| 1. What is your specialty and/or subspecialty? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| Cardiology |  | 28.2% | 33 |
| Family Medicine / General Practitioner | | 20.5% | 24 |
| Internal Medicine without subspecialty | | 23.9% | 28 |
| Internal Medicine with subspecialty | | 27.4% | 32 |
 Other (please specify) | 10 | ||
| answered question | 117 | ||
| skipped question | 7 | ||
| 2. If you checked "Internal Medicine with subspecialty" in the question above, what is your subspecialty? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| Allergy-Immunology | | 2.9% | 1 |
| Emergency Medicine | | 2.9% | 1 |
| Endocrinology | | 23.5% | 8 |
| Gastroenterology | | 11.8% | 4 |
| Geriatrics | | 17.6% | 6 |
| Hematology | | 5.9% | 2 |
| Infectious Disease | | 11.8% | 4 |
| Nephrology | | 2.9% | 1 |
| Oncology | | 11.8% | 4 |
| Pulmonary | | 2.9% | 1 |
| Rheumatology | | 11.8% | 4 |
| Other (please specify) | 4 | ||
| answered question | 34 | ||
| skipped question | 90 | ||
| 3. How many years have you been practicing medicine? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| 1-5 | | 1.7% | 2 |
| 6-10 | | 16.7% | 20 |
| 11-15 | | 15.0% | 18 |
| 16-20 | | 15.0% | 18 |
| 21-25 | | 17.5% | 21 |
| 26-30 | | 19.2% | 23 |
| More than 30 | | 15.0% | 18 |
| Other (please specify) | 1 | ||
| answered question | 120 | ||
| skipped question | 4 | ||
| 4. Prior to the results of the Vytorin-ENHANCE study being made public in January 2008, which was your preferred cholesterol-lowering drug? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| Lipitor | | 51.2% | 62 |
| Lescol | 0.0% | 0 | |
| Mevacor | 0.0% | 0 | |
| Pravachol | 0.0% | 0 | |
| Crestor | | 11.6% | 14 |
| Zocor | | 2.5% | 3 |
| Zetia | | 0.8% | 1 |
| Vytorin | | 12.4% | 15 |
| Simvastatin (generic Zocor) | | 24.8% | 30 |
| Lovastatin (generic Mevacor) | | 2.5% | 3 |
| Pravastatin (generic Pravachol) | | 2.5% | 3 |
| Other (please specify) | | 5.0% | 6 |
| answered question | 121 | ||
| skipped question | 3 | ||
| 5. Based on your clinical experience, does Vytorin lower cholesterol more than a statin alone? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| Yes | | 84.5% | 98 |
| No | | 16.4% | 19 |
| Other (please specify) | 6 | ||
| answered question | 116 | ||
| skipped question | 8 | ||
| 6. Based on your clinical experience, does Zetia plus a statin lower cholesterol more than a statin alone? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| Yes | | 84.2% | 101 |
| No | | 15.8% | 19 |
| Other (please specify) | 4 | ||
| answered question | 120 | ||
| skipped question | 4 | ||
| 7. How did the results of the Vytorin-ENHANCE study, released in late January 2008, affect your prescriptions for Vytorin and Zetia? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| It did not change my prescriptions for these drugs. | | 52.1% | 62 |
| It decreased my prescriptions for these drugs. | | 47.9% | 57 |
| It increased my prescriptions for these drugs. | | 0.8% | 1 |
| Other (please specify) | 9 | ||
| answered question | 119 | ||
| skipped question | 5 | ||
| 8. The Vytorin-ENHANCE study was done on patients with a severe form of familial hypercholesterolemia that were previously being treated for elevated cholesterol with other agents. Can the results of such a study be applicable to patients who have a non-familial elevated cholesterol secondary to age, obesity, poor diet and sedentary life style? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| Yes | | 28.4% | 31 |
| No | | 71.6% | 78 |
| Other (please specify) | 13 | ||
| answered question | 109 | ||
| skipped question | 15 | ||
| 9. The Vytorin-ENHANCE study used measurements of carotid artery plaque thickness measured by ultrasound as a surrogate marker for coronary artery plaque. The ENHANCE study showed no significant plaque reduction with Vytorin as compared to Zocor alone. What is your opinion of this finding? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| I don't think that carotid artery plaque is a good surrogate for coronary artery plaque. | | 15.8% | 19 |
| I don't think that the specific group of ENHANCE patients studied were a good surrogate for the average patient with elevated cholesterol. | | 34.2% | 41 |
| I think that lowering cholesterol and LDL cholesterol are the most important treatment endpoints regardless of the carotid artery plaque findings in the ENHANCE study. | | 24.2% | 29 |
| The carotid artery plaque findings in the ENHANCE study are significant and cast doubt on the effectiveness of Vytorin and Zetia, even if they do lower cholesterol better than Zocor alone. | | 26.7% | 32 |
| I am not sure of the significance of the ENHANCE study findings. As a result I have not changed my prescriptions for Vytorin and Zetia. | | 20.0% | 24 |
| I am not sure of the significance of the ENHANCE study findings. As a result I have reduced my prescriptions for Vytorin and Zetia. | | 16.7% | 20 |
| Other (please specify) | 7 | ||
| answered question | 120 | ||
| skipped question | 4 | ||
| 10. If patients have asked you to switch them from Vytorin to another drug, what have you done? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| Advised them not to switch since I believe Vytorin works better than a statin alone. | | 13.2% | 15 |
| Advised them not to switch, but if they insist, switched them to a different agent. | | 29.8% | 34 |
| Switched them to a different drug since I believe the ENHANCE study shows that Vytorin is no better than Simvastatin alone. | | 21.1% | 24 |
| It depends on the specific patient and other factors. | | 37.7% | 43 |
| Other (please specify) | 7 | ||
| answered question | 114 | ||
| skipped question | 10 | ||
| 11. At the recent American College of Cardiology meeting in late March 2008, an expert panel of cardiologists determined that the ENHANCE study put Vytorin and Zetia in a bad light, and recommended that doctors go back to prescribing statins alone. Here is a media summary of that: http://www.cnbc.com/id/23871395. As a result of this panel's recommendations in late March 2008, what have you done? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| I have NOT CHANGED the number of prescriptions I write for Vytorin and Zetia as a result of the American College of Cardiology expert panel report in late March 2008. | | 50.4% | 58 |
| I have REDUCED the number of prescriptions that I write for Vytorin and Zetia as a result of the American College of Cardiology expert panel report in late March 2008. | | 49.6% | 57 |
| I have INCREASED the number of prescriptions that I write for Vytorin and Zetia as a result of the American College of Cardiology expert panel report in late March 2008. | | 0.9% | 1 |
| Other (please specify) | 14 | ||
| answered question | 115 | ||
| skipped question | 9 | ||
| 12. Recent published reports have implied that some Merck/Schering-Plough executives, some cardiologists who ran the ENHANCE study, and some expert panel cardiologists from the recent American College of Cardiology meeting have at times been less than competent, or have been influenced by ego issues, or have had conflicts of interest that affected how the ENHANCE study was run and subsequently analyzed. Additionally, there have been allegations that some minutes from meetings held regarding the ENHANCE study were altered or modified long after the meetings were held. Articles about this can be found in the Wall Street Journal at http://blogs.wsj.com/health/?s=vytorin&x=11&y=9 (scroll down to the bottom of the web page first, to read the Vytorin-related articles chronologically). In view of these published reports and information that you have heard and read independently, what is your view of the Vytorin ENHANCE study results and subsequent analysis? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| Yes, there are conflicts of interest tainting the ENHANCE study results and its analysis. | | 42.9% | 48 |
| No, there are no conflicts of interest and the ENHANCE study results are reliable and meaningful. | | 15.2% | 17 |
| I am not sure whether the ENHANCE study is reliable. | | 42.9% | 48 |
| Other (please specify) | 14 | ||
| answered question | 112 | ||
| skipped question | 12 | ||
| 13. How have the news reports subsequent to the release of the ENHANCE study affected your prescribing habits for Vytorin and Zetia? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| I am continuing to prescribe Vytorin and Zetia as I did after reading the ENHANCE study results and am ignoring the media reporting since then. | | 46.7% | 56 |
| I have REDUCED my prescriptions for Vytorin and Zetia in view of the media reports subsequent to the release of the ENHANCE study. | | 52.5% | 63 |
| I have INCREASED my prescriptions for Vytorin and Zetia in view of the media reports subsequent to the release of the ENHANCE study. | | 0.8% | 1 |
| answered question | 120 | ||
| skipped question | 4 | ||
| 14. In late March 2008 an expert panel of cardiologists at the American College of Cardiology meeting gave a negative report on Vytorin and Zetia and recommended that doctors go back to prescribing statins alone. How has this affected your prescriptions for Vytorin and Zetia? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| I am ignoring the expert cardiologist panel report. | | 39.2% | 47 |
| I am reducing my prescriptions for Vytorin and Zetia following the expert cardiologist panel report. | | 59.2% | 71 |
| I am increasing my prescriptions for Vytorin and Zetia following the expert cardiologist panel report. | | 1.7% | 2 |
| answered question | 120 | ||
| skipped question | 4 | ||
| 15. Prior to the recent American College of Cardiology expert panel negative report on Vytorin and Zetia, would you have prescribed these drugs for yourself or a family member? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| Yes | | 70.2% | 85 |
| No | | 29.8% | 36 |
| Other (please specify) | 7 | ||
| answered question | 121 | ||
| skipped question | 3 | ||
| 16. After reviewing the negative recommendations of the recent American College of Cardiology expert panel on Vytorin and Zetia, would you prescribe Vytorin for yourself or a close family member? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| Yes | | 50.4% | 60 |
| No | | 49.6% | 59 |
| Other (please specify) | 7 | ||
| answered question | 119 | ||
| skipped question | 5 | ||
| 17. It has been reported that ENHANCE study data and results were ready to be released as long as one year ago. Some cardiologists, consultants and consumers have suggested that release of results of the ENHANCE study were purposely delayed by Merck and Schering-Plough to prevent decreased sales of Vytorin. Regarding this issue which do you believe is true? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| Merck and Schering-Plough purposely delayed releasing ENHANCE study data and results to avoid a drop in sales of Vytorin and Zetia. | | 37.0% | 44 |
| Merck and Schering-Plough delayed releasing ENHANCE data and results because the data were confusing and difficult to analyze. | | 12.6% | 15 |
| I am not certain why release of ENHANCE study data and results were delayed. | | 52.1% | 62 |
| Other (please specify) | 4 | ||
| answered question | 119 | ||
| skipped question | 5 | ||
| 18. The Vytorin controversy has created debate as to whether reduction of cholestrol and LDL cholesterol is a valid endpoint for clinical trials. Do you believe that cholesterol lowering drugs should be approved as long as they demonstrate safe reduction of cholesterol and LDL cholesterol, or the drugs first have to be shown to reduce or stabilize carotid artery plaque before being approved by the FDA? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| Significant lowering of cholesterol and LDL cholesterol should be sufficient for approval by the FDA. | | 64.8% | 70 |
| Lowering of cholesterol and LDL cholesterol is not sufficient for FDA approval. The drugs must demonstrate STABILIZATION of carotid artery plaque to be approved. | | 18.5% | 20 |
| Lowering of cholesterol and LDL cholesterol is not sufficient for FDA approval. The drugs must demonstrate REDUCTION of carotid artery plaque to be approved. | | 17.6% | 19 |
| Other (please specify) | 15 | ||
| answered question | 108 | ||
| skipped question | 16 | ||
| 19. The Vytorin controversy has stirred debate as to whether reduction of cholestrol and LDL cholesterol and stabilization and/or reduction of carotid artery plaque are valid endpoints for clinical trials. Do you believe that cholesterol lowering drugs should be approved as long as they demonstrate safe reduction of cholesterol and LDL cholesterol and stabilization/reduction of carotid artery plaque, or must the drugs also have to demonstrate reduction of myocardial infarction incidence to be approved by the FDA? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| Cholesterol lowering drugs do NOT have to prove reduction of myocardial infarction incidence to be approved by the FDA. | | 53.8% | 63 |
| Cholesterol lowering drugs MUST prove that they reduce myocardial infarction incidence to be approved by the FDA. | | 46.2% | 54 |
| Other (please specify) | 6 | ||
| answered question | 117 | ||
| skipped question | 7 | ||
| 20. The USA House of Representatives Committee on Energy and Commerce and its Subcommittee on Oversight and Investigations are probing the Vytorin-ENHANCE controversy by studying the withholding of clinical trial data that may significantly affect the medical management of hypercholesterolemia, as well as the use of misleading statement in direct-to-consumer advertisements for prescription medicines. Do you believe that this investigation is worthwhile? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| Yes | | 67.2% | 80 |
| No | | 32.8% | 39 |
| Other (please specify) | 6 | ||
| answered question | 119 | ||
| skipped question | 5 | ||
| 21. The study of Vytorin continues with the IMPROVE IT clinical trials http://clinicaltrials.gov/ct2/show/NCT00202878?term=IMPROVE+IT&rank=1This "is a randomized, active-control, double-blind study of subjects with stabilized high-risk acute coronary syndrome (ACS). The primary objective is to evaluate the clinical benefit of Ezetimibe/Simvastatin Combination 10/40 (single tablet, under the brand VYTORIN in the United States) compared with Simvastatin 40 mg. Clinical benefit will be defined as the reduction in the risk of the occurrence of the composite endpoint of CV death, major coronary events, and stroke." This study will conclude in June 2012. What do you think the IMPROVE IT study will show? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| Vytorin WILL significantly reduce the incidence of major coronary events and stroke as compared to Zocor/Simvastatin. | | 29.2% | 35 |
| Vytorin WILL NOT significantly reduce the incidence of major coronary events and stroke as compared to Zocor/Simvastatin. | | 15.8% | 19 |
| I am not sure what this study will conclude. | | 55.0% | 66 |
| Other (please specify) | 3 | ||
| answered question | 120 | ||
| skipped question | 4 | ||
| 22. Do you like to participate in online healthcare related surveys? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| Yes | | 82.8% | 96 |
| No | | 17.2% | 20 |
| Other (please specify) | 4 | ||
| answered question | 116 | ||
| skipped question | 8 | ||
| 23. Do you want to participate in other WhatDoctorsThink.com surveys in the future? | |||
|---|---|---|---|
| Response Percent | Response Count | ||
| Yes | | 80.0% | 92 |
| No | | 20.0% | 23 |
| Other (please specify) | 5 | ||
| answered question | 115 | ||
| skipped question | 9 | ||