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Avandia suffering less in Europe

Published on 10/12/07 at 02:20pm

New research by market data company TNS Healthcare suggests that fewer patients are being taken off Avandia in Europe than in the US.

Concerns about cardiovascular side-effects seen in patients taking GSK's diabetes drug emerged in May, and have caused a major fall in US sales.

TNS Healthcare's 'DiabetesDynamics' confirms that between July and September of 2007 nearly 70% of Avandia prescribing changes in the US resulted from withdrawals - mainly doctors switching patients from Avandia to another therapy.

In contrast, the picture in the five main European countries was very different, with withdrawals ranging from 42% to just 3% of all Avandia prescribing changes.

In the first half of 2007, 20% of physician consultations in the US resulted in some kind of therapy change, with the majority of these changes in favour of Avandia.

But this changed dramatically in the third quarter after the concerns had emerged, when almost 70% of prescribing changes in the US were due to doctors taking patients off the drug.

Philip O'Hagan, international client services director for TNS Healthcare, said: "Europe has seen far less drastic change in Avandia prescribing."

He added: "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."

The reason for this much lower rate of withdrawing patients in Europe seems to be that doctors are less concerned about the side-effects, which had already been reflected in label changes in Europe in 2006.

TNS Healthcare says there is further variation across Europe in terms of concern.

It says UK doctors expressed the same concerns as US physicians, citing cardiac risks as the driver behind 28% of withdrawals. But doctors in other European countries didn't share these concerns over cardiac safety - in Spain, for instance, no doctor mentioned cardiac risk as a reason for prescribing changes.

"Clearly, reports of Avandia being linked to increased cardiovascular risk are having a different impact in different countries," O'Hagan said. "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."

O'Hagan concluded that other recent developments, such as the withdrawal of Exubera and new concerns over Byetta's possible link to acute pancreatitis, will cause further upheaval in the market, which is one of the industry's most dynamic and fast-growing.

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