SmithKline is hoping to use the connections Bristol-Myers has built over the years marketing Glucophage. And Bristol-Myers is hoping to retain its share in the diabetes drug market after its patent on Glucophage expires in three years. It projects treating diabetes with fewer risk to the liver than Warner-Lambert's Rezulin, a drug that had new warning labels added by the FDA last month because of patients suffering liver failure. Food and Drug Administration officials say 43 Rezulin patients have suffered acute liver failure with seven liver transplantations and 28 deaths. Approximately 15 million people have Type 2 or adult-onset diabetes in the United States.
Most patients take a single pill or a combination of pills.
An important question is how will sales representatives recommend doctors use these drugs. SmithKline President J.P. Garnier said he expects Bristol-Myers sales representatives to recommend that doctors prescribe Avandia for new diabetes patients and in combination with Glucophage. Patients who currently use Glucophage will not be switched to Avandia. As part of the deal, the two companies would share profits generated by Avandia. Neil Kaplowitz, M.D., chief, Division of Gastrointestinal and Liver Disease, University of Southern California, and James W. Freston, M.D., Ph.D., professor and director, Office of Clinical Research, University of Connecticut Health Center.