Diabetes Patients withdrawn from Avandia Are Most Likely Switched to the New First-in-Class Agents, Januvia or Byetta, According to TNS Healthcare.

NEW YORK -- New research from TNS Healthcare's DiabetesDynamics USA[TM] shows that between July and September 2007 just over half of all patients taken off Avandia because of reported links to cardiac risk were switched to one of the new first-in-class anti-diabetic agents--Januvia, the first DDPIV inhibitor or Byetta, the first GLP-1 agonist--or to insulin. The remaining Avandia patients switched to another agent were moved to pioglitazone, marketed as Actos, Actoplus Met and Duetact. Like Avandia, pioglitazone is a glitazone.

"During the same three month period we saw an increase in Avandia withdrawals, we also noted a rise in pioglitazone withdrawals, though at a lower rate," says Philip O'Hagan, International Client Services Director for TNS Healthcare. "In percentage terms, there were only a third as many withdrawals from pioglitazone as from Avandia. In addition, only 10% of pioglitazone withdrawals were due to cardiac issues, while 20% of Avandia withdrawals were driven by concerns over cardiac problems."

Only Half of Avandia Prescribing Changes Resulted in Switching to Another Drug

According to DiabetesDynamics, only half of the changes in Avandia prescribing resulted in patients being switched to another drug. Another 40% were dosage changes, with doctors replacing a fixed dose combination of Avandia with plain Avandia.

In the final 10% of cases, doctors took patients off Avandia but made no other changes in treatment. Physicians chose to leave their patients on their concomitant anti-diabetic therapy at the same dose as when they were taking Avandia.

"Doctors are taking a variety of approaches in response to Avandia's potential cardiac risks, with most opting either to switch diabetes patients to replacement drugs or to change dosage," says O'Hagan. "We are likely to see volatility in diabetes prescribing for some time, as doctors respond to negative news about Avandia and other anti-diabetic agents. For example, how will reports of possible links to acute pancreatitis affect Byetta prescribing?

"We will be tracking market changes closely with DiabetesDynamics to see which products lose and which gain patients, as new information hits the media. We will be looking at what happens to patients who change therapies...which drugs are chosen as replacements...and, most critically, what factors drive treatment decisions. This will be crucial information for companies that need to protect and grow their business in a market that's now in turmoil."

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.

We are the world's foremost provider of custom research and analysis, combining in-depth industry sector understanding with world-class expertise in the areas of Retail and Shopper Insights, Stakeholder Management, New Product Development, and Brand and Communications. We are a major supplier of consumer panel, media intelligence and internet, TV and radio audience measurement services.

TNS is the sixth sense of business.

For More Information...

For more information on DiabetesDynamics, please contact Philip O'Hagan at [phone] or Philip.O'[e-mail]. 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 [e-mail].