominant market share, wider use of the test is likely to find far more people for whom Plavix isn’t working.

Certain genetic variations in a patient’s DNA can also diminish the effectiveness of Plavix. Lilly has said Effient will work for many of these patients. Mr. Schaefer said the Accumetrics test provides a faster answer than a genetic test.