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Slow grow for U.S. prescription sales

WASHINGTON—U.S. prescription-drug sales grew in 2004 at their slowest rate in nine years, according to a study released Monday.

Why? A mild flu season, greater use of over-the-counter drugs, higher consumer co-pay charges and safety concerns about antidepressants and the painkillers known as Cox-2 inhibitors combined to cut sales.

Total U.S. prescription-drug sales reached $235.4 billion in 2004, up 8.3 percent from $217.3 billion in 2003, according to IMS Health, a private drug-industry research firm in Fairfield, Conn.

It was the first one-year spending hike since 1995 that was under 10 percent.

"The industry delivered solid performance overall, despite significant business pressures in areas such as drug safety, pricing and generics competition," said Bruce Boggs, the president of IMS Americas.

Seven products with the potential for blockbuster sales—more than $1 billion worldwide—are expected to keep industry profits strong in 2005, the report said. They are:

_Eli Lilly's Alimta for lung cancer,

_Pfizer's Lyrica for neuropathic pain,

_Novo Nordisk's Levemir for diabetes,

_GlaxoSmithKline's Ariflo for asthma,

_Sanofi-Aventis' Menactra for meningitis,

_Genentech/OSI's Tarceva for lung cancer and

_Roche/GlaxoSmithKline's Boniva for osteoporosis.

Cost-conscious managed-care plans helped fuel the 2004 slowdown in prescription-drug spending by encouraging the use of over-the-counter anti-ulcer acid-reflux drugs and antihistamines.

Higher consumer out-of-pocket costs, or "co-pays," also slowed sales, the report found.

The number of prescriptions dispensed rose slightly, from 3.44 billion in 2003 to about 3.52 billion in 2004.

But patient volume for nonsteroid anti-inflammatory painkillers, including Cox-2 inhibitors, fell 9 percent after studies linked them to heart problems.

Cox-2 inhibitors, according to their makers, stop an enzyme that causes pain and inflammation in arthritic joints but don't interfere with another enzyme that protects the stomach from ulceration.

The drugs were popular with arthritis patients until Merck voluntarily pulled its Cox-2 product, Vioxx, off the market in September after users in a clinical trial showed markedly elevated risks of heart attack and stroke.

Since then, several other studies have questioned the safety of Pfizer's Cox-2 drugs, Celebrex and Bextra.

An advisory panel of the Food and Drug Administration will hold a three-day hearing beginning Wednesday in Gaithersburg, Md., to determine whether Cox-2 drug sales should be regulated more stringently or possibly discontinued.

The study's other key findings include:

_Cholesterol reducers are the top-selling class of drugs, with Pfizer's Lipitor the biggest-selling U.S. product for the fourth straight year.

_Only 1.2 percent of retail prescriptions and 5.1 percent of senior retail prescriptions involved the use of Medicare discount cards, launched in June 2004.

_Imported drugs from Canada accounted for less than 1 percent of U.S. drug sales in 2004.

_The number of new prescription drugs approved for sale in the United States increased to 31 in 2004 from 21 in 2003.

_Sales of generic drugs grew by about 10 percent in 2004, a dramatic decline from previous annual-growth rates of more than 25 percent.

_U.S. prescription-drug sales are projected to grow up to 8.5 percent in 2005.

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(c) 2005, Knight Ridder/Tribune Information Services.

GRAPHIC (from KRT Graphics, 202-383-6064): DRUGSALES

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