Avandia Withdrawal Rates Low Despite Risks

Avandia Withdrawal Rates Are Far Lower in EU than in the US, According to TNS Healthcare

LONDON, December 9, 2007- New research from TNS Healthcare's DiabetesDynamics shows major differences between the US and Europe in Avandia prescribing since the publication of a meta-analysis in New England Journal of Medicine (May 2007) raising concerns about cardiac safety. In the US between July and September of 2007 nearly 70% of Avandia prescribing changes resulted from withdrawals-mainly physicians switching patients to another therapy. The picture in the five main European countries was very different, however, with withdrawals ranging from 42% to just 3% of all Avandia prescribing changes.

"Avandia prescribing has always been dynamic," says Philip O'Hagan, International Client Services Director for TNS Healthcare. "Our research shows that, in the first half of 2007, 20% of physician consultations in the US resulted in some kind of therapy change. During that time, 84% of those changes were positive-physicians starting new patients on Avandia, adding it to existing regimens or switching patients to Avandia from other therapies. In the third quarter-following Avandia's reported link to cardiac risk-there was a dramatic turnaround, with almost 70% of Avandia changes in the US resulting from doctors taking patients off the drug.

"Europe has seen far less drastic change in Avandia prescribing. As in the US, during the first half of the year, the vast majority of Avandia prescribing changes in Europe were positive-93% in Spain, 92% in Germany and Italy, 88% in the UK and 80% in France. In the third quarter, we do see a rise in patients taken off Avandia, with withdrawals accounting for 42% of prescribing changes in the UK, 30% in France, 28% in Spain, 12% in Germany and 3% in Italy. The increase in European Avandia withdrawals, however, is not nearly as dramatic as in the US."

Fear about Cardiovascular Risks Is Lower in Europe

DiabetesDynamics reveals that one of the main reasons physicians in the US are switching patients from Avandia is its reported link to cardiovascular risks. During the first half of 2007, there were no cases of switching due to cardiac problems, though there were the first rumblings that publicity about side effects was beginning to have an effect. During the third quarter of the year, however, there was a massive change, with cardiac problems now the reason for 20% of Avandia withdrawals.

Once again however, the story across much of Europe was different, though results varied by country. UK physicians expressed the same concerns as US doctors, citing cardiac risks as the driver behind 28% of withdrawals. Physicians in other European countries, however, did not share these concerns over cardiac safety. For instance, no Spanish physicians mentioned cardiac risk as a reason for prescribing changes. (continued)

"Clearly, reports of Avandia being linked to increased cardiovascular risk are having a different impact in different countries," says O'Hagan. "While the reports have had a huge effect on US prescribing, their influence has been less intense and less consistent across Europe. There is quite a wide range in the levels of both withdrawal activity and cardiac concern from country to country. These variations make it critical for companies to track Avandia prescribing across all their key markets-and be able to compare and respond to different dynamics.

"Over the next several months, we will use DiabetesDynamics to monitor prescribing activity across the US and major European markets, tracking what happens to patients taken off Avandia or other treatments.which therapies are serving as replacements and why.and how recent media reports have affected other drugs and classes. With the recent withdrawal of Exubera and new concerns over Byetta's possible link to acute pancreatitis, the upheaval in the diabetes market is likely to continue and grow. Diabetes marketers will need ongoing, market-specific information to manage their brands effectively in this volatile environment."

DiabetesDynamics Tracks Therapy Changes

TNS Healthcare's findings on diabetes prescribing changes are drawn from DiabetesDynamics-its quarterly resource for tracking therapy changes and the causative factors behind them in the type-2 diabetes market. DiabetesDynamics samples only type-2 diabetes patients who have experienced some type of treatment change in their last consultation. It focuses on monitoring market dynamics, including prescribing initiations, switches, add-ins, dosage changes and withdrawals, as well as the impact of new launches, competitive activity or other market events.

About TNS Healthcare.

TNS Healthcare provides market research consulting to the worldwide pharmaceutical, biotech and medical device industries, as well as health-focused ad agencies, media and analysts. It offers globally consistent solutions and custom advisory services to support product introductions; brand, treatment and sales performance optimization; and physician and DTC promotional assessment.

Informing decisions across the life cycle, TNS Healthcare offers action-ready insights for pre-launch landscaping, market and opportunity assessment, segmentation, positioning, message and campaign creation, pricing, forecasting, attitude and awareness measurement and post-launch tracking. It delivers information across stakeholders-including physicians, patients and consumers-to help companies anticipate and impact customers' behaviors. TNS Healthcare provides both qualitative and quantitative offerings, using traditional and on-line methodologies, combining worldwide reach with local expertise.

About TNS.

TNS is a global market insight and information group.

Our strategic goal is to be recognized as the global leader in delivering value-added information and insights that help our clients to make more effective decisions.

As industry thought leaders, our people deliver innovative thinking and excellent service to global organizations and local clients worldwide. We work in partnership with our clients, meeting their needs for high-quality information, analysis and foresight across our network of over 70 countries.

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For More Information.

For more information on DiabetesDyamics, please contact Philip O'Hagan at +44 1372 825622 or Philip.O'Hagan@tns-global.com. To learn more about TNS Healthcare, please visit our Web site at www.tnsglobal.com/healthcare or contact Ilene Siegalovsky, Senior Vice President of Marketing and Communications at 201-836-0040, ext. 225 or Ilene.Siegalovsky@tns-global.com.