News gets even worse for Vytorin and Zetia

Anyone who follows the fortunes of the US pharmaceutical companies has heard of the trials and tribulations of Merck and Schering regarding the ENHANCE trial. As I have explained previously, this trial was a moderate sized trial comparing zocor to zocor plus zetia( this combination is sold as vytorin.) The trial was delayed and delayed again- and many of us assumed and still believe that the companies where trying to suppress the results. Two months ago, the data was released to the press. Zetia showed no benefit in slowing the progression of atherosclerosis of the carotid arteries. The sales of the drug fell a little (about 20%) but not as much as some of us expected. My colleagues who still used the drug told me that they still wanted to see the data officially presented before changing their prescription patterns.

Today the data was officially presented and discussed at the ACC. The forum was the first plenary session of this year’s ACC meeting- just after a particularly poor talk by the President of the ACC about nothing in particular. The room must at McCormack Place in Chicago must fit 20,000 and it was standing room only. After a 9 minute presentation of the data- most of which we were all familiar with, the fun began. The panel of distinguished cardiologists gave their opinions of the trial. Any lingering suspicions that Merck and Schering could buy their way out of this jam( They do both give generously to the “ACC”and ads for Vytorin and Zetia hang throughout the conference hall and can be seen in the daily newspaper of the meeting.) I cannot remember such a negative presentation. Krumholtz( a well respected Cardiologist at Yale) spoke at great length about how this drug was massively overused, and how he felt that the only open question was whether it should be used as a third line drug or not at all. Comparisions to torceptrapib abounded( this was the failed drug from Pfizer last year which also improved choledterol but seemed to increase death and heart attacks.

After the talk, I headed over the the Zetia/Vytorin booth in the vendor section of the meeting. It was eerily empty. Not even a line for the fresh squeezed OJ.

I have short positions in both Merck and SGP (I went short Friday morning when the stocks were up in anticipation of positive PR out of the meeting) and suspect I will do very well when the market opens tomorrow. SGP can fall quite a ways from here- they are not very well diversified. Merck may be a buy once it gets into the high 30s.