Thursday, October 22, 2009

DECISION RESOURCES: Cymbalta and Lyrica Most Prescribed for Fibromyalgia, but Neither as First Line

Cymbalta Is the Agent Most Likely to Lose Patient Share to Savella Over the Next Two Years, According to a New Report from Decision Resources

Patient-Flow Models Will Need to Take Into Account That the Highest Percentage of Patients Take Lyrica Before Adding or Switching to Cymbalta

(Waltham, Mass. - October 21, 2009) - Decision Resources, one of the world’s leading research and advisory firms focusing on pharmaceutical and healthcare issues, finds that although the majority of surveyed U.S. physicians prescribe Eli Lilly’s Cymbalta and Pfizer’s Lyrica for the treatment of fibromyalgia, neither agent has the majority of its uses in the first line. In the case of Cymbalta, surveyed rheumatologists report that 37 percent of their prescriptions for the drug are in the first line; in the case of Lyrica, 32 percent of prescriptions for the drug are in the first line.

“None of the fibromyalgia agents we surveyed physicians about has the majority of its uses in the first line. Surveyed rheumatologists told us that similar percentages of their prescriptions for amitriptyline and cyclobenzaprine are in the first line compared with their prescriptions for Lyrica or Cymbalta, likely because amitriptyline and cyclobenzaprine have a long history of use in the treatment of fibromyalgia (albeit off-label) and are available as inexpensive generics,” stated Andrea Buurma, analyst at Decision Resources.

The new Treatment Algorithms in Fibromyalgia report also finds that Cymbalta is the agent most likely to lose patient share to Forest Laboratories/Cypress Bioscience’s Savella by 2011. Savella was recently launched into the fibromyalgia drug market in April 2009. However, Cymbalta is currently the only agent that is approved for both fibromyalgia and depression and therefore it will continue to be surveyed physicians’ drug of choice for fibromyalgia patients with comorbid depression.

By combining patient-level claims data with physician survey data, this report can be used to build patient-flow models and analyze the assumptions driving these models. Patient-level claims data show that more patients turning to Cymbalta as a second-line or later therapy are prescribed the drug after Lyrica than vice versa. These data suggest that Cymbalta is positioned behind Lyrica; a likely scenario given Cymbalta was approved for fibromyalgia one year following Lyrica’s approval.

About Treatment Algorithm Insight Series

Decision Resources combines in-depth primary research with the most extensive claims-based longitudinal patient-level data from IMS Lifelink: Health Plans Claims database to provide exceptional insight into physicians' prescribing trends and the factors that drive therapy product choice, from diagnosis through multiple courses of treatment, for a specific disease.

About Decision Resources

Decision Resources ( is a world leader in market research publications, advisory services and consulting designed to help clients shape strategy, allocate resources and master their chosen markets. Decision Resources is a Decision Resources, Inc. company.

About Decision Resources, Inc.

Decision Resources, Inc. is a cohesive portfolio of companies that offers best-in-class, high-value information and insights on important sectors of the healthcare industry. Clients rely on this analysis and data to make informed decisions. Please visit Decision Resources, Inc. at

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