One-Third of U.S. Primary Care Physicians and Cardiologists Do Not Currently Prescribe Treatment to Meet HDL Cholesterol Targets as Recommended By National Guidelines

Thursday, March 20, 2008 General News
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WALTHAM, Mass., March 19 Decision Resources, one of theworld's leading research and advisory firms for pharmaceutical and healthcareissues, finds that approximately one-third of surveyed primary care physicians(PCPs) and cardiologists do not consider it necessary to treat low high-density lipoprotein (HDL) until patients' HDL levels drop below therecommended threshold established by the U.S. National Cholesterol EducationProgram's Adult Treatment Panel III guidelines.

The new Physician & Payer Forum primary market research report entitledAre Payers and Physicians Ready for a Paradigm Shift in Preventive Cardiology?An Assessment of Current and Future Use of HDL-Targeting Therapies finds thatmost surveyed PCPs and cardiologists anticipate that the number of patientstreated for low HDL will increase due to the launch of new HDL-raisingtherapies. These drugs, which offer improved tolerability and/or efficacycompared with currently available agents, include Merck's Cordaptive, Merck'sMK-0524B and novel agents such as Merck's anacetrapib and Roche's dalcetrapib.However, 19 percent of surveyed managed care organizations' (MCOs) pharmacydirectors said that they would not add any novel HDL drug to their privateplan formularies. The report finds that MCOs have lower efficacy expectationsthan physicians do for new HDL-raising therapies and are more willing to tradeoff improvements in efficacy in return for treatments that offer better safetyand tolerability.

"MCO pharmacy directors say that the most important key factors that wouldaffect their willingness to include a novel HDL-raising therapy into theirprivate plan formularies include outcomes data, low cost and efficacy inreducing low-density lipoprotein (LDL) cholesterol or high triglycerides inaddition to raising HDL," said Donny Wong, Ph.D., principal analyst atDecision Resources. "Drug companies are unlikely to get good formulary tierplacement for novel HDL therapies on the basis of improved tolerabilityalone."

Are Payers and Physicians Ready for a Paradigm Shift in PreventiveCardiology? An Assessment of Current and Future Use of HDL-Targeting Therapiesis based on a U.S. survey of 73 U.S. cardiologists, 73 PCPs, and 21 MCOpharmacy directors. Their responses were compared to assess similarities anddifferences of opinion regarding clinical, economic and scientific factors.

About High-Density Lipoprotein Cholesterol

Patients with low levels of HDL cholesterol are at elevated risk forcardiovascular disease, even if their levels of LDL cholesterol are wellcontrolled. An estimated 50 percent of cardiovascular events occur in patientswith low HDL, an under-treated disorder that afflicts nearly 30 millionindividuals in the United States. In 2007, agents that target low HDL achievedless than $800 million in sales, compared with close to $8 billion achieved bystatins targeting high LDL.

About Physician & Payer Forum

Physician & Payer Forum is a primary research service from DecisionResources that offers access to high volume-prescribing physicians,specialists, and managed care organization representatives in the UnitedStates; analysis of events and survey participants' responses to them; insightinto prescribing patterns; and an examination of the implications of eventsand issues for the pharmaceutical market.

About Decision Resources

Decision Resources ( is a world leader inmarket research publications, advisory services, and consulting designed tohelp clients shape strategy, allocate resources, and master their chosenmarkets. Decision Resources is a Decision Resources, Inc. company.

All company, brand, or product names contained in this document may betrademarks or registered trademarks of their respective holders.For more information, contact: Elizabeth Marshall Decision Resources, Inc. 781-296-2563

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