Lilly says that the risk validates its strategy of comparing prasugrel directly to Plavix.
He has been paid for work by the makers of both Plavix and prasugrel.
Unlike vorapaxar, which is given in addition to Plavix, prasugrel is a Plavix competitor.
Hype or no hype, the story of prasugrel should be a cautionary tale for Merck investors.
But in November 2007, final results of a 13, 600 patient trial showed more bleeding with prasugrel.
Even if prasugrel isn't a big seller, it could become a medium-sized seller really fast.
So not every patient gets prasugrel, and the size of its potential market drops further.
Anthony Ware, who leads Lilly's prasugrel team, says this market accounts for about 24% of Plavix sales.
He is listed as an inventor on a patent application for using prasugrel to treat vascular disease.
Eli Lilly 's most important pipeline drug is prasugrel, a Plavix-like pill being invented by Japanese drug giant Sankyo.
Unlike Plavix, prasugrel (brand name Effient) carries a bolded warning that it should not be used in stroke patients.
That might keep prasugrel from becoming the big seller some expected, but it at least gets it on the market.
Prasugrel was only tested in patients undergoing angioplasty, a procedure in which a balloon is snaked into a clogged artery.
Prasugrel wasn't tested in the wide range of heart patients who get Plavix, which is sold by Bristol-Myers Squibb and Sanofi-Aventis.
And not only do patients who get prasugrel have fewer heart attacks, they are 50% less likely to suffer from in-stent clotting.
Because of the risk of more bleeding, doctors are unlikely to extrapolate from this data to give prasugrel to lots of patients.
About 20% of patients in the study had no benefit from prasugrel.
In recent months, Lilly-backed researchers have shown that prasugrel's risk-benefit profile looks better in diabetics and patients with certain types of heart attacks.
The prasugrel data were released Sunday at the annual scientific meeting of the American Heart Association and in the New England Journal of Medicine.
Eli Lilly is already close to market with an attempt at an improved Plavix called prasugrel, which may work for people for whom Plavix fails.
Lilly and Sankyo paid for a Harvard-run study of 14, 000 patients that showed prasugrel prevented more heart attacks than Plavix, from Sanofi-Aventis and Bristol-Myers Squibb.
Prasugrel adds a similar benefit to these previous leaps, Antman argued.
The harshness of Serebruany's comments shows how controversial prasugrel has become.
Barbara Ryan at Deutsche Bank also told investors that if a cheaper version of Plavix emerges, it means Lilly might have to charge less for prasugrel.
Certain groups of people, including those who have had strokes, are over 75 or weigh less than 60 kilograms, get no benefit from prasugrel at its current dose.
Even if successful, prasugrel won't rival Plavix in time to make up for the losses Lilly faces when top seller Zyprexa, a schizophrenia drug, loses patent protection in 2011.
One big hope for Lilly and Sankyo is that prasugrel has been tested entirely in angioplasty, a procedure in which a balloon is used to open a clogged artery.
The most likely answer: Prasugrel will get to the market someday, and it has a good chance of doing so during this go-round with the Food and Drug Administration.
Eli Lilly 's (nyse: LLY - news - people ) most important pipeline drug is prasugrel, a Plavix-like pill being invented by Japanese drug giant Sankyo.
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