Vytorin fallout doesn't faze analysts

It's a pile-on. Experts and non-experts alike are expounding on yesterday's dismal ENHANCE results. For every cardiologist of unshaken faith, such as this one who talked to the Wall Street Journal's Health Blog, there are a half-dozen or more detractors gleefully trashing Merck and Schering-Plough. Congress is pledging to forge ahead with its investigation of the study. Only Wall Street analysts appear unfazed by the news that generic simvistatin performed as well in the study as did the high-priced Zetia and Vytorin, which combines Zetia with Zocor (simvistatin). Here are some representative quotes:

• "This drug doesn't work. Period. It just doesn't work," Steven Nissen, head of cardiology at the Cleveland Clinic and the researcher whose study of Avandia side effects has grown infamous, told Forbes.
• "Obviously, we would have preferred a more favorable result," Skip Irving, a company spokesman told the Washington Post.
• "It is easy to conclude that Merck and Schering-Plough intentionally sought to delay the release of this data," said Rep. Bart Stupak, one of the House Democrats leading the investigation of the study.
• "Merck and Schering-Plough's delay in releasing study results, as well as their attempt to manipulate the data is, quite frankly, suspicious," said Rep. John Dingell, head of the House Energy and Commerce Committee investigating the study. "American consumers and their doctors should not have had to wait nearly two years for this information."
• "We believe...the impact on Schering-Plough and Merck stocks to be minimal," Cowen & Co. analyst Steve Scala wrote, despite the fact that Schering's stock plummeted by 8 percent yesterday.
• "All industry experts we corresponded with...felt that [Nissen's] description of the results was overly dramatic," analyst Tim Anderson of Sanford Bernstein told the Wall Street Journal Health blog.
• "I think most thoughtful people won't be much affected by the study because they're waiting for the outcome trial," said Robert Califf, a Duke University vice chancellor and co-principal investigator on that study of Zetia's effect on patient outcomes.

If Califf is correct, then "thoughtful people" will behave as they did pre-ENHANCE for two or three more years, when the outcome study is expected to be released. But if Merck and Schering have to rely on that "thoughtful" subset of the population to buoy Zetia, then the drug makers could be in trouble.

- get the House Energy and Commerce Committee's statement on its investigation
- read the report in Forbes
- here's another take in the Hartford Courant
- read the Health Blog's roundup of analyst comments and its talk with heart researchers

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