August 13, 2009 – The pharmaceutical and healthcare research firm Decision Resources found Merck/Schering-Plough's Zetia and Vytorin lost substantial patient share in second- and third-line therapy since last. This decline is most likely attributed to the publication of the ENHANCE trial, which called into question the ability of these agents to improve clinical outcomes beyond the ability of statin monotherapy.
The new “Treatment Algorithms in Dyslipidemia” report from Decision Resources also finds statins have gained patient share with Zetia's and Vytorin's decline in use since the ENHANCE fallout. Survey results indicate that over the next two years cardiologists and primary care physicians intend to be more aggressive in their treatment of dyslipidemia. They also plan to increase their use of the most potent statins, particularly Pfizer's Lipitor and AstraZeneca's Crestor, and adjunct agents belonging to the classes of fenofibrates and bile acid sequestrants.
"Our survey of physicians indicates that favorable results from the 2008 JUPITER trial are likely to increase the percentage of physicians prescribing Crestor in the first line and may lead to increases in Crestor's patient share. However, Crestor will have to compete with the availability of generic Lipitor in 2011 and AstraZeneca should try to gain as much traction as possible prior to the arrival of this additional competition," said Amanda Puffer, M.Sc., analyst at Decision Resources.
By combining patient-level claims data with physician survey data, this report can be used to build patient-flow models and analyze the assumptions driving these models. Patient-flow analysis for dyslipidemia shows that a sizable percentage of second-line or later users of Abbott's Simcor switched to the drug from Vytorin, suggesting that Simcor may have benefited from concerns over the efficacy of Vytorin following the ENHANCE trial. Survey results indicate that Simcor will be increasingly incorporated into the treatment algorithm as a first-line agent and it could continue to steal share from Vytorin prior to the launch of emerging fixed-dose combinations such as Abbott/AstraZeneca's Certriad (Crestor/TriLipix FDC).
For more information: www.DecisionResources.com