Replies to post #51988 on Biotech Values

[DewDiligence]

>…no physician would take a patient who was doing poorly on atorvastatin and switch them to simvastatin in the hopes that they would respond better to simvastatin.<

That’s a reasonable premise, IMO. The plausible options for switching such patients in the hopes of obtaining better efficacy are: i) Crestor, and ii) Vytorin.

[iwfal]

Patients in this study are unlikely to be switched for efficacy reasons. ... You have to understand that no physician would take a patient who was doing poorly on atorvastatin and switch them to simvastatin in the hopes that they would respond better to simvastatin.

On this I significantly disagree. Even with my small data set I have personally seen it happen several times in different classes of drugs - when there were no other classes anywhere near as potent.

I'd be willing to bet that the *vast* majority were likely to have been switched because of a cost issue--even before it went generic, simva was significantly less expensive than Lipitor.

Not substantially/uniformly true - at least in the US over the last 5 years.

In any case, there is no way to design a randomized trial to test this. You have to rely on real-world data. This is the best you're going to get

Sometimes the best isn't good enough - e.g. that difference in drop out rate speaks volumes.

[DewDiligence]

Pfizer Sees Lipitor Sales at Low End

[It must be from all of those docs switching patients to Zocor to get better efficacy. (That’s a joke :-) )]

http://biz.yahoo.com/ap/070910/pfizer_lipitor.html?.v=1

>>
Monday September 10, 3:43 pm ET

Pfizer Sees Lipitor Sales Toward Lower End of View; Competition From Generic Zocor

NEW YORK (AP) -- Pfizer Inc. Monday said sales of its blockbuster cholesterol drug Lipitor are trending toward the lower end of its previous views.

In July, the New York-based pharmaceutical company projected 2007 Lipitor sales to be flat or down as much as 5 percent from last year's $12.9 billion.

In a presentation at the Bear Stearns Healthcare Conference on Monday, Chairman and Chief Executive Jeffrey Kindler cited market dynamics, fundamentals, and continuing competition for the shortfall in Lipitor sales.

In July, the company projected 2007 earnings of $1.30 to $1.41 per share, revenue of $47 billion to $48 billion. Kindler said the company stood by those projections.

Lipitor has come under heavy pressure due to the June 2006 expiration of the U.S. patent for Merck & Co.'s Zocor statin, which cleared the way for cheaper generic copies of Zocor. Although Zocor isn't identical to Lipitor, administrators of drug-benefit plans have tried to encourage members to switch to generic Zocor, or simvastatin, from Lipitor in order to cut costs.

Shares of Pfizer fell 29 cents, or 1.2 percent, to $23.96 in afternoon trading Monday.
<<