Decision Resources, one of the world's leading research and advisory firms focusing on pharmaceutical and healthcare issues, finds that Merck's Januvia has become a popular second-line agent for the treatment of type 2 diabetes at the expense of Takeda's Actos. In fact, Januvia's increase in second-line patient share versus the 2008 analysis of claims data is among the highest in the analysis. Although Januvia does not have the glucose-lowering ability of some of its competitors, surveyed physicians highly value Januvia's benign side-effect profile.

The only agent to surpass Januvia's growth in the second line year over year is Merck's fixed dose combination of Januvia and metformin, Janumet. The new Treatment Algorithms in Type 2 Diabetes report finds that a higher percentage of Januvia-treated patients (17.6 percent) than Actos-treated patients (7.4 percent) stay within the brand franchise when progressing from the first line. Although patient share for Janumet is equivalent to Takeda's Actoplus Met (the fixed dose combination of Actos and metformin) in first-line therapy, Janumet consistently trumps Actoplus Met in second- and third-line patient share in newly diagnosed patients.

"Part of the reason for Janumet's great performance in second-line treatment is that more patients move to the drug after metformin, metformin ER or a sulfonylurea than go to Actoplus Met. This finding is especially interesting because Janumet launched in April 2007, only two months before we started collecting data on the treatment patterns in newly diagnosed patients," stated Madhuri Borde, Ph.D., product director at Decision Resources.

By combining patient-level claims data with physician survey data, this report can be used to build patient-flow models and analyze the assumptions driving these models.

Patient-level claims data show that between 30 to 40 percent of patients who start Actos, Januvia or Amylin/Eli Lilly's Byetta receive the drugs in the second line. However, less than 25 percent of patients prescribed the leading first-line agent, metformin, move to a second-line drug within a year, emphasizing the limited pool of newly diagnosed patients available for starting branded drugs as a second-line therapy.

About Treatment Algorithm Insight Series

Decision Resources combines in-depth primary research with the most extensive claims-based longitudinal patient-level data from IMS Lifelink: Health Plans Claims database to provide exceptional insight into physicians' prescribing trends and the factors that drive therapy product choice, from diagnosis through multiple courses of treatment, for a specific disease.

About Decision Resources

Decision Resources ( is a world leader in market research publications, advisory services and consulting designed to help clients shape strategy, allocate resources and master their chosen markets. Decision Resources is a Decision Resources, Inc. company.

About Decision Resources, Inc.

Decision Resources, Inc. is a cohesive portfolio of companies that offers best-in-class, high-value information and insights on important sectors of the healthcare industry. Clients rely on this analysis and data to make informed decisions. Please visit Decision Resources, Inc. at

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  For more information, contact:    Gisselle Morales                          Elizabeth Marshall   Decision Resources                        Decision Resources, Inc.   781-296-2691                              781-296-2563          

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CONTACT: Gisselle Morales of Decision Resources, +1-781-296-2691,, or Elizabeth Marshall of Decision Resources, Inc.,

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