[LLY MRK Novartis] Lilly's New Drug to Heat Up Battle for Bone      Market: Spotlight 
       Bloomberg News      September 9, 1998, 6:13 a.m. ET 
       Lilly's New Drug to Heat Up Battle for Bone Market: Spotlight
       Berlin, Sept. 9 (Bloomberg) -- The battle for the $2.8      billion market for osteoporosis treatments will likely heat up      this weekend as Eli Lilly & Co. unveils evidence that its new      treatment for the bone-thinning disease may leapfrog rival      drugs from Merck & Co. and American Home Products Corp.
       Lilly, the world's 10th biggest drugmaker, is pitting its      new hormone treatment Evista against both the standard drug      for the age-related illness -- American Home's blockbuster      Premarin -- and also against Fosamax, the bone-building drug      that was Merck & Co.'s fastest-growing pharmaceutical last      year. Lilly aims to show that Evista has the qualities of both      Premarin and Fosamax, a huge potential marketing advantage.
       The U.S. drugmakers, along with European rivals including      SmithKline Beecham Plc, Novartis AG and Hoechst AG, are      battling for what could become one of the most lucrative      niches in the $244 billion industry. The osteoporosis market      is expected to double by 2005 as the number of elderly people      rises and new drugs are approved. Some 20 million people in      the U.S. alone are affected by the disease, mostly women.
       ''It will be interesting to get indications on how these      various types of therapies fit together,'' said Ian Smith, an      analyst at Lehman Brothers. ''We need to know which patients      should get which therapy.''
       Estrogen Treatment
       Osteoporosis has for years been treated with limited      results with estrogen, a bone and skin-strengthening hormone      that falls in women after menopause, and Premarin has been the      best-selling hormone replacement therapy, generating $1      billion in 1997 sales. Calcium and vitamin D supplements are      also commonly prescribed.
       The 1995 approval of Fosamax changed all that. Unlike      Premarin, the Merck drug was found to actually build bone mass      in post-menopausal osteoporosis patients. Sales of Fosamax      took off, reaching $532 million in 1997 sales, an 89 percent      rise from 1996. It also fueled development of other similar      drugs called bisphosphonates by Hoechst, Roche Holding AG and      others.
       Now its Lilly's turn to make its mark with Evista, a drug      many analysts predict could sell more than $1 billion a year      at peak sales. Evista is the first of a class of new hormone      drugs called selective estrogen receptor modulators, or serms,      and it reflects a different approach to treating osteoporosis.
       SmithKline Beecham Plc, Pfizer Inc. and others are racing      to develop similar high-tech estrogens, while other companies      are looking at osteoporosis drugs called parathyroid hormones      or synthetic versions of the hormone calcitonin.
       They will likely find a ready market for treating the      disease, which causes bones to become brittle and break      easily. Each year, such fractures cost some $14 billion to      treat, according to Merck.
       Patient groups hail the new focus by drugmakers in a      market that has historically been one of the slowest growing      in the pharmaceuticals industry. And drug company executives      are aiming to make sure they know more about the drugs at a      conference next week in Germany.
       ''I believe the more choice there is, the better,'' said      Mary Frazier, executive director of the European Foundation      for Osteoporosis, one sponsor of the European Congress on      Osteoporosis, starting in Berlin on Friday. ''The ultimate      test is to show that the drugs stop bone fractures.''
       Lilly's Turn
       At the Berlin gathering of more than 3,000 doctors and      researchers, Lilly will have a chance to counter a Merck study      last year which showed that Fosamax cut non-spinal bone      fractures by almost half over a one-year period.
       Lilly plans to release two-year data in a study of some      7,700 post-menopausal women that's expected to show Evista      reduced new spinal fractures by around 50 percent. Analysts      say they anticipate a strong showing for the drug.
       ''We are probably going to get more good news,'' said      Jeffrey Kraws, an analyst with Everen Securities. ''There is      no reason why this drug would not be continuing its trend of      strong efficacy.''
       A positive presentation is important for Indianapolis-      based Lilly. The company faces patent loss early next decade      for Prozac, the blockbuster antidepressant that made up a      third of its 1997 sales of $7.9 billion.
       Evista is now approved for use in the prevention of      osteoporosis, while Fosamax is approved both for the      prevention and treatment of the disease. Lilly aims to show      that the drug not only prevents the disease, but can increase      bone mass like Fosamax.
       Evista may also have another major advantage. Tests have      shown that it reduces the rate of breast cancer and heart      attacks in women, a major marketing advantage over      osteoporosis-only drugs. Earlier studies showed that Evista      reduced by more than 50 percent the incidence of newly      diagnosed breast cancer, Lilly said.
       ''That's what they need for a big product,'' said Rick      Drake, a money manager with Duff & Phelps Investment      Management, which holds about $120 million worth of Lilly      shares. ''For them to get all those, it's probably going to      take a few years.''
       Other Competitors
       Competitors have no plans to let Lilly grab the whole      spotlight at the conference, however. Swiss drugmakers Roche      and Novartis will both present data on their new drugs,      although neither said the data from earlier studies is      completely new.
       Roche, Europe's fifth-biggest drugmaker, will discuss      ibandronate, a bisphosphonate like Fosamax that Roche claims      is more palatable to patients since it can be taken with one      injection every three months. Fosamax, by contrast, must be      taken on an empty stomach each day, usually in the morning.
       ''You can expect it to have a reasonable turnover,'' said      Roche spokesman Roland Haefeli of ibandronate, which was      developed by Boehringer Mannheim GmbH, the German company      Roche bought for about $7 billion this year.
       Haefeli said ibandronate is the only injected drug in the      class of bisphosphonates, which he called ''a major      advantage.'' Roche predicts bisphosphonates like ibandronate      and Fosamax will grab half the market for osteoporosis drugs      in 2000.
       Novartis, the world's third-biggest drugmaker, will      discuss the benefits of Miacalcic, an injected or nasal spray      drug used to treat pain in osteoporosis. Miacalcic is      Novartis' tenth-biggest selling drug, generating 224 million      Swiss francs ($158 million) in sales in the first half of      1998, a 26 percent rise.
       Novartis Product
       Novartis spokesman Felix Raeber said his company will      present four-year data from a study expected to last five      years aimed at demonstrating the analgesic properties of      Miacalcic, which is a synthetic salmon calcitonin. Miacalcic      is the second biggest prescribed drug for osteoporosis in the      U.S. after Fosamax, according to IMS Health, a market research      firm.
       Hoechst, Germany's third-largest drugs and chemicals      maker, plans to discuss Actonel, also a bisphosphonate which      is now in final stage clinical trials with Procter & Gamble      Co. The drug is approved for Paget's disease, but the company      said it will present major new data mostly at later      conferences.
       Other companies expected to be make news at the      conference are Cortecs Plc, which is developing an oral salmon      calcitonin, and Akzo Nobel NV, which will present new data on      its drug Livial for post-menopausal women. Germany's Merck      KGaA is due to discuss its calcium product Ostram.
       --Dane Hamilton in the London newsroom (44-171) 330-7727 with       quote.bloomberg.com
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