Lilly, Merck Bone Drugs Widen Choice, Say Doctors (Update1)
Bloomberg News
September 14, 1998, 6:47 a.m. ET
(Adds share price reaction in 5th paragraph.)
Berlin, Sept. 14 (Bloomberg) -- Eli Lilly & Co.'s and
Merck & Co.'s new osteoporosis drugs may be more effective
than anticipated, studies released today showed, offering new
hope to women facing devastating age-related disorders.
While the new drugs aren't a panacea, doctors at the
European Congress of Osteoporosis conference said they're a
major advance in treating a condition that previously was
viewed not as a disease, but as a natural part of aging.
Lilly's Evista may eventually generate annual sales of
more than $1 billion, analyst say, while Merck's Fosamax
generated $532 million in 1997 and was the biggest-
selling osteoporosis-only drug in the U.S. Osteoporosis
affects some 200 million women, in a $2.8 billion market for
treatments, causing bones to become brittle and break easily.
''Osteoporosis is a major public health problem, yet many
people don't know what it is or how to treat it,'' said Mary
Fraser, executive director of the European Foundation for
Osteoporosis, a sponsor of the Berlin conference that
attracted some 4,000 doctors from all over the world.
Lilly shares traded in Switzerland rose as much as 2.75
francs, or 2.7 percent, to 106.25 francs ($74.30), while Merck
shares traded in France rose as much as 17 French francs, or
2.4 percent, to 737 French francs ($129).
Doctors predict that usage of the drugs -- which compete
with those of American Home Products Corp., Novartis AG and
others -- will rise as awareness grows that they can help
prevent hip and spinal fractures common in older women.
They are not without disadvantages, though. For continued
effectiveness, the new drugs will probably have to be taken
daily for decades, and they have undesirable side-effects.
Key Study
One key study, sponsored by Eli Lilly, the world's 10th-
biggest drugmaker, showed that Evista reduced the risk of spinal
fractures by about half in a two-year study involving 7,700 post-
menopausal women with osteoporosis, compared with patients who
took no drug.
In previous large trials, Evista was also shown to reduce
serum cholesterol levels, a risk factor for heart disease, and
reduce the new breast cancer cases by about half.
Evista ''in this large study looks favorable from several
points of view,'' said Steven R. Cummings, assistant dean of
research at the University of California, San Francisco, and a
lead researcher in the trial.
After hip fractures, which always land a patient in
hospital, spinal fractures have the biggest impact on
osteoporosis patients, causing severe pain, height loss and
back deformities. According to the National Osteoporosis
Foundation, about half the 1.5 million osteoporosis fractures
that occur each year in the U.S. are spinal. And often one
spinal fracture can lead to another.
With Evista, Eli Lilly hopes to build a bigger franchise
in a growing market for osteoporosis drugs, and compete
against common treatments like hormone replacement therapy
made by American Home Products and Novartis, as well as newer
bone-building drugs made by Merck, SmithKline Beecham Plc and
others.
Evista was approved in the last year in Europe and the
U.S. for prevention of osteoporosis, but the company is
looking to gain approval for the treatment of osteoporosis, a
much bigger market.
Fracture Risk
Women taking Evista also reported less of vaginal
bleeding and breast discomfort, which are common complaints in
hormone replacement therapy that is used by about nine million
women each year in the U.S. for treating post-menopausal
symptoms.
However, Evista wasn't shown to benefit patients by
reducing hip fractures, a drawback that may benefit Merck with
Fosamax, the only drug so far to be proven to cut the risk of
hip fracture in post-menopausal women.
Osteoporosis, which is thought to be caused by an
imbalance between bone-building cells and bone-destroying
cells, causes about 250,000 hip fractures a year in the U.S.,
with many suffering permanent disability requiring nursing
home care.
Merck, the world's biggest drugmaker, today released new
findings from the Fracture Intervention Trial, a 6,000 patient
trial, that showed that Fosamax cut the risk of hip fractures
by 56 percent among women who hadn't had a previous spinal
fracture. It also showed that Fosamax reduced the likelihood
of spinal fractures by 49 percent.
The new findings were part of a continuing clinical trial
for Fosamax. Previous results from the same trial showed that
Fosamax reduced the risk of hip fractures by 51 percent.
Doctors said whether to prescribe Fosamax, Evista or
other drugs to prevent or treat osteoporosis will depend on a
number of factors, including cost, risk of disease escalation
and side-effects.
Cost of Treatments
The University of California's Cummings said the cost of
the new treatments is a ''huge issue'' for health maintenance
organizations, because ''the odds are that this is something
she will have to take for decades.''
Evista and Fosamax each cost about $600 a year per
patient at the retail level, while older therapies like
hormone replacement therapy cost $300 a year or less, said
Cummings.
However, experts said the cost of prevention and
treatment is cheap compared to the cost of hospitalization. In
Britain, for instance, the cost of hospitalizations for hip
fractures is about 400 million pounds ($670 million) a year,
said John A. Kanis, a professor at the University of Sheffield
in England who treats osteoporosis patients.
While new drugs could dramatically cut those costs, Kanis
said the cost of a long-term drug treatment for osteoporosis
in patients who may already be on other medications is ''an
issue for people who have to pick up the bill.''
--Dane Hamilton in Berlin through the London newsroom (44-171) |
