10 direct-to-consumer drugs by sales

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1 LIPITOR $6.6 billion U.S.

With a record $7.97 billion in sales in 2002, Lipitor was on an 11% growth pace through October of this year and could threaten its own lofty mark. The cholesterol-fighting drug from Pfizer is also the second-most frequently prescribed medication in the U.S. Lipitor is so well-known that at one point Pfizer was running a 15-second version of a spot, from agency Merkley Newman Harty & Partners, New York, in which the product name is said but no indication of what it treats was mentioned.

2 ZOCOR $4.3 billion

Not surprisingly, Merck's own cholesterol-lowering medication is second to Lipitor in U.S. sales. The prescription medication, along with a healthy diet, has also proved to be effective in lowering the risk of heart attack and stroke in people with diabetes or heart disease, regardless of their cholesterol level. WPP Group's Ogilvy Healthcare, a division of Ogilvy & Mather, New York, handles the account.

3 PREVACID $3.9 billion

While Nexium is all the rage in the proton pump inhibitor category, TAP Pharmaceuticals' Prevacid actually has $1 billion more in sales than its little purple peer. Prevacid relieves heartburn pain and blocks the stomach's acid-producing mechanism from causing further irritation. It can also heal damage to the esophagus and keep damage from returning if used as maintenance therapy. Merkley Newman Harty & Partners handles.

4 PROCRIT $3.3 billion

A blockbuster from Johnson & Johnson's Ortho Biotech division, Procrit is used to fight anemia (a lack of red cells or hemoglobin in the blood) in patients who have cancer, HIV, kidney disease or are undergoing chemotherapy. The anemia causes fatigue and shortness of breath. Procrit helps patients produce red blood cells in the same manner the body does naturally. Omnicom's DDB Worldwide, New York, is the agency of record.

5 ZYPREXA $3.2 billion

Developed by Eli Lilly & Co., Zyprexa is a treatment for schizophrenia; for maintenance of treatment response in schizophrenia; and for treatment of acute mania associated with bipolar I disorder in patients displaying a manic or mixed episode. Zyprexa is the most widely prescribed drug in the category, with 11 million people having used it since its approval in 1996. Zyprexa makes up a third of Lilly's overall sales.

6 EPOGEN $3.0 billion

A genetically engineered drug from biotech firm Amgen, Epogen is a recombinant version of a human protein that stimulates the production of red blood cells and is used in the treatment of anemia associated with chronic renal failure for patients on dialysis. The medication works the same way as naturally produced erythropoietin in that it "tells" bone marrow to make red blood cells, which carry oxygen throughout the body.

7 NEXIUM $2.8 billion

One of the more difficult things in the pharmaceutical business has been making the transition from blockbuster to successor drug. AstraZeneca did it, and did it with fabulous results in going from heartburn medication Prilosec to Nexium, the aforementioned "little purple pill." AstraZeneca spent $198 million in measured media in 2002, according to TNS Media Intelligence/CMR, and $192 million of it was for Nexium. Omnicom's Klemtner Advertising, New York, handles.

8 ZOLOFT $2.8 billion

Pfizer's anti-depressant trailed competitor Paxil, from GlaxoSmithKline, by almost $50 million sales in 2002. Through October of this year, Zoloft has had a 10% increase in sales while Paxil has dropped 19%. Pfizer is awaiting new work on the drug from Publicis Groupe's Kaplan Thaler Group, New York, which won the account after the marketer dropped Interpublic's Deutsch from Zoloft, Zyrtec and Bextra earlier this year.

9 CELEBREX $2.5 billion

Celebrex, also from Pfizer, is the market leader in the anti-arthritis category. It is also approved to treat acute pain and painful menstrual cramps, or dysmenorrhea. It works by inhibiting the COX-2 enzyme, which affects pain and inflammation. The drug-maker took the account away from WPP's J. Walter Thompson during the three-way Zoloft-Zyrtec-Bextra review, and put it up for a shootout between Kaplan Thaler Group and Arnold Worldwide. Kaplan Thaler prevailed.

10 NEURONTIN $2.4 billion

Yet another blockbuster from Pfizer, giving the pharmaceutical giant four of the top 10 drugs according to sales. Neurontin has three efficacies: It treats postherpetic neuralgia, pain that lingers after shingles has healed. The pain may result from nerve damage caused by shingles. It also helps control partial seizures in adults and children with epilepsy. Patients over the age of 3 take it with other medicines to control epilepsy.

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