EZNiches

photos Robin Gibb – a life and times(10 photos)

Robin Gibb, co-founder of the Bee Gees, has died after a long battle with cancer. He was 62.

Article source: http://www.nzherald.co.nz/business/news/article.cfm?c_id=3&objectid=10807151&ref=rss

Once upon a time, there was a fairytale prince who caught the eye of noblewomen, commoners and starlets alike. Later, that same prince became a subject of ridicule, better known for his big ears. Finally, he took on the role of a two-timing cad, outraging the world by cheating on a woman seen as the fairest princess of them all.

But what’s happened to Charles, the Prince of Wales, since then?

Now 63 years old and the longest-serving king-in-waiting in British history, the Queen’s oldest son is being largely overshadowed by his own sons, William and Harry, and of course, Will’s attention-grabbing wife, Kate.

While Charles has played many roles in his lifetime, experts and those who have met him agree the real Charles – the Charles of today and the Charles who will be king – isn’t really understood in the public realm.

For the past 20 years, Charles’s public story has been largely a negative one, focused on the breakdown of his marriage with Diana, Princess of Wales, and his relationship with Camilla Parker Bowles, now his wife, the Duchess of Cornwall, says Robert Finch, the dominion chairman of the Monarchist League of Canada.

“The story of the progressive Charles, the ‘green’ Charles, the man who bridges the religious divide, the man who raises millions of dollars for underprivileged children – that’s the story a lot of people just don’t know,” Finch says.

“I believe Charles will be a major force for modernizing the monarchy just based on his views of the world. A lot of people just don’t appreciate that side of him.”

How Charles portrays himself on his Canadian visit starting today – part of the Queen’s Diamond Jubilee celebration – has the potential, some contend, to help rebrand how the Commonwealth perceives the man who will someday sit on the throne.

“When he comes to Canada, it is an opportunity to cement that image and to portray himself as that modern, forward-thinking Prince of Wales,” Finch says.

“It’s an opportunity to reach out to all Canadians, but particularly young Canadians, and to really tell the story of Prince Charles.”

It wasn’t always such a rough ride in the public eye for Charles. Though it may seem strange to a younger generation, he was once every bit the rock-star royal.

“He was one of the boys when he was here,” says Elbridge Wilkins, the former mayor of Fredericton.

Wilkins, now 85, was the mayor of New Brunswick’s capital city from 1974 to 1986, a period when Charles visited several times, for both official business and for pleasure.

Charles undertook some of his military training in the mid-1970s at Canadian Forces Base Gagetown, and went into Fredericton on several occasions. And, “more than once,” he stopped in at a popular dance club, The Cosmo, Wilkins says with a chuckle.

“He danced with a girl one night, at least a couple of times. And she asked him what his name was, and he just said ‘Charles,’ ” Wilkins says.

“And she didn’t realize until after he had left who he was, and she got a real kick out of that.”

In the 1970s and up until his 1981 marriage to Diana, Charles was considered the world’s most eligible bachelor.

Article source: http://www.timescolonist.com/entertainment/Charles+Finding+royal+niche/6651920/story.html

As if going up against one of the best-selling drugs ever wasn’t challenging enough.

Now Eli Lilly and Co.’s blood-thinner Effient has it even tougher.

Its chief rival, Plavix, has gone generic in the U.S. This week, low-priced knockoffs will start flooding the market.

How to keep Effient on the prescribing pads of doctors?

The survival plan by Lilly and its partner Daiichi Sankyo is this: They will stake out a clearly defined niche for Effient (treating a minority of patients whose bodies don’t respond well to Plavix) and not bother competing head-on with the generics.

Effient, a one-a-day pill which went on the market in 2009, was seen then as a game-changer that could quickly grab a billion dollars or more in Plavix’s annual sales, which topped $9 billion last year. Plavix is sold by Bristol-Myers Squibb Co. and Sanofi-Aventis SA.

Instead, Effient’s sales have been disappointing. They barely topped $300 million last year (though they kicked up to $116 million in the latest quarter).

Effient’s early lackluster sales prompted one drug stock analyst to write, “Even if the company isn’t ready to give up on Effient, we are.”

Far from throwing in the towel, Lilly and its Japanese partner actually have visions of growing sales of Effient.

“Clearly, we realize the economics” of competing against a low-priced generic, said Vincent Truax, Lilly’s U.S. senior marketing director for Effient. “But medical guidelines drive a lot of use, and Effient is supported by the data. We think those guidelines still will hold true even with generic alternatives in the marketplace.”

He points to a growing fan base for the drug.

More than 85 percent of U.S. interventional cardiologists have been trained in using Effient and more than 1.7 million prescriptions have been written. And most medical plans, including Medicare, cover Effient.

The drug is made in Indianapolis by 175 Lilly workers.

Deutsche Bank drug stock analyst Barbara Ryan sees generic Plavix remaining by far the dominant blood-thinner in the market, but she thinks Effient and AstraZeneca’s Brilinta have a role, as medications that will be prescribed mostly to new heart patients starting therapy. Brilinta is a newcomer that hit the market last year.

The drugs are typically taken with aspirin by patients who’ve had stents implanted in their arteries to keep them from reclogging.

Effient is approved for use in patients with acute coronary syndrome, who’ve suffered a heart attack and chest pain called unstable angina. In the United States, that market runs to one million people a year.

What differentiates Effient from its famous established rival is that it works to prevent new artery clogs in a minority of heart patients (2 percent to 14 percent, depending on ethnicity) who have a genetic variation that means they respond poorly to Plavix.

That’s the difference Lilly and Daiichi now hope to exploit in the market.

“Our (marketing) focus really is the lack of this variability with Effient,” said Tony Silfani, Effient senior brand manager for Daiichi. “It clearly makes Effient different than Plavix.”

Whether that’s enough to boost Effient’s sales is debatable. Insurers and government are under more pressure than ever to encourage generic drug use, and cardiologists might not even try to justify prescribing Effient at its wholesale cost of $6.38 a tablet when generic Plavix will be much cheaper. (The generic price wasn’t known last week.)

Blood-thinners typically are taken for one year after artery-opening stent surgery.

Drug analyst Seamus Fernandez of Leerink Swann Co. puts Effient’s peak sales at $865 million in 2017 — under the $1 billion level that earns a drug the title of a blockbuster.

Dr. Alan Niederman, an interventional cardiologist at Holy Cross Hospital in Ft. Lauderdale, Fla., who blogs on medical issues, thinks Lilly and Daiichi might be hard-pressed to justify Effient’s usefulness given the lower price of generics.

“I personally don’t use much Effient,” he said. “I know about the studies” that it treats some patients who don’t do well on Plavix. “But I don’t feel it’s something which I must do to satisfy the clinical needs of my patients.”

In addition, Niederman notes, “There’s pushback we get from insurance companies” when a brand drug is prescribed over a generic.

Dr. Kirk Parr, who practices with St. Vincent Medical Group Cardiology in Indianapolis and Carmel, said he thinks cardiologists do appreciate the medical differences of Effient and Brilinta.

“Cardiologists, I don’t think, are just going to default to prescribing generic Plavix. In some patients both (Effient and Brilinta) may have advantages over Plavix, and I think cardiologists realize that.”

Dr. Elisabeth von der Lohe, director of interventional cardiology at Indiana University School of Medicine, said Effient occupies a medical niche appreciated by cardiologists.

“Plavix is not a perfect drug. We have a lot of nonresponders,” she said, who can often benefit from Effient.

Lilly is anxious for Effient to perform after seeing its longtime No. 1 drug, the antipsychotic Zyprexa, go generic last year. Zyprexa’s $4.6 billion in 2011 sales are expected to largely evaporate by the end of this year.

Truax said Effient’s sales also could benefit from new studies pitting it against Plavix in larger populations of heart patients, including those who haven’t received any stents and are being treated with medication.

Even with new studies, Niederman isn’t convinced the brand-name blood-thinners can hold their own against generic Plavix.

“This will most likely put the final nail in the coffin of the newer drugs in this class,” he told readers of his medical blog.

Article source: http://www.mydesert.com/article/BG/20120520/BUSINESS03/305200001/Lilly-seeks-niche-its-blood-thinner-Effient?odyssey=mod_sectionstories