Eli Lilly (NYSE:LLY) may not have been my pick for Best Stock of 2009, but recent news has bumped it up my list a bit.

Lilly and partner Daiichi Sankyo got good news about their blood thinner, prasugrel, from the European Union yesterday. The Committee for Medicinal Products for Human Use (CHMP) gave the drug a positive recommendation. Now the duo just needs to wait the customary two to three months for approval from the European Commission, and they'll be able to begin marketing the drug.

In the U.S., they're still waiting.

The year started out good for the companies, with the Food and Drug Administration giving prasugrel a priority review, which usually shaves four months off the standard 10-month review. But in June the FDA bumped its decision back to late September, and here we sit, almost three months beyond that, without any sign of when a decision might take place.

The only ones smiling in all this are Sanofi-Aventis (NYSE:SNY) and Bristol-Myers Squibb (NYSE:BMY). They sell the blockbuster blood thinner Plavix, which brought in more than $4.7 billion in sales last year. Sales of Plavix will be somewhat hurt by prasugrel approval in Europe, but 85% of that $4.7 billion came from the U.S., so it's the FDA's decision that matters most to these two.

The question is, then, does the CHMP recommendation make it more likely that the FDA will approve prasugrel stateside? Unfortunately, it's not clear cut. There are plenty of drugs which were approved by one agency and not the other. Schering-Plough's (NYSE:SGP) Bridion and Pfizer's (NYSE:PFE) Thelin both come to mind as having been approved by European regulators, but not American ones.

With the decision dragging on for so long past the September deadline, my best guess is that there's an internal debate at the FDA over whether the benefits of prasugrel outweigh the side effects -- the drug causes excessive bleeding in some patients. It wouldn't shock me to see the drug sent out to an advisory panel, further delaying any stateside approval.

However, I think prasugrel will eventually get approved, perhaps with a stringent label. Eli Lilly's investors will just have to wait awhile longer. At least they're getting paid well while doing so.

Pfizer and Eli Lilly are Motley Fool Income Investor recommendations. To see how dividend-paying stocks can offer both secure income and the opportunity for growth, take a free look at this newsletter with a 30-day free trial. 

Fool contributor Brian Orelli, Ph.D., drives the long way just so he doesn't have to wait in traffic. He doesn't own shares of any company mentioned in this article. Pfizer is an Inside Value selection and the Fool owns shares. After they took a wrong turn and ended up in Tijuana, the Fool's disclosure policy won't ride in a car with Brian.