Merck's strategy of offering novel medicines that are competitively priced has positioned our products well in the marketplace. Sales of our core product franchises continue to rank either No. 1 or 2 worldwide in large and growing therapeutic areas. This record of success has been achieved by providing patients, physicians and payers with better treatment options and proven value, backed up by rigorous health-outcomes studies.

In 2003, Merck began promoting to physicians and consumers the landmark Heart Protection Study (HPS) with Zocor 40 mg, conducted by Oxford University and funded in part by Merck. The study has provided further evidence of the value of Zocor, Merck's statin for modifying cholesterol. The HPS, the largest statin study conducted to date, demonstrated that Zocor 40 mg, combined with diet, is the first and only cholesterol-lowering medication proven to reduce the risk of heart attacks and stroke in people with heart disease or diabetes, regardless of cholesterol level.

A highly effective agent for hypertension, Cozaar/Hyzaar is the No. 1 angiotensin II antagonist in Europe in terms of sales and is the No. 2 medicine of its kind in terms of sales in the United States. Two major research studies are driving sales: "LIFE," which demonstrated that Cozaar reduces the combined risk of cardiovascular death, heart attack and stroke in patients with hypertension and left ventricular hypertrophy; and "RENAAL," which showed the drug reduces the risk of progressing to end-stage renal disease in which dialysis or transplantation is required for survival in patients with Type II diabetes, hypertension and nephropathy.

Our highly successful osteoporosis treatment, Fosamax, retained its long-standing position as the world's most-prescribed osteoporosis medication in 2003. Fosamax is well-positioned to continue its strong performance as the market and class leader because it is the only agent indicated to reduce osteoporotic fractures consistently at both the hip and spine. Fosamax has strong potential for further growth—fewer than 25 percent of women with osteoporosis have been diagnosed and treated in seven major markets.

Singulair, Merck's once-a-day, non-steroidal oral medication for the treatment of chronic asthma and the relief of symptoms of seasonal allergic rhinitis, remains the No. 1 asthma controller in terms of total prescriptions in the United States and is the most widely used once-daily medicine of its kind in the world, in part because it is the only allergy medicine that blocks leukotrienes, an underlying cause of allergy symptoms, for 24 hours. Singulair continues to have good prospects for growth—within two years, Merck expects to submit applications for potential new uses, including the treatment of perennial allergic rhinitis, respiratory symptoms subsequent to respiratory syncytial virus, acute asthma, the prevention of exercise-induced bronchospasm and a new IV formulation of Singulair to treat acute exacerbations of asthma.

Vioxx, Merck's widely used medicine for pain relief, continues to perform well worldwide, holding the No. 2 sales position in the competitive U.S. coxib market and maintaining its record as the best-selling arthritis and pain medicine outside of the United States. In the United States, 91 million prescriptions for Vioxx have been written since the product launched in 1999. Merck has filed supplemental NDAs with the FDA for new uses of Vioxx to treat acute migraine and juvenile rheumatoid arthritis.

In the United States, more than 5.7 million prescriptions for Zetia, the cholesterol absorption inhibitor from Merck/Schering-Plough Pharmaceuticals, have been filled since the FDA approved the medicine in November 2002, and studies continue to demonstrate the product's safety and effectiveness. Zetia—the first major advance in 15 years with a unique mechanism of action in the treatment of high cholesterol—has been launched in five European countries under the brand name Ezetrol.

Merck's market leadership is testament to the value of our product franchises, the effectiveness of our sales and marketing efforts, and the ongoing strength of our research capabilities. Clearly, our strategy of offering competitively priced, novel medicines that demonstrably improve patients' health will drive our growth.