Nor does Amarin acknowledge that the article quoted another doctor who “did not praise Vascepa or MARINE, but instead dismissed MARINE’s significance because typical increases in LDL-C with Lovaza were ‘modest’ and ‘not that big an issue,’ especially since Lovaza ‘works well with statins.’” Appx42-43 (quoting Appx88650).
... That is especially true here since severe hypertriglyceridemia is “rare,” and statins were “extremely well tolerated.” Appx88309, Appx1408-1409(809:21-810:14) (Heinecke).
...
It was not until JELIS taught in 2007 (one year before the alleged invention) that EPA is “a promising treatment for prevention of major coronary events,” that there was a major commercial incentive to pursue pure EPA in the United States. Appx88633; Appx2697(1903:5-17) (Toth). The market for cardiovascular-riskCase: 20-1723 Document: 49 Page: 52 Filed: 06/16/2020 39 reduction is considerably larger than that for severe hypertriglyceridemia.
Singers reply:
Defendants are also wrong to downplay (at 37) the importance of having a single drug to treat severe hypertriglyceridemia, repeating their rejected arguments that adding a statin to Lovaza® was sufficient. But doctors strongly prefer using a single drug, as opposed to multiple drugs, because patients often stop taking the coprescribed drug. (Appx1412–13 (Heinecke).) Defendants’ answer is also of no comfort to those patients who couldn’t tolerate statins or who needed them to lower their pre-existing LDL-C levels yet received no benefit from the statins other than to offset the LDL-C increases caused by their treatments for severe hypertriglyceridemia. (Appx2352–2353 (Toth).)