Prasugrel 意外失落还是惊喜?

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福布斯载文分析Eli Lilly Prasugrel Surprise
Matthew Herper, 11.29.07, 11:30 AM ET

Cardiologists in the trenches may be far more eager to prescribe Eli Lilly's anti-clot drug prasugrel than statements by academic doctors would suggest, according to a new survey commissioned by the investment bank Credit Suisse First Boston.

Analyst Catherine J. Arnold, who has been bullish on Lilly shares, commissioned a survey of 85 interventional and clinical cardiologists from ImPactRx, which collects prescribing data for drug companies. The doctors surveyed treat a lot of patients and prescribe a lot of pills.

Arnold writes in a note to investors that doctors were more likely than she expected to use prasugrel in patients undergoing angioplasty, a procedure in which a balloon is used to open a clogged heart artery. According to the survey, 36% of those patients who undergo angioplasty would get the drug.

This is the population in which a big trial showed prasugrel prevented more heart attacks but also caused more dangerous bleeding than its rival, Plavix, from Sanofi-Aventis (nyse: SNY - news - people ) and Bristol-Myers Squibb (nyse: BMY - news - people ).

(For my look at why these results could mean sales will be small, see \"Doing The Math On Lilly.\")

In a result Arnold calls \"more surprising,\" these doctors would extrapolate to patients who don't undergo angioplasty. A quarter of those who present to the hospital with chest pain or heart attacks would get prasugrel instead of Plavix. Whether or not these patients get prasugrel at all, given the bleeding risk, is probably the big determining factor of its eventual sales.

Arnold is still lowering her 2011 estimate for prasugrel sales to $1.02 billion from $1.12 billion. But that's still better than she thought: \"Our previous take on the drug's bleeding rates was less positive than our survey results and so these negative forecast changes are less than we had expected,\" Arnold writes.

But Arnold expects the sales of prasugrel could hit $2.7 billion in 2015, making up for a spate of big patent expirations around that time.

Prasugrel still has to go through the FDA approval process, and a lot could change for worse or better as the FDA and its advisers look at the data surrounding the drug. This is only one survey, and by itself it isn't a reason to be sure prasugrel won't be stuck as a tiny, niche product for years. But it does provide a hint that some doctors may be more willing to prescribe the drug than it seemed on Nov. 4, when the data were released.