Zetia (Merck)
Patent expiry: December 2016

2012 sales: $2.567 billion
2011 sales: $2.428 billion
Change: 6%

Zetia is not the moneymaker it used to be for Merck, but that's not to say the drug is no longer one of Merck's ($MRK) top sellers. In 2007, Zetia and sister drug Vytorin had combined sales of $5 billion. Last year it was $4.3 billion.

The drug has struggled in comparison to competitors in clinical trials, with Zetia losing out to AbbVie's ($ABBV) Niaspan at unclogging arteries. Vytorin, a combo of Zetia and statin Zocor, has proved no more effective at the task than Merck's Zocor on its own. Vytorin and Zocor are now going head to head once more in Merck's IMPROVE-IT study, which it hopes will prove the benefits of combining Zocor and Zetia, silencing critics once and for all.

Merck won't give up on extending the reach of Zetia. The company has won FDA approval for another Zetia/statin tandem drug--this time using a generic form of Lipitor--to be called Liptruzet. The approval, announced earlier this month, immediately faced criticism for Liptruzet's lack of cardiovascular benefits, including a failure to reduce trial participants' chances of developing heart disease. But the FDA maintains that proven success at lowering high LDL levels, a risk for the disease, is enough to put the drug to market.

For more:
Analysts cheer decision to continue Merck's controversial Vytorin study
Merck wins FDA nod for new Zetia-Lipitor combo, despite lack of outcomes benefit
Merck's new cholesterol combo faces delay


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