Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that the percentage of primary care physicians (PCPs) and endocrinologists who consider the cardiovascular safety of GlaxoSmithKline's Avandia to be a major concern increased more than nine-fold following publication of a meta-analysis. Published in May 2007 by Steve Nissen in the New England Journal of Medicine, the meta-analysis calls into question the cardiovascular safety of Avandia and features analysis of data from several different trials showing that the drug increases the risk of myocardial infarction by 43 percent. Prescriptions for Avandia dropped significantly in the weeks following publication of the meta-analysis. According to the new Physician and Payer Forum report entitled Avandia One Year Later-A Physician and Payer Perspective, the full impact of the meta-analysis on Avandia prescribing has not yet been felt. 58 percent of PCPs and 52 percent of endocrinologists say they will reduce their prescribing of Avandia over the next year.
The report also finds that nearly three-quarters of physicians say they have switched patients to Merck's Januvia as a result of the Avandia meta-analysis. More than 80 percent of surveyed physicians say they will increase the number of total prescriptions they write for Januvia over the next two years. Although clinicians and managed care organizations surveyed consider metformin (Bristol-Myers Squibb's Glucophage, generics) to offer the best overall safety and efficacy, Januvia received the second greatest number of votes for "agent with the best overall safety profile" and for "lowest risk of hypoglycemia." In comparison, Amylin/Eli Lilly's Byetta was chosen by endocrinologists and MCOs as the agent least likely to cause weight gain, and the drug also received the third greatest number of votes for "agent with the best overall efficacy profile."
"Cardiovascular safety concerns have significantly impacted prescriptions for Avandia and created opportunities for other antidiabetic agents," said Donny Wong, Ph.D., principal analyst at Decision Resources. "Nearly three-quarters of physicians say they have switched patients to Januvia as a result of the Avandia meta-analysis, and one-third of PCPs and endocrinologists say they have switched patients to Byetta following publication of the Avandia meta-analysis. Nevertheless, Takeda's Actos will continue to be the market share leader among oral antidiabetic agents until the drug loses patent protection in 2011."
Avandia One Year Later-A Physician and Payer Perspective is based on a U.S. survey of 74 PCPs, 70 endocrinologists and 20 managed care pharmacy directors. Their responses were compared to assess similarities and differences of opinion regarding clinical, economic, and scientific factors.
About Physician & Payer Forum
Physician & Payer Forum is a primary research service from Decision Resources that offers access to high volume-prescribing physicians, specialists, and managed care organization representatives in the United States; analysis of events and survey participants' responses to them; insight into prescribing patterns; and an examination of the implications of events and issues for the pharmaceutical market.
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