Release issued 13th May 2008

May 13, 2008, Waltham, Mass. Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that Simvastatin (Merck’s Zocor, generics) leads Pfizer’s Lipitor in second-line patient share—22.9 percent versus 14.7 percent. Most patients progressing to Simvastatin do so after switching from Lipitor. Surveyed primary care physicians and cardiologists cite Simvastatin’s better reimbursement and formulary status as the primary reason to prescribe Simvastatin instead of Lipitor. Nevertheless, despite the availability of generic statins, more than 75 percent of Lipitor’s prescriptions stem from first-line therapy.

The report entitled Treatment Algorithms in Dyslipidemia also finds that, prior to the release of the Enhance trial results, Merck/Schering-Plough’s Vytorin and AstraZeneca’s Crestor also gained significant second-line patient shares—13.1 percent and 10.9 percent, respectively. These gains reflect physicians’ efforts to boost efficacy in patients whose initial Low-Density Lipoprotein (LDL) lowering treatment had been less than optimal; surveyed physicians perceive these agents to offer the best LDL-reducing ability. However, 47 percent of surveyed primary care physicians and 49 percent of surveyed cardiologists have changed their prescribing of Merck/Schering-Plough’s Zetia and Vytorin because of data from the Enhance trial, which showed that the addition of Zetia to Simvastatin treatment did not significantly change carotid artery thickness. The majority of surveyed physicians now prescribe Vytorin and Zetia in fewer new patients, with a smaller percentage of physicians switching patients off of these drugs.

“Cardiologists we surveyed expect to decrease their first- and second-line prescriptions for Vytorin between 2008 and 2010, and to increase their third-line use of the drug in the same time period.” said Madhuri Borde, Ph.D., analyst at Decision Resources. “However, fewer surveyed primary care physicians anticipate lower use of Vytorin in first- and second-line therapy over the next two years.”

About Treatment Algorithm Insight Series
Decision Resources combines in-depth primary research with the most extensive claims-based longitudinal patient-level data from PharMetrics® to provide exceptional insight into physicians' prescribing trends and the factors that drive therapy product choice, from diagnosis through multiple courses of treatment, for a specific disease.

For each disease examined, Decision Resources' Treatment Algorithm Insight Series provide the following:

• Summary of U.S. medical practice based on interviews with leading experts in the field.
• Qualitative diagnosis/referral/treatment algorithm for the United States.
• Drug usage by lines of therapy (1st, 2nd, 3rd line).
• Discussion of key freeform combinations by lines of therapy.
• Product share (class and specific compound level) within each line of therapy (1st, 2nd, 3rd line).
• Progression of therapy from key 1st line products.
• Pathway to key therapies from previous therapies.
• Qualitative analysis of two-year forecast incorporating upcoming launches, changes in reimbursement, etc.

About Decision Resources
Decision Resources (www.DecisionResources.com) is a world leader in market research publications, advisory services, and consulting designed to help clients shape strategy, allocate resources, and master their chosen markets. Decision Resources is a Decision Resources, Inc. company.

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