The Unsung Vytorin Victim: Primary-Care Marketing

Not quite three weeks after triggering a medico-commercial earthquake with the ENHANCE trial results, Schering-Plough and Merck have yet to win back three key constituencies: prescribers, patients and investors. The stakes for not doing so are enormous. But more importantly for the industry as a whole, ENHANCE is the latest and strongest sign that the cornerstone on which blockbuster franchises are built-simple, compelling and easy-to-verify measures of treatment success--is crumbling in the face of biological complexity. And that means that primary-care success is going to get a lot more expensive.