Merck & Co. Inc. (MRK)

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  • commenter
    Bob C.
    Apr 04 10:48 PM
    Merck, Schering-Plough: More Nails in Vytorin’s Coffin [view article]
    I agree whole-heartedly with the above 2 comments. What needs to be done is that Dr. Steve Nissen needs to be investigated. Everybody takes his comments as the "holy grail" of medicine. Let's examine the connections he has and what money is given him from sources within the healthcare industry. Maybe he doesn't have high regard for certain pharma companies? Whatever the case, Grassley needs to do a complete review of Nissen. If we want to fully understand Nissen's reactions, we need to understand his motives. Reply
  • commenter
    leh
    Apr 04 08:38 PM
    Thursday's Options Report: GRMN, RIMM, CSCO, WFR, RSH, MRK, SGP [view article]
    Are you sure the SGP puts were buys and not sells, or part of a spread position? Reply
  • commenter
    Mazel Tov
    Apr 04 01:17 PM
    My Website
    Wall Street Breakfast: Must-Know News [view article]
    Shabbat Shalom Rabbi Hoffmann Reply
  • commenter
    WaveNet
    Apr 04 12:28 PM
    Merck, Schering-Plough: Confessions of a Vytorin Patient [view article]
    Finally Dr. Josh has admitted that he does NOT know whether Zetia is good or bad, and won't until 2012.
    Conversely, I do know that the statins I have tried did not lower my cholesterol and when taken in higher doses affected my liver -- which led my doctor to advise me to stop using them. (i.e. it was bad for me.)

    In view of my experimentation over so many years, I have found that Vytorin is the drug that works for me and have no intention of switching unless and until proven that it is as bad for me as the statins you seem to be favoring. As to your comment on costs, again check your numbers once and for all : if you must buy Zetia with another statin ( any) , Vytorin contains both and is a cheaper alternative.

    It was nice getting your views on the topic, but I would still like to see you admititng that Vytorin, for a certain patient population, is yet another alternative to treating high-cholesterol efficiently and economically.     Reply
  • commenter
    4ndr3w
    Apr 04 12:14 PM
    Wall Street Breakfast: Must-Know News [view article]
    Don't you hate it when CEOs fling their dentures about the room? Reply
  • commenter
    Mazel Tov
    Apr 04 09:24 AM
    My Website
    Wall Street Breakfast: Must-Know News [view article]
    John Thain is lying threw his teeth, Merril needs plenty more money or they will fall like Bear Sterns did. Its over for them, their finished. Reply
  • commenter
    gratianus
    Apr 03 09:31 PM
    Merck, Schering-Plough: Confessions of a Vytorin Patient [view article]
    I'm an SGP shareholder. I don't take Zetia or Vytorin but a generic statin that does a fine job of supressing my LDL. As a shareholder I find almost everything expressed above--even the comments critical of the products' broad use--encouraging, since there obviously is a continuing need for these drugs even if the panel's and the NEJM's editorials were to be substantiated by subsequent studies. The point as an investor is that at current prices there seem to be absolutely no revenues or profits factored into SGP's share price. If there is continued revenue, even attenuated as it will be, the market is grossly misreading Schering's position.
    Though I wonder about how the data was presented at the ACC meeting, I'm not surprised by the hysterical media reporting or the market's Henny Penney response. Let's see where SGP is six months from now.     Reply
  • commenter
    Dr. Josh
    Apr 03 08:18 PM
    Merck, Schering-Plough: Confessions of a Vytorin Patient [view article]
    I beleive that higher doses of more potent statin are better than lower doses of less potent statin at preventing cardiac events. This has been shown repeatedly. Whether LDL, TG, APO-B or CRP numbers are important or just epiphenoma, we dont really know at this point. Certainly there are compound which treat these numbers and show no benefit. The most obvious example is torceptrapib. (I suspect zetia will be put in the same category when we know for sure in 2012.)
    Placebo actual does lower all of the things you mentioned in various studies- but that really isn't the point.
    You seem to be quite confused in your reference to Radiance. This was a trial of torceptrapib with lipitor as the baseline in both arms. I don't see what this says about lipitors effectiveness. That would be like trying to say that zocor was ineffective from Enhance.
    @ Wavenet- There is no proof that Zetia is either good for you or bad for you. All we know is that it lowers LDL( a surrogate) and seems to cause a trend to more IMT thinkening in familial hypercholesterolemic patient population than placebo- and that we know it is rather expensive. So I would turn the question on you and ask- Do you have any scientifically acceptable proof that this compound decreases morbidity? Given the lack of proof, I would again suggest you consider Crestor or Lipitor plus niaspan. ( all of which do have this proof.)     Reply
  • commenter
    User 1224
    Apr 03 07:45 PM
    Merck, Schering-Plough: Confessions of a Vytorin Patient [view article]
    Dr. Josh,
    glorified placebo? Since when does placebo significantly lower TC, LDL, TG, CRP , non-HDL cholesterol, and APO-B more than Zocor? I must have missed that study!
    Trials with Pravachol, a drug with excellent outcomes data, have shown increases in IMT. The most recent Lipitor IMT trial (RADIANCE) failed to show any significant change in IMT with Lipitor 80. Where was your reference of that trial? Crestor used much different patients, with much thicker baseline IMTs and significantly lower LDLs, in their studies.
    Crestor has shown decreased plaque and decreased CV events vs. placebo, hardly earth shattering. Why didn't they use an active comparator such as the much cheaper simvastatin? What proof is there that it is better than the generics other than in reducing LDL and CRP? If it is no better than simva or prava at reducing events why not stick with them for $5 a month? Or maybe you really do believe that further lowering LDL, TG, APO-B, & CRP play a role in reducing events.

     Reply
  • commenter
    User 172200
    Apr 03 05:18 PM
    Merck, Schering-Plough: Confessions of a Vytorin Patient [view article]
    Dr Josh ! Yeah .... well Enough of this dueling over silliness .... Once your LDH settles out at 60 or below you reach such a sublime a feeling of WELLNESS ... Just hard to describe ... Like levitating ..... The only challenge remaining is to try and convince others to experience the same !! Reply
  • commenter
    WaveNet
    Apr 03 04:24 PM
    Merck, Schering-Plough: Confessions of a Vytorin Patient [view article]
    Dr. Josh

    You have assumed that I haven't tried other simvastatins before and that I haven't tried exercise, dietary changes and other supplements to lower my lipid panel indicators. I am sorry to disappoint your brilliant analysis , but wrong on all counts. 26 years of a patient's own experience and records is behind my decision to stick with Vytorin.

    The only thing that worked for me so far is Vytorin and this is because of Zetia and not Zocor. ( The latter was no better than Lipitor or Mevacor or Pravachol, all of which I've tried.). Something that you and some other MD's insist to overlook.

    Why are you suggesting that Zetia's presumed lack of comparative vasoreactivity is more dangerous than a very high LDL when it comes to morbidity ? Do you have any scientifically acceptable proof that this is the case ?

    At least in my scientific world, when we don't know what we don't know we keep our opinions to ourselves....     Reply
  • commenter
    Dr. Josh
    Apr 03 02:17 PM
    Merck, Schering-Plough: Confessions of a Vytorin Patient [view article]
    If you look at the trial that Merck/SGP did comparing Crestor to Vytorin, you will notice that there were actually more side effects in the vytorin group.
    In patients who can't reach goal on a statin, or cant tolerate a statin, I would add Niaspan, a fibrate, a resin binding agent, and dietary changes and if these all failed I would consider under Zetia- realizing that I am probably just treating my own need to longer lipids and that this intervention is probably not helping the patient.
    If I were WAVENET's doctor, I would switch him to crestor, which would acheive the same LDL reduction, same level of side effects, same cost, but with actual positive trials for both surrogate endpoints and mordibity.
    I would also refer you to an article two years ago- in JACC I beleive- which compared 10 of simva to 10 of zetia. Both acheived the same LDL reduction, but Zetia failed to have positive changes in flow mediated vasoreactivity- a measure of vascular health.
    I can't see any reason to opt for vytorin as a first, second, or third line drug. Fourth line is debatable.     Reply
  • commenter
    User 172200
    Apr 03 01:55 PM
    Merck, Schering-Plough: Confessions of a Vytorin Patient [view article]
    DR JOSH ! Welcome! Hey ! Your own guys ( NEJM Articles) when "pushed by the facts", recommend to their patients Vytorin if their previous medication was ineffective in LDH lowering !! Hey (again !) YOU should know ( As I certainly do, being an MD) that there ARE out there, a hell of a lot of folks that don't tolerate increased statin dosage! Like chemist10 & others I enjoy the relative safety with Vytorin of having my LDH at 60 ( from 100+ after years on Zoccor 40mg alone. Please also read the AJC article ( June 15, 2007) referred to above !! Reply
  • commenter
    Dr. Josh
    Apr 03 01:37 PM
    Merck, Schering-Plough: Confessions of a Vytorin Patient [view article]
    It is always amazing to me how funny some people are. Between the guy who persist on trying to lower his "LDH" and the author who is too blinded by his long position in SGP to take his health into consideration. People seem to disregard CIMT as a surrogate, and focus on LDL which is also of course a surrogate- just a weaker one. There are multiple examples of drugs which lower LDL- or LDH if you prefer- and increase your risk of MI. These include oral contraceptive and torceptrapib.
    A few factual points:
    1- The author compares the cost of vytorin to the cost of generic zocor(simva) plus zetia. The more appropriate comparision would be to generic simva- which would of course be much cheaper. Since this trial suggests that zetia is in fact a glorified placebo.
    2- Not all of the patients in this trial had been on statins. 19% were statin naive. Subset analysis didn't show any difference in these patients. Subset analysis also didn't show any different results in those patients with thicker IMTs. It was these subsets analyses which really cripple the whole argument that MRK/SGP and their stockholders who are posting above are trying to make.
    3- This trial didn't prove safety. It was not an endpoint trial. There were not marked more adverse outcomes in the vytorin arm- That is a very different thing. The drug may well be dangerous and we will have to wait for the large multi-center trial to know that.
    4- In response to the original post- Crestor has unambiguously descreased plaque in arteries- both in the carotids and the coronaries, by CIMT, IVUS, and QCA. Lipitor has been also shown to decrease plaque progression compared to placebo- even in population much like the one studied in ENHANCE. See the ASAP trial
    The better question is which cholesterol drugs have been proved unambiguously to prevent heart attacks. The answer to that question is Simvastatin, Pravachol, Lipitor, Crestor, Mevacor, Gemfibrozil, Niaspan. Really everything except Zetia, vytorin and tricor. It is that question that guides my choice of therapy. I would think that from a patient perspective in might be more important too.
    Disclosure: I am a cardiologist who shorted MRK and SGP on Friday and bought AZN on Monday. (Which I guess means I won) Currently though, no position either long or short in MRK or SGP.     Reply
  • commenter
    chemist10
    Apr 03 12:52 PM
    Merck, Schering-Plough: Confessions of a Vytorin Patient [view article]
    Without a doubt this had to be one of the dumbest trials ever conceived. It was like trying to hit a moving target with a stationary gun. Stupid !! I was on lipitor for years and never had cholesterol below 200 on 10 milligrams (I didn't want a higher dose of any statin). Vytorin reduced my cholesterol to 130. Unfortunately it doesn't affect HDL, only LDL, and this is what it did in the trial. It lowed LDL better than Zocor alone and there were no safety issues. I don't plan on using anything else. Reply

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