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Vytorin Scripts Plummet


Pharmaceutical Executive

Pharmaceutical ExecutivePharmaceutical Executive-01-30-2008
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In the wake of the ENHANCE study, new prescriptions of the cholesterol-lowering drug Vytorin are dropping drastically, but calls to sales reps by physicians are on the rise.

New written prescriptions (NWRx) of Vytorin have taken a nose dive since Merck and Schering-Plough reported the results of their study that found that the drug worked no better at reducing arterial plaque than lower-cost alternatives.

According to new data from ImpactRX, market share of Vytorin stumbled from 17 percent at the start of the year to 4 percent as of last Wednesday. Meanwhile, new prescriptions of generic simvastatin, the market leader, have spiked from 30 percent to 44 percent share in that same period.

NWRx refers to treatment starts, add-ons, and switches and not renewals of existing prescriptions. Information is gathered at the doctors' office, unlike NRx, which tracks prescriptions refilled and new scrips being dispensed at the pharmacy.

The prescription volume drop is being compared with that of GSK's embattled diabetes drug, Avandia?even though there is no reported clinical safety issue in the case of Vytorin. "If there is any issue with Vytorin?whether it be efficacy issues or not?doctors know that they have a perfectly effective alternative in simvastatin, and they are switching," said Patrick Angelastro, senior vice president, strategic development at ImpactRx.

Avandia lost approximately two-thirds of its NWRx share, eventually leveling off, but never rising. "This is similar to what we are seeing in Vytorin," Angelastro said.

Docs Want Answers
As new scrip writing has dropped, the number of requests by physicians for sales details has spiked since the Vytorin story broke. Between Jan. 13 and 21, Vytorin's share of details had increased from 28 percent to 39 percent, rivaling the amount of detail being done for Lipitor.

"It seems as if the doctors are providing the Vytorin reps more access than they had previously because they want to know more about what these ENHANCE results mean," Angelastro said. "This is not unlike what we saw after both the Avandia and the Vioxx situations. After Vioxx was withdrawn, we saw the drug's share of attention spike upwards because docs wanted to know what was going on?they were detailing a product that was no longer on the market."

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