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Endo Pharmaceuticals’ Lidoderm - Physician survey indicates increased use likely to fuel sales

Launched in the US in 1999 as the only topical lidocaine patch, Lidoderm has demonstrated very strong growth year-on-year, with annual growth of 114% in 2003, 73% in 2004, and 36% in 2005. Lidoderm’s continued growth in both labeled and off-label indications is highly important to the company’s future success.

Scope

Report Highlights
Surveyed physicians expect to continue to increase their use of Lidoderm in post-herpetic neuralgia and a variety of off-label pain conditions with use varying by specialty.

The largest barriers to use of Lidoderm are price and reimbursement but some physicians believe the situation is improving.

Near-term competitive threats are not expected to substantially derail Lidoderm’s growth rate.

Reasons to Purchase

Table of Contents

• SUMMARY - page 1
  • Physician survey indicates increased use of Lidoderm likely to fuel above-consensus sales growth - page 1
• ENDO PHARMACEUTICALS - page 5
  • Overview - page 5
• LIDODERM - page 5
  • Lidoderm is the only topical lidocaine patch available in the US - page 5
  • Lidoderm is FDA-approved in post-herpetic neuralgia but has data in other pain indications - page 5
  • Five years post-launch, Lidoderm sales are still showing strong growth - page 6
• PHYSICIAN SURVEY BACKGROUND - page 7
  • Pain specialists are the highest prescribers of Lidoderm - page 7
• USE OF LIDODERM - page 7
  • Indication and specialty - page 7
  • Physicians report increasing use of Lidoderm on- and off-label - page 7
  • All surveyed physician types expect to prescribe greater volumes of Lidoderm - page 9
  • Lidoderm continues to penetrate approved indication and low back pain, its largest off-label condition - page 9
    • In PHN, pain specialists have leveled off use at 60% of patients, while other specialists predict increases - page 9
    • Lidoderm share of low back pain market expected to expand across all physician types - page 10
• DRIVERS OF LIDODERM'S GROWTH - page 11
  • Survey results indicate Lidoderm growth fueled by both new and existing prescribers - page 11
  • Growing physician familiarity and appreciation of benign safety profile drive use - page 12
  • Increased marketing and publication of off-label data also spur growth - page 12
  • Lidoderm detailing has become more frequent, especially for neurologists - page 13
  • Price and reimbursement barriers exist, but some physicians report improvements - page 13
  • Pfizer's Lyrica, a recent entrant to pain market poses little competitive threat - page 14
  • Efficacy results from ongoing low back pain trial likely to only be moderately important - page 14
• LIDODERM FORECAST - page 15
  • We forecast sustainable growth, ahead-of-consensus sales - page 15
• APPENDIX - page 17
  • Datamonitor Healthcare - page 17
  • Disclosure information - page 17
  • Ask the analyst - page 18


• List of Tables
• Table 1: Post-marketing data released on Lidoderm in chronic pain conditions - page 5
• Table 2: Historic Lidoderm sales 1999-2005 - page 6
• Table 3: Breakdown of surveyed physicians by specialty - page 7
• Figure 1: Average number of prescriptions per month of Lidoderm by indication - page 8
• Figure 2: Average number of prescriptions per month of Lidoderm by physician specialty - page 9
• Table 4: Average penetration of Lidoderm in PHN according to time and physician specialty - page 10
• Table 5: Average penetration of Lidoderm in low back pain according to time and physician specialty - page 11
• Figure 3: Impact of treatment settings on sales growth on a scale of 1 to 5, where 1 = no impact, 5= strong impact - page 12
• Figure 4: Most commonly identified factors behind Lidoderm sales growth (percentage of physicians) - page 13
• Figure 5: Physician expectation of the impact of Lyrica on Lidoderm use (percent of physicians) - page 14
• Figure 6: Physician expectation of the impact that negative trial results from ongoing Phase II low back pain trial would have on Lidoderm use (percentage of physicians) - page 15
• Table 6: US Lidoderm sales forecast 2006-2008 - page 16

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