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Biotech / Medical : Monsanto Co. -- Ignore unavailable to you. Want to Upgrade?

To: Michael Kucera who wrote (1472)	3/4/1999 12:27:00 AM
From: Anthony Wong	Read Replies (1) \| Respond to of 2539

Will's pharma commentary on Celebrex & Vioxx from labpuppy.com: labpuppy.com I attended a panel of doctors discussing Monsanto's (MTC) Celebrex and Merck's (MRK) Vioxx. The following is a brief summary of the interesting tidbits that came out of this presentation: Many in medical community are using Celebrex for pain (despite the lack of an indication for this usage) given its medical data. They don't think a once-per-day product is a great advantage for pain. Up to 50% of their patients want twice a day so they can use the product again later in the day if the pain flares up. Vioxx is a once-per-day product and Celebrex is a once-per-day and twice-per-day product. Arthritis patients switch products often as they experiment with products to find the best relief to their pain. However, doctors guidance regarding Celebrex's and Vioxx's the lack of ulcer related problems (versus traditional NSAIDs) should reduce this switching. Arthritis patients self-medicate and thus have a problem with "over" dosing. Vioxx has a problem with edema (swelling/fluid retention) at high doses thus "over" dosing by patients could lead to a larger number of edema problems. Vioxx does not have an edema problem with its planned dosage sizes. I would be interested to know if any of the doctors who read this commentary are seeing the same behavior from their patients in regards to Celebrex. If you have any comments, please post them on my message board. labpuppy.com Here's a post to Will commenting on the subject: Celebrex Use Posted By: Francis (spider-wm024.proxy.aol.com) Date: Wednesday, 3/3/99, at 11:34 p.m. Hi Will: In regarding to your question about Celebrex use in your daily commentary--I'm not a physician but I am a hospital pharmacist who dispenses Celebrex to physicians for personal use and I'll tell you this. They are using Celebrex for all types of pain and imflammation regardless of what the FDA label says. And it's completely legal and proper to do this. There really is no valid reason to wait for FDA approval for an indication if it is already acceptable medical practice to use the medication for FDA unapproved use. As far as your comments on Vioxx they are very interesting (I am MRK shareholder). I think MTC took the right route in having Celebrex approved only for RA and OA and not getting a "safer" label from the FDA. The headstart over Vioxx is obvious and usually the 1st product on the market in a new drug group will maintain dominance of that group. There are exceptions but the 2nd or 3rd drug out in a group has to be significantly better than the 1st drug approved in the group. Examples are--Tagamet was the 1st H2 receptor antagonist on the market and it had huge market share till Zantac became available. (Zantac had far fewer drug interactions than Tagamet--drugs like Coumadin, Theophylline, Phenobarbital interacted with Tagamet but not with Zantac). Lipitor was hardly the 1st anti-cholesterol drug on the market but it is clearly the best selling (about 45% of prescriptions) because it is a better drug than the others--it is more powerful and priced below many of the others. The big question is how does Vioxx fit in the above scheme with Celebrex. It is my own opinion (and I own MRK) that Celebrex will continue to be the dominant drug in the COX-2 inhibitor market. People already on Celebrex will NOT switch to Vioxx if they are satisfied with their results while on Celebrex. And from how Celebrex is flying off the shelf it is easy to see a lot of patients ARE satisfied. Thanks, Francis labpuppy.com