Lilly, Roche dive deep into diagnostics

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Two Indianapolis giants—Eli Lilly and Co. and Roche Diagnostics—are working hard to pair up drugs and diagnostic
tests to gin up more sales.

Lilly, which launched
its own diagnostic division last month to focus on cancer and Alzheimer’s drugs, has also found a test that could help
its slow-selling blood thinner, Effient.

Indianapolis-based Lilly said Monday that its sales reps will talk up to doctors a blood test made by a San Diego firm that
measures the clotting ability of each patient’s blood after taking a blood thinner. From Lilly’s standpoint, the
idea is to identify which patients aren’t benefiting from Effient’s main competitor, Plavix.

Plavix’s annual sales of $9.5 billion dwarf those of Effient—$35 million in its first nine months on the market.
But studies have shown that genetic variations cause as many as 14 percent of Plavix patients to receive little or no anti-clotting
benefit from the drug.

Both Effient and Plavix are given to patients who have had their arteries propped open through balloon angioplasties or stents.

The diagnostic blood test, made by Accumetrics Inc., costs about $60, according to The New York Times. That’s
cheaper and faster than a genetic test that could determine which patients won’t respond well to Plavix.

"We believe physicians will want to know the specific effect of a patient's antiplatelet [blood thinning] therapy
and whether additional measures may be needed," said Dr. Rogelio Braceras, senior medical director of thrombosis at Lilly's
development partner on Effient, Japan-based Daiichi Sankyo Inc.

Switzerland-based Roche, which operates both drug and diagnostic businesses, is testing one of its diagnostic tests against
traditional Pap smears to see which detects the precursor of cervical cancer earliest. Roche Diagnostics' U.S. headquarters
is in Indianapolis.

On July 9, Roche announced results of a clinical trial that showed its test, the cobas 4800 HPV Test, said one in 10 women
who had the precursor to cervical cancer, the human papillomavirus, did not test positive for cancer in a Pap smear.

Roche’s test could potentially help sales of its blockbuster cancer drug Avastin. The drug is approved to treat various forms of cancer, and recent studies have examined it as a possible treatment for cervical cancer. Doctors have freedom to prescribe it for any treatment regimen.

Expect a lot more of these efforts in the future. An October study by consulting firm PricewaterhouseCoopers estimates the
drug, device and diagnostic market at $24 billion a year and growing at 10 percent each of the next five years.

“This is kind of the next step,” said Tiffany Olson, Lilly’s vice president of diagnostics, in an interview
at Lilly’s corporate headquarters south of downtown. “It’s making the promise actionable: right patient,
right time, right dose."
 

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