Docs switching patients off Vytorin

A one-two punch of bad news on Vytorin today. First, scrips are down again, dropping 7 percent last week to 327,698. Overall, those prescriptions have fallen by almost 18 percent since the week before Enhance study results were announced January 14.

Vytorin's half-brother Zetia saw scrips decline by 8 percent last week to 237,797, some 19 percent fewer than pre-Enhance numbers. (Vytorin, remember, is a combo of Zocor and Zetia; Enhance showed that the combo pill didn't stave off arterial disease any better than Zocor alone.) These numbers contradict Merck's assertion in early February that scrips for both drugs had stabilized and started to rebound.

For a crystal-ball look at the two drugs' fortunes, we turn to a new survey of docs. GPs, cardiologists, and internists all said they'd prescribe Vytorin less often as a first-line treatment (20 percent less, 9 percent, and 7 percent, respectively). As a second-line med, usage would drop by 8 percent to 14 percent. But docs would use the drug as a third-line treatment 20 percent to 30 percent more often.

Worse, the GPs in the survey said they'd switch more than 40 percent of their patients off Vytorin or Zetia to other meds in the next few months. Internists and cardiologists also were planning to switch, but in only 25 percent to 30 percent of their patients.

- read the scrip numbers at the Wall Street Journal Health Blog
- see the item on scrip-switching at Pharmalot