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These Companies Smile at Avandia's Woes

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It's better than nothing -- but not by much.

Yesterday, European regulators decided to pull GlaxoSmithKline's (NYSE: GSK  ) diabetes drug Avandia off the market, and the U.S. Food and Drug Administration put such stringent requirements on the drug that sales will likely be so low they won't even get broken out by the company.

After an FDA advisory panel split its vote in July over whether heart problems justified pulling the drug, strict prescribing requirements seemed like the most likely outcome.

In the U.S., people on Avandia will be able to continue taking the drug, but for new patients, doctors will have to certify that they've tried other drugs before it can be prescribed. Diabetes drugs are a revolving door since type 2 diabetes is a progressive disease; the drugs only work for so long. Being unable to get new patients to replace the old ones easily means Avandia sales are sure to drop. Plus, some of the current patients will likely stop taking the drug now simply because of the most recent news; "If it's not good enough for the Europeans, it's not good enough for me."

Where there's a loser, there's usually a winner nearby; in this case, more than one.

On the surface, Takeda's Actos would look to be the biggest winner, since it's in the same class as Avandia, but it has potential side effect issues of its own. Merck's (NYSE: MRK  ) Januvia, which is also taken orally, could be the biggest winner. Onglyza from Bristol-Myers Squibb (NYSE: BMY  ) and AstraZeneca (NYSE: AZN  ) , a newcomer in the same class as Januvia, could also earn some sales, although there doesn't seem to be much reason to prescribe it over the more established Januvia.

Then there are the injected drugs. As the disease progresses, people will eventually need insulin products from companies such as Novo Nordisk (NYSE: NVO  ) and Eli Lilly (NYSE: LLY  ) , but I'm not sure the lack of Avandia as an option will really increase the rate. The GLP-1 class of drugs, which includes Novo Nordisk's Victoza and Byetta sold by Eli Lilly and Amylin Pharmaceuticals (Nasdaq: AMLN  ) , could benefit as patients try to avoid the inevitable step of having to take insulin.

Most of the damage to U.K.-based Glaxo has already been done, but there's still about $1 billion in annual sales up for grabs. Come and get it.

Anand Chokkavelu thinks health-care giant Johnson & Johnson is a perfect core stock for your portfolio.

GlaxoSmithKline is a Motley Fool Global Gains selection. Investing internationally doesn't have to be scary and it can certainly be profitable. Click here to grab a 30-day trial subscription to the newsletter where you'll see all of our current picks for a global economy.

True to its name, The Motley Fool is made up of a motley assortment of writers and analysts, each with a unique perspective; sometimes we agree, sometimes we disagree, but we all believe in the power of learning from each other through our Foolish community. 

Fool contributor Brian Orelli, Ph.D., doesn't own shares of any company mentioned in this article. The Fool owns shares of GlaxoSmithKline and has a disclosure policy.

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