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Changes in prescribing behavior appear inconsistent with ACC statements on
ENHANCE study results
MOUNT LAUREL, N.J., Jan. 24 /PRNewswire/ -- ImpactRx, Inc., the pioneering force in measuring the impact of pharmaceutical promotion on physicians' prescribing behavior, has released data showing a sharp drop in prescribing Zetia and Vytorin since Merck / Schering-Plough's release of the ENHANCE study results on January 14. That study was designed to determine if ezetimibe (Zetia) and simvastatin used in combination was more effective than simvastatin alone in slowing the growth of plaque in the carotid artery. There was no statistically significant difference between treatment groups on the primary endpoint: mean change in the intima-media thickness (IMT) measured at three sites in the carotid arteries.
In the past week, primary care physicians' usage of Vytorin, the combination of Zetia and simvastatin, has declined from 15% of new treatment decisions to 5%. Among cardiologists, the decline has been less severe, from 15% of new treatment decisions to around 8%. Zetia's share of this treatment population has declined from about 8% to less than 5% among both PCPs and cardiologists. Switching from Vytorin and Zetia is driving this trend, along with less initial use among patients naive to drug therapy. As of yesterday, it appears this decline may have begun to stabilize.
"The reaction among physicians and patients is a bit puzzling," said
John Kain, Vice President of Marketing at ImpactRx. "The American College
of Cardiology released a statement recommending 'that major clinical
decisions not be made on the basis of the ENHANCE study alone'. Both
medicines were generally well tolerated and the overall incidence rates of
cardiac events were nearly identical between both treatment groups, it
concluded. The College specifically noted, 'There should be no reason for
patients to panic'," Kain continued, "but the data certai
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