Good Data, Big Drug Market, but Still Risky

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Eli Lilly (NYSE: LLY  ) could use a blockbuster, considering that it's losing many of its top-selling drugs to generic competition over the next few years. And it might have found one in cholesterol drug evacetrapib. That's the good news.

We'll get to the bad news in a bit; first, the data.

In a phase 2 trial, evacetrapib increased HDL cholesterol -- that's the good kind -- by 53.6% at the lowest dose and more than doubled the good cholesterol at the highest dose. LDL cholesterol -- that's the bad kind -- went in the right direction, too; evacetrapib lowered the bad cholesterol by as much as 36% when used by itself or by as much as 14% when used in combination with a statin.

Those are some pretty solid numbers in a pretty gigantic market. Remember Pfizer (NYSE: PFE  ) sold $10.7 billion worth of its statin, Lipitor, last year. And that's down from its peak.

So what's the bad news? Eli Lilly is behind Roche (OTC: RHHBY.PK) and Merck (NYSE: MRK  ) , which have cholesterol drugs in the same class as evacetrapib. Being second or third to market isn't a death sentence, but you usually have to bring something to the table. It's too early to tell whether evacetrapib has a better efficacy or safety profile. Outcomes -- heart attacks, strokes, and the like -- in a large phase 3 trial will be what doctors deem important, not a surrogate endpoint like cholesterol levels.

Speaking of safety, the previous leader in this class, Pfizer's torcetrapib, crashed and burned in 2006 after it appeared patients taking the drug were doing worse than those on placebo. Everything looks OK with evacetrapib now, but that was true of torcetrapib before it entered phase 3 trials. It remains to be seen whether the problem is a class effect or specific to torcetrapib.

Evacetrapib might be a blockbuster, but it'll probably be years before we know; outcome trials take a while. Amarin (Nasdaq: AMRN  ) , which has already passed two phase 3 trials, is a less risky, more immediate option if you're looking to invest in the large cholesterol market.

And for those trying to grow their nest egg, make sure to download The Motley Fool's special free report "The Shocking Can't-Miss Truth About Your Retirement."

Fool contributor Brian Orelli holds no position in any company mentioned. Check out his holdings and a short bio. Motley Fool newsletter services have recommended buying shares of Pfizer. Try any of our Foolish newsletter services free for 30 days. We Fools don't all hold the same opinions, but we all believe that considering a diverse range of insights makes us better investors. The Motley Fool has a disclosure policy.

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