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To: russet who wrote (13698)	10/6/2004 3:25:24 PM
From: russet	Read Replies (2) \| Respond to of 14101

Pfizer Is Early Winner As Vioxx Users Switch Drugs By SCOTT HENSLEY Staff Reporter of THE WALL STREET JOURNAL October 6, 2004; Page D13 Many patients who were taking Merck & Co.'s Vioxx, a pain drug most often used for arthritis, are switching to other prescription drugs, particularly two Vioxx competitors sold by Pfizer Inc. Some 2.4% of Vioxx users in the U.S. got prescriptions for new medicines within 24 hours of Merck's announcement last Thursday that it was withdrawing the drug from the market, according to NDCHealth, a health-information company based in Atlanta. NDCHealth derives its estimate from a large database of prescriptions. NDCHealth estimates 1.2 million patients were taking Vioxx in the U.S. Pfizer was the early winner with 58% of the switchers receiving Celebrex or Bextra, once-a-day pills that belong to the same class of painkillers as Vioxx, according to NDCHealth. These newer drugs, called Cox-2 inhibitors, are supposed to reduce the risk of gastrointestinal bleeding and ulcers that hinder the broader class of painkillers called nonsteroidal anti-inflammatory drugs, or NSAIDS. Merck pulled Vioxx after a study of the drug in cancer prevention detected a doubling of the risk for heart attack and stroke after 18 months of use. About a third, or 32%, of U.S. patients with current Vioxx prescriptions had been taking the drug for more than 18 months, according to NDCHealth. While other Cox-2 medicines so far haven't shown the same link to heart trouble that Vioxx exhibited, some doctors are concerned that some level of heart risk could be common to the entire class of drugs, leading them to try older remedies instead. A researcher of drug promotion, ImpactRx of Mount Laurel, N.J., also finds patients switching to Pfizer's Cox-2 drugs. A sample of primary-care doctors who prescribe the most medicine showed that Celebrex picked up about 41% of new prescriptions written during the five days ended Monday. Bextra, a newer Pfizer drug, picked up 31% of prescriptions. "The current trends point to solidification of Celebrex and Bextra as the preferred choices, but it will take another few days to know for sure," said Nancy Lurker, chief executive of ImpactRx. Among the other drugs doctors are trying instead of Vioxx is Mobic, an NSAID that is sold by German drugs maker Boehringer Ingelheim and Abbott Laboratories of North Chicago, Ill. About 14% of Vioxx switchers in the past five days were sent to Mobic, according to ImpactRx. One reason may be that Boehringer Ingelheim drastically increased its Mobic sales calls to doctors immediately following the Vioxx withdrawal, ImpactRx data show. Another factor could be that the companies began offering a one-month free coupon for the drug in newspaper advertisements that targeted patients who had been prescribed Vioxx for arthritis. Write to Scott Hensley at scott.hensley@wsj.com