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ImpactRx Tracks Decline in Zetia and Vytorin Prescribing

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 certainly indicate a change in attitude towards these drugs has occurred."

"ImpactRx collects information directly from a panel of high prescribing physicians," noted Kain. "By focusing on physicians' new written prescriptions (NWRx), defined as drug therapy for newly diagnosed patients, add-on therapy or brand switches, our research is more sensitive and typically leads dispensed (NRx) trend changes. Our methodology provides unique insight, especially during periods of rapid change in prescribing behavior driven by market events."

Kain continued, "As always, ImpactRx will be monitoring prescribing changes closely. The incidence of drug switching in this category has risen dramatically since ENHANCE was released, with simvastatin now garnering two- thirds of those changes from Vytorin. Yet patient requests have increased only moderately. We'll be conducting research among physicians to explore their current attitudes towards Zetia and Vytorin and to understand their concerns regarding the latest clinical data."

About ImpactRx

Founded in October 2000, the physician networks of ImpactRx are the source of an unprecedented intelligence capability for tracking the promotional initiatives of the pharmaceutical industry and for measuring their impact on physician prescribing behavior. Based in Mount Laurel, New Jersey, ImpactRx is a private company with investment financing provided by Mediphase Venture Partners (, Oxford Bioscience Partners (, Merck Capital Ventures ( and 3i Group (


John Kain

Vice President, Marketing

ImpactRx, Inc.

856-273-0221, ext. 141

SOURCE ImpactRx, Inc.
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