Merck "Get To Goal" Guarantee for Zocor

In a desperate attempt to win the battle of the cholesterol-loweringstatins, Merck & Co has taken the unprecedented step of guaranteeing that its Zocor (simvastatin) will lower low density lipoprotein cholesterol to target levels set by patient's physicians in combination with diet. If it fails, patients and insurers will be eligible for a refund for up to six months of their prescriptions.

To qualify for a refund, patients have to obtain certification from their physician that LDL targets were not met after at least one 30-day prescription at the maximum 80mg dosage of Zocor. If patients discontinue treatment for alternative reasons, eg side effects, they will not receive a refund.

The Get-to-Goal initiative will encourage physicians to titrate patients to higher doses of Zocor from the initial recommended 20mg daily to 40mg, then 80mg at four-week intervals in order to achieve effective cholesterol-lowering. This will not increase the cost to the healthcare provider, however, as all doses of Zocor are priced the same per tablet; it is the only statin to have this equal pricing structure. The prescribing doses were changed earlier this year when the 80mg dosage was approved by the US Food and Drug Administration (Marketletter July 27). At the same time Merck increased the recommended initial dose from 10mg to 20mg, although the 10mg dose is still available for patients in whom only moderate cholesterol lowering is needed.