Lilly, Others Fight Schizophrenia With Drugs: Medical Market
Bloomberg News
June 17, 1998, 10:58 a.m. PT
Lilly, Others Fight Schizophrenia With Drugs: Medical Market
Atlanta, June 17 (Bloomberg) -- Eli Lilly & Co.'s Zyprexa
drug is making it possible for a 45-year-old Atlanta woman with
schizophrenia to look for a job and consider moving out of her
parents' home for the first time since her illness started in
1982.
Other drugs, such as the generic Mellaril, had calmed her
delusions and hallucinations over the years. Still, they left her
unmotivated and depressed.
''I mostly just sat in my parents' house and stared at the
walls,'' said the woman, who asked not to be identified. ''Taking
Zyprexa, I feel happier, more normal and think more clearly most
of the time.''
Zyprexa, introduced in 1996, belongs to a relatively new
class of drugs that's helping some schizophrenia patients lead
more normal lives. Pfizer Inc.'s Zeldox, due to get regulatory
approval this summer, will join Zyprexa, Johnson & Johnson's
Risperdal and Zeneca Group Plc's Seroquel in a market that could
grow to $5 billion or $6 billion in five years from about $2
billion now.
In addition to relieving the depression and apathy that can
accompany schizophrenia, the new drugs, called antipsychotics
because they treat mental disorders, or psychoses, seem less
likely to cause the permanent damage to muscles that often
developed in patients treated with older drugs.
''The new drugs are doing so well because the older drugs
weren't as good,'' said David Saks, an analyst with Gruntal & Co.
''This is a category that has been under-served and the new drugs
are better.''
More Expensive
Lilly's Zyprexa was one of the most successful drug
introductions ever, with $760 million in sales in 1996, its first
year on the market. Zyprexa sales will rise to $1.4 billion this
year, analysts at Cowen & Co. estimate, while Johnson & Johnson's
Risperdal, approved in 1994, will have sales of almost $1
billion, Hambrecht & Quist forecasts.
The new drugs are considerably more expensive. While older
drugs like Johnson & Johnson's Haldol cost pennies a day per
patient, Zyprexa, Risperdal and Seroquel run about $8 to $9.
While taking Zyprexa costs a patient more than $3,000 a
year, Lilly says using the drug can actually produce a net
savings to the patient of about $10,000, compared to using an
older drug. That's because Zyprexa patients spend less time in
the hospital, according to Lilly, which based its findings on an
analysis of medical records of about 800 patients in a clinical
trial comparing Zyprexa to Haldol.
Hospitalizing patients to treat schizophrenia can cost $500
to $1,000 a day, said Richard Jed Wyatt, chief of neuropsychiatry
at the National Institute of Mental Health. ''You very quickly
can see how even a small relapse would even out any difference in
the cost of medicine,'' he said.
Mental Illness
Some 2.5 million people in the U.S. have schizophrenia, with
about 100,000 in state mental hospitals. Caring for people with
this disease costs about $20 billion annually in the U.S.
Schizophrenia, which doctors consider the most serious
mental illness, is marked by hallucinations, delusions and
paranoia. The popular identification of schizophrenia with
multiple personalities, a rare malady now known as dissociative
identity disorder, isn't clinically accurate. The cause of
schizophrenia is unknown.
''Schizophrenia robs people of so much of what we think of
as being human,'' said Alan Breier, a Lilly researcher working
with Zyprexa.
Schizophrenia strikes most often while people are in their
teens and 20s. While some patients may recover after a few bouts
with the disease, the majority suffer from it for the rest of
their lives.
Both old and new antipsychotic drugs seem to work by
altering the processing of a chemical messenger in the brain
called dopamine. Researchers believe the newer drugs have fewer
side effects because they target the parts of the brain linked to
thought and emotion more effectively.
Side Effects
Dopamine also works in parts of the brain linked to motor
function. Common side effects of older antipsychotic drugs
include trembling, rigidity and a shuffling gait. The symptoms
are similar to Parkinson's disease, which also is linked to
dopamine processing.
Some patients were reluctant to use the older drugs because
some of the side effects, such as making a person's tongue stick
out periodically or mouth chew constantly, were irreversible.
Old people are more vulnerable to these side effects, and
that made doctors concerned about using the older drugs for
treating Alzheimer's, a brain disease that causes memory loss,
confusion and dementia. The newer drugs are easier for elderly
patients with Alzheimer's disease to use, said Jeffrey Cummings,
director of the Alzheimer's Disease Center at the University of
California at Los Angeles, giving the drugs an additional
application.
The breakthrough in these new medicines, though, is treating
schizophrenia's hallucinations and delusions without causing the
Parkinson's disease-like side effects. They also ease the
depression and social withdrawal accompanying schizophrenia that
once tormented the Atlanta woman and thousands like her.
''They feel less zombified, as we say it,'' said Michael
Carvalho, a clinical specialist at the Veterans Administration
Medical Center in Manchester, New Hampshire. ''People tend to be
more social and they have a sense of well-being. They feel better
about themselves.''
--Kerry Dooley in the Princeton newsroom (609) 279-4016/dd |
