Merck & Co., Inc.

Meeting patients' needs through product innovation
Meeting patients' needs through product innovation

The foundation of Merck’s strength, and the engine of its growth, has always been the novel medicines we discover and develop to meet the healthcare needs of patients, physicians and payers. Merck’s franchises continue to drive growth, supported by new products, indications, formulations and clinical trials. At the same time, we are rapidly building our capacity to successfully compete in new therapeutic areas such as diabetes, insomnia and cancer and new vaccine markets. That capacity has been further enhanced by the redeployment of the talented Merck sales representatives who had previously supported Vioxx.

Our ability to continue to expand our position in the growing cholesterol market was further strengthened by the successful launch of Vytorin from Merck/Schering-Plough Pharmaceuticals. (See right.) Vytorin is marketed as Inegy in many countries outside of the U.S. Meanwhile, Zetia, the cholesterol-absorption inhibitor launched by Merck/Schering-Plough in 2002, is now reimbursable for nearly 90 percent of all patients in managed care plans in the U.S. Zetia, marketed as Ezetrol outside of the U.S., is currently sold in more than 50 countries.

Zocor, Merck’s statin for modifying cholesterol, and Cozaar/Hyzaar, our highly effective medicines for hypertension, rank either No. 1 or 2 in their respective classes based on worldwide sales.

Fosamax is the most prescribed medicine in the world for treatment of osteoporosis. As previously noted in this report, we are pursuing options in light of the January 2005 court ruling that found Merck’s patent claims for Fosamax Once Weekly to be invalid. Meanwhile, we plan to capitalize on opportunities to grow this franchise. For example, we will promote a study comparing FDA-approved once-weekly osteoporosis treatments in post-menopausal women with osteoporosis. The study showed that Fosamax Once Weekly demonstrated significantly greater increases in bone mineral density. Increases in bone mineral density improve bone strength and help reduce the risk of fractures.

We have an opportunity to further expand the franchise by combining the active ingredient in Fosamax with Vitamin D, which is critical for calcium absorption and bone strength. That enhancement is expected to help osteoporosis patients who have inadequate levels of Vitamin D.

Singulair, our asthma and seasonal allergy medicine, continues to be the second-most-prescribed product in the overall respiratory market in the U.S., and we are continuing to seek approval for important new indications as new clinical data become available. In the second half of 2004, we filed with the FDA for a new indication for perennial allergic rhinitis. Later this year, we expect to file for the use of Singulair to prevent exercise-induced bronchospasm. We plan to file for additional indications for acute asthma during the second half of 2006 and for respiratory syncytial bronchiolitis in 2008.

Merck’s ability to build on the strengths of our existing product franchises, coupled with our dedication to discovering and developing medicines and vaccines that address significant unmet medical needs, help us to continue to fulfill our obligation to patients and shareholders alike.

In addition to the cholesterol that comes from food, the body also produces it naturally, making heredity a critical factor in determining the overall amount of cholesterol in the bloodstream. Research shows that treating the two sources of cholesterol can significantly lower LDL (bad) cholesterol levels, especially when combined with diet and exercise.

Vytorin provides powerful LDL cholesterol reduction by inhibiting cholesterol production in the liver while also helping to block absorption of the cholesterol from food. Vytorin has gained strong acceptance among patients, physicians and payers since it was approved by the FDA in July. Its launch is considered to be one of the most successful product introductions in the category of cholesterol-lowering medicine.

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