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Sales Animal Health sales at USD 157 million were up 5% 0% in local currencies ; from the high level of the previous year's first quarter. Sales accelerated dynamically towards the quarter end following a soft start due to the economic uncertainty and unusual weather conditions in key regions. The companion animal franchise grew strongly, driven by double-digit sales growth from Fortekor heart kidney failure in dogs cats ; and complemented by good market share gains by a number of new products launched towards the end of last year. In February, Deramaxx received US approval, extending its indication to chronic pain and inflammation control associated with osteoarthritis in dogs. Sales in the farm animal franchise were led by a continuing strong performance in the Latin American and Asian regions, which helped partially to offset the impact of the prolonged drought on the Australian livestock industry and the adverse market conditions in some European countries and the US. Operating income Operating income decreased 8% to USD 23 million, leading to an operating margin of 14.6%. Investments in Research & Development were higher than in the previous first quarter, owing to the timing of large studies for development projects. Marketing & Sales outlay increased in line with sales to support the recently launched brands. The increased investments were partially offset by a favorable development in the cost of goods sold. Administration of Pegasys 180 micrograms once weekly for 4 weeks in healthy male subjects did not show any effect on mephenytoin, dapsone, debrisoquine and tolbutamide pharmacokinetics profiles, suggesting that Pegasys has no effect on in vivo metabolic activity of cytochrome P450 3A4, 2C9, 2C19 and 2D6 isozymes. In the same study, a 25% increase in the AUC of theophylline marker of cytochrome P450 1A2 activity ; was observed, demonstrating that Pegasys is an inhibitor of cytochrome P450 1A2 activity. Serum concentrations of theophylline should be monitored and appropriate dose adjustments of theophylline made for patients taking theophylline and Pegasys concomitantly. The interaction between theophylline and Pegasys is likely to be maximal after more than 4 weeks of Pegasys therapy.
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Flonase and high blood pressure Tykerb CARES arranges for a specialty pharmacy to fill your patient's prescription and deliver TYKERB to your patient's home, unless she receives TYKERB directly from your office or the treatment center. Tykerb CARES will inform you when TYKERB has been shipped to your patient. Adequate to assure and preserve its identity, strength, purity, and quality 21 CFR 3 14.127 a ; l section 505 j ; 4 ; A ; the Act ; . ANDA applicants must submit, with one exception not relevant here, the same type of CMC information as required in an NDA 2 1 CFR 3 14.94 a ; 9 ; i The required CMC information includes, among other things, " .a description of the manufacturing and packaging procedures and in-process controls for the drug product" and "the specifications necessary to ensure the identity, strength, quality, [and] purity of the drug product " CFR 3 14.50 d ; l ; ii ; 14.94 a ; 9 .~~ GSIC argues that because in vitro tests of product quality are different from in vitro comparative bioequivalence studies, "separate and apart from BE testing, product quality must be evaluated on an absolute basis, to assess whether applicable quality standards are being met with acceptably low variation" GSK November Petition at 6-7 ; . GSK argues that the FDA-approved reductions in relative standard deviations for DSD and SP between 6.6 and 8 percent for DSD and between 6.5 and 11.3 percent for SP ; should set the specifications for ANDA applicants GSK November Petition at 11 - 1 cites GSK Bracco Diagnostics, Inc. v. Shalala, 963 F. Supp. 20 D.D.C. 1997 ; for the proposition that FDA must apply the applicable legal standard for product quality consistently to generic and innovator applicants GSK November Petition at 12-17 ; . GSK argues that the "same principles would apply with equal force here, were FDA to approve generic fluticasone propionate nasal spray prod~~cts have not been shown to meet that specifications for DSD and SP comparable to those that were required for Glonase under S-019" Id. at 16 ; . The CMC review of a proposed product includes the review of the manufacturing process and results in a set of specifications a combination of test and acceptance criteria for a and astelin. We have audited the Group and parent Company financial statements the "financial statements" ; of Flomerics Group PLC for the year ended 31 December 2007 which comprise the consolidated income statement, the consolidated statement of changes in equity, the consolidated balance sheet, the consolidated cash flow statement, the related notes 1 to 34 and the Company balance sheet and related notes A to K. These Group financial statements have been prepared under the accounting policies set out therein. Respective responsibilities of Directors and auditors The Directors' responsibilities for preparing the annual report and Group financial statements in accordance with applicable law and International Financial Reporting Standards IFRSs ; as adopted by the European Union and for preparing the parent Company financial statements in accordance with applicable law and United Kingdom Accounting Standards United Kingdom Generally Accepted Accounting Practice ; are set out in the statement of Directors' responsibilities. Our responsibility is to audit the financial statements in accordance with relevant legal and regulatory requirements and International Standards on Auditing UK and Ireland ; . We report to you our opinion as to whether the financial statements give a true and fair view and have been properly prepared in accordance with the Companies Act 1985 and whether the information given in the Directors' report is consistent with those financial statements. We also report to you if, in our opinion, the Company has not kept proper accounting records, if we have not received all the information and explanations we require for our audit, or if information specified by law regarding Directors' remuneration and other transactions is not disclosed. We read other information contained in the annual report, and consider whether it is consistent with the audited financial statements. This other information comprises only the Chairman's statement, the Chief Executive's Review, the business review and the Directors' report. We consider the implications for our report if we become aware of any apparent misstatements or material inconsistencies with the financial statements. Our responsibilities do not extend to any other information. Our report has been prepared pursuant to the requirements of the Companies Act 1985 and for no other purpose. No person is entitled to rely on this report unless such a person is a person entitled to rely upon this report by virtue of and for the purpose of the Companies Act 1985 or has been expressly authorised to do so our prior written consent. Save as above, we do not accept responsibility for this report to any other person or for any other purpose and we hereby expressly disclaim any and all such liability. Basis of audit opinion We conducted our audit in accordance with International Standards on Auditing UK and Ireland ; issued by the Auditing Practices Board. An audit includes examination, on a test basis, of evidence relevant to the amounts and disclosures in the financial statements. It also includes an assessment of the significant estimates and judgments made by the Directors in the preparation of the financial statements, and of whether the accounting policies are appropriate to the Group's and Company's circumstances, consistently applied and adequately disclosed. We planned and performed our audit so as to obtain all the information and explanations which we considered necessary in order to provide us with sufficient evidence to give reasonable assurance that the financial statements are free from material misstatement, whether caused by fraud or other irregularity or error. In forming our opinion we also evaluated the overall adequacy of the presentation of information in the financial statements. Opinion In our opinion: the Group financial statements give a true and fair view, in accordance with IFRSs as adopted by the European Union, of the state of the Group's affairs as at 31 December 2007 and of its loss for the year then ended; the parent Company financial statements give a true and fair view, in accordance with United Kingdom Generally Accepted Accounting Practice, of the state of the parent Company's affairs as at 31 December 2007; the financial statements have been properly prepared in accordance with the Companies Act 1985; and the information given in the Directors' Report is consistent with the Group financial statements.

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Peter Kellogg - Merck & Co., Inc. - EVP & CFO I would like to take the question on GARDASIL, if the I could, David. Clearly, GARDASIL has gone through a just a excellent launch this year and the team has done a great job of driving penetration in the primary nine to 18-year-old female group and obviously, they've done quite well in the first year of the launch and they'll continue to drive that. As our label expands and as we kind of set our sights to other groups, obviously you'll see some expansion in those other areas as well. I think our guidance -- we don't break out guidance, obviously, for individual products, but I think one of the things that's true for GARDASIL, and just generally for all vaccines, is you obviously have to model this, which you all are well aware, based on cohorts and penetration and then the continuing label expansion that really allow you to move further. We did talk a lot about the different sPLAs that we're submitting next year. And over a number of years that obviously will drive further penetration in other areas such as those. So I think you have to look at the vaccines business, both in the context of cohorts penetration, but also you have to see it as a multi-year growth program to work your way through the populations initially and then settle in on the continuing flow of populations into the indicated areas. So as we pull all that together, we do recognize that GARDASIL's just had a phenomenal year in 2007 and we also have set kind of very appropriate targets for next year, given all those factors. The following is a list of the most commonly prescribed drugs. It represents an abbreviated version of the drug list formulary ; that is at the core of your pharmacy benefit plan. The list is not all-inclusive and does not guarantee coverage. In addition to using this list, you are encouraged to ask your doctor to prescribe generic drugs whenever appropriate. Over-the-counter medications are not covered under the pharmacy benefit. The following is a list of some non-formulary brand medications with examples of selected alternatives that are on the formulary. Thank you for your compliance. Non-Formulary Accuretic Aceon Aciphex Activella Aerobid M Allegra, D Alphagan P Altocor Atacand Atacand HCT Avalide Avapro Avinza Axert Azelex Azmacort Beconase AQ QL ; Benicar Benicar HCT Cardene SR Cardizem CD Catapres-TTS Ceclor Cedax Cenestin Clarinex Covera- HS Dipentum Dynabac Dynacirc CR Estraderm Focalin Frova QL ; Glyset Helidac Kadian Lamisil topical Lescol, XL Lorabid Lumigan Mavik Maxalt, mlT QL ; Maxaquin Metadate CD, ER Micardis Micardis HCT Monopril HCT Nasarel QL ; Formulary Alternative enalapril hctz, lisinopril HCTZ, Lotensin HCT G ; captopril, enalapril, lisinopril, Altace, Lotensin G ; omeprazole 10mg ; QL ; , Nexium PAR ; QL ; , Protonix PAR ; , Prilosec OTC FemHRT, Prempro Premphase Flovent QL ; , Pulmicort QL ; , Qvar QL ; OTC Alavert, OTC Claritin, OTC loratadine brimonidine tartrate lovastatin, Pravachol G ; , Zocar G ; , Lipitor Cozaar, Diovan Diovan HCT, Hyzaar Diovan HCT, Hyzaar Cozaar, Diovan Generics, MS Contin Amerge QL ; , Imitrex QL ; , Zomig ZMT QL ; Generics, Differin PAR ; Flovent QL ; , Pulmicort QL ; , Qvar QL ; Flonwse QL ; G ; , Nasacort QL ; , Nasonex QL ; Cozaar, Diovan Diovan HCT, Hyzaar nifedipine extended release, Norvasc diltiazem extended release clonidine hcl cefaclor extended release amox tr potassium clavulanate, Augmentin ES G ; , Augmentin XR Premarin OTC Alavert, OTC Claritin, OTC loratadine verapamil extended release Asacol, Pentasa, Rowasa erythromycin, Biaxin G ; , Biaxin XL, Zithromax G ; nifedipine extended release, Norvasc Generics, Climara G ; methylphenidate, Concerta Amerge QL ; , Imitrex QL ; , Zomig ZMT QL ; Precose Prevpac Generics, MS Contin OTC Lamisil lovastatin, Pravachol G ; , Zocor G ; , Lipitor amox tr potassium clavulanate, Augmentin ES G ; , Augmentin XR Travatan, Xalatan captopril, enalapril, lisinopril, Altace, Lotensin G ; Amerge QL ; , Imitrex QL ; , Zomig ZMT QL ; Avelox, ciprofloxacin, ofloxacin, Levaquin methylphenidate Cozaar, Diovan Diovan HCT, Hyzaar enaplapril hcyz, lisinopril hctz, Lotensin HCT Flonnase QL ; G ; , Nasacort QL ; , Nasonex QL ; Non-Formulary Optivar Oxytrol Penetrex Pravigard Prevacid QL ; PAR ; Protopic Prozac Weekly QL ; Quixin Relenza Relpax Rescula Restoril 7.5mg Rhinocort AQ Risperdal M-Tab Ritalin, LA Serzone Skelid Sonata QL ; Spectracef Sular Suprax Tarka Tequin Testoderm Testim Teveten Teveten HCT Uniretic Vancenase AQ QL ; Vantin Ventolin QL ; Vexol Vivelle-Dot Zagam Zyflo Zyprexa Zydis Zyrtec Formulary Alternative Patanol, Zaditor Detrol LA G ; Avelox, ciprofloxacin, ofloxacin, Levaquin lovastatin, Pravachol G ; , Zocor G ; , Lipitor Omeprazole 10mg ; QL ; , Nexium PAR ; QL ; , Protonix PAR ; , Prilosec OTC Elidel fluoxetine daily ; , Celexa 10mg and 40mg ; G ; , Lexapro PAR ; , paroxetine, Paxil CR, Zoloft 25mg and 100mg ; G ; Ciloxan, Vigamox rimantadine Amerge QL ; , Imitrex QL ; , Zomig ZMT QL ; Travatan, Xalatan temazepam Flonqse QL ; G ; , Nasacort QL ; , Nasonex QL ; Risperdal non M-tabs ; methylphenidate, Concerta, Strattera non-stimulant ; bupropion, Effexor G ; , Effexor xr, mirtazapine, Wellbutrin SR PAR ; Actonel, Didronel G ; , Evista, Fosamax Ambien QL ; amox tr potassium clavulanate, Augmentin ES G ; Omnicef nifedipine extended release, Norvasc amox tr potassium clavulanate, Augmentin ES G ; , Augmentin XR, Omnicef verapamil + ACE inhibitor, Lotrel Avelox, ciprofloxacin, ofloxacin, Levaquin Androderm, Androgel Androderm, Androgel Cozaar, Diovan Diovan HCT, Hyzaar enalapril hctz, lisinopril hctz, Lotensin HCT Flonase QL ; G ; , Nasacort QL ; , Nasonex QL ; amox tr potassium clavulanate, Augmentin ES G ; Augmentin XR, Omnicef albuterol inh QL ; , Maxair Auto QL ; , Proventil HFA QL ; Generic steroids, Lotemax Generics, Climara G ; Avelox, ciprofloxacin, ofloxacin, Levaquin Singulair PAR ; Zyprexa non-Zydis ; OTC Alavert, OTC Claritin, OTC loratadine and aristocort.

5.1.5 Hepatic Coma Assessment of the efficacy of a particular treatment is made difficult by the severity of the clinical picture, the heterogenicity of the underlying liver diseases and the large number of life-saving measures employed simultaneously. First experiences with EPL in hepatic coma and pre-coma came from studies by E. Rottini et al. 586 ; and Y. Sakai et al. 592 ; who obtained good results. P. Davcev and V. Serafimovski 132 ; administered a basic treatment consisting of ammonia-lowering agents, glucocorticoids and a low-protein diet to 55 comatose patients by intubation. 35 of these patients received, in addition, EPL in form of a continuous drip infusion. In this group, the reduction in the highly pathological ammonia values as well as in the AST and AP activities in serum was more pronounced than in the controls. 18 out of 35 patients in the EPL group and 7 out of 20 patients in the control group awoke from their coma. However, the extent to which EPL contributes to a better prognosis in hepatic coma remains to be clarified. In 1989 E.Kuntz 390 ; published his results with a new galenic EPL application see chapter 6.2.2. ; . The patients with severe liver insufficiency received in this pilot study 3g of EPL day i.v. for 8-16 days. Seven of the 10 patients showed a clear improvement. After termination of the 4-week period of observation 9 of the 10 patients were still alive and had a recompensated and stabilized condition. In a recent randomized open clinical trial 28 patients with acute icteric fulminant hepatitis and 22 patients with fulminant hepatitis on chronic active hepatitis or on decompensated cirrhosis of the liver were divided into 2 groups. 2Q04 Dom. Drugs OTC ETC Exports Total 65.6 9.9 51.7 Chg. 24.8 -24.2 36.8 -16.5 17.1 Note Decrease of OTC sales, increase of ETC sales Influenced by anemic domestic economy The amoldipine and glimepide sales recorded W11.6bn and beconase.
The patent position with respect to the active ingredients in significant products is as follows: Avandia and Avandamet. The patent on rosiglitazone is not due to expire until 2012a, c USA ; and 2013b Europe ; . Patents on the commercial form of the active ingredient rosiglitazone maleate are not due to expire until 2015 USA ; and 2014b Europe ; . Litigation challenging the validity of the patents protecting these products is ongoing in the USAe. Avodart. The patent on dutasteride is not due to expire until 2015a USA ; and 2017b Europe ; . Combivir. The patent on the specific combination of lamivudine and zidovudine is not due to expire until 2012 USA ; and 2013b Europe ; . Coreg. GSK is the exclusive licensee under the US patent on carvedilol, which is not due to expire until 2007a, c. Epivir. The patent on lamivudine is not due to expire until 2010a, c USA ; and 2011b Europe ; . Flixotide Flovent and Flixonase Flonase. The patents on fluticasone propionate have expired in the EU and USA. Generic competition to Flixonase exists in the EU and the FDA recently approved a generic version of Flonase in the USAe. Imigran Imitrex. The patent on sumatriptan is not due to expire until 2009c USA ; and generally 2006b Europe, except 2008b Italy . Litigation challenging the validity of the patent protecting this product is ongoing in the USAe. Lamictal. The patent on lamotrigine is not due to expire until 2009a, c USA ; . Litigation challenging the validity of this patent in the USA has been settlede. In Europe, the corresponding patent has expired and generic competition exists. Levitrad. GSK has co-promotion rights under the US patent on vardenafil which is not due to expire until 2018 in the USA. Lexiva Telzir. GSK is the exclusive licensee under the patent on fosamprenavir, which is not due to expire until 2017 USA ; and 2019b Europe. If you are pregnant or intending to become pregnant ; , If you are breastfeeding a baby, If you are allergic to FLONASE Nasal Spray or any other nasal corticosteroid, If you are taking a medicine containing ritonavir commonly used to treat HIV infection or AIDS ; , TELL YOUR DOCTOR BEFORE STARTING TO TAKE THIS MEDICINE. In some circumstances, this medicine may not be suitable and your doctor may wish to give you a different medicine. Make sure that your doctor knows what other medicines you are taking and deltasone. Bulk-forming laxatives Only to be used if an increase in dietary fiber does not work. They act by causing retention of fluid and an increase in fecal mass. Flatulence and distension may occur, but long-term use is safe. Adequate fluid intake is essential. Stimulant laxatives These act by directly stimulating the colonic nerves. The effect is usually within 8 12 hours; suppositories are faster, at 2060 minutes. Routine use of danthron is discouraged due to its potential carcinogenicity. Osmotic laxatives These act by retaining fluid in the bowel by osmosis, changing the water distribution in the feces. This means that a good fluid intake is important. Specific situations The elderly Pregnancy. In Europe, a number of projects conducted in 2005 are indicative of the Group's determination to work through social dialogue to cope with the situations arising from the merger of the two organizations that formed sanofi-aventis. For example, in the United Kingdom, a forum of employee representatives from the various Research and Development, Industrial and Commercial Operations sites was established in 2005, going far beyond legal obligations, in order to encourage social dialogue between the unions, employees and management. The forum meets once a quarter, alternating between different sites, and discusses economic and social issues employment, workforce, organizations ; , as well as Research, Production and Marketing prospects and flovent and Cheap flonase online. Worse, but the mental health scales were comparable to healthy Finns. The mean score on emotional role functioning was even better than in the general population. When the study populations were pooled, increasing degree of age was associated with increasing scores on mental health and vitality figure 5 ; . Men scored 5 points higher on physical functioning and vitality. Increasing degree of BMI was associated with decreasing scores on physical functioning, bodily pain, general health, mental health, and vitality. The mean sd ; OP scale score was 60.1 24.3 ; in the pooled population n 164 ; . Increasing degree of age and BMI were associated with higher score indicating more obesity-related psychosocial problems figure 6 ; . Women scored higher than men on the OP scale.
Healthcare accounts: Salix Pharmaceuticals: Rifaxamin, Colazal, Azasan; Valeant Pharmaceuticals: Permax, Zelapar, Mestinon, corporate; Duke University Health System; Merz Pharmaceuticals: Mederma, Appearex; Misys Healthcare Systems; GlaxoSmithKline: Flonase professional ; , projects; Ortho-Clinical Diagnostics: projects; Sentara Health Systems: media, projects; EMD Pharmaceuticals: projects. Accounts gained 4 ; : Valeant Pharmaceuticals: Permax, Zelapar, Mestinon, corporate; Merz Pharmaceuticals: Mederma, Appearex; Salix Pharmaceuticals: Azasan; Duke University Health System. Accounts lost 1 ; : US Oncology: resigned due to conflict with Duke Cancer Centers ; . Services: Medical communications division, marketing consulting, branding and strategic positioning, sales training materials. Divisions: Healthcare, Consumer, Business to Business and benadryl.
Per year through 2004. 5 If that comes to pass, Americans will spend an estimated 8 to 4 billion on prescription drugs in 2005 and drug spending will represent as much as 14 percent of all health care spending, up from around 10 percent in 2000. The primary driver of this trend is the increase in the number of prescriptions being written, and the shift to newer, more expensive drugs.6 Numerous observers FIGURE 1 have raised concerns about whether mass Promotional Cumulative expenditure in Share of DTC Share of DTC media ads are inapproTherapeutic Category Rank Brand Name Spending 1999 $million ; Spending priately inducing demand for some new prescription 9% 1 Oral Antihistamine Claritin 136.8 9% 5% Antiulcerant Prilosec 79.4 14% medicines. They worry that 5% 3 Anti-obesity Xenical 76.2 18% people are beginning to 4% Male pattern baldness Propecia 71.1 23% ask their doctors for newer 4% 5 Oral antihistamine Zyrtec 57.1 26% 3% Cholesterol reducer Lipitor 55.5 30% and costlier medicines 3% 7 Smoking cessation Zyban 53.9 33% when less expensive drugs 3% 8 Respiratory steroids inhaled ; Flonase 53.5 37% may work just as well in 3% 9 Sexual function disorder Viagra 53.0 40% 3% Respiratory steroids inhaled ; Nasonex 52.3 43% many cases. There is also 3% 11 Oral contraceptives Ortho tri-cyclen 50.1 46% mounting concern that a ; 3% 12 Anti-obesity Meridia 43.5 49% mass media ads transform 3% 13 Oral diabetes Glucophage 43.1 52% 3% Oral anitihistamine Allegra 42.8 55% medicines into just another 3% 15 Antiviral Valtrex 40.9 57% consumer product and 2% 16 Bladder control Detrol 39.6 60% b ; put pressure on drug 2% 17 Cholesterol reducer Zocor 35.0 62% 2% Menopause Prempro 34.7 64% makers to build "brand" 2% 19 Anti-migraine Zomig 34.4 66% name products that may 2% 20 Respiratory steroids inhaled ; Flovent 31.7 68% have misplaced consumer 2% 21 Antidepressant Paxil 31.5 70% 2% Antiarthritic Celebrex 27.6 72% allegiance. 2% 23 Asthma control Singulair 25.4 74% Proponents of DTC 2% 24 Anti-alzheimer Aricept 25.2 75% advertising argue that the 2% 25 Asthma control Accolate 25.0 77% 1% Breast cancer Nolvadex 23.7 78% ads have added enor1% 27 Allergic conjunctivitis Patanol 23.0 80% mously to the information 1% 28 Smoking cessation Nicotrol inhaler 19.7 81% consumers are getting 1% 29 Antivirals Relenza 19.3 82% 1% Lyme disease vaccine Lymerix 18.3 83% about prevalent health 1% 31 Anti-migraine Imitrex 18.0 84% conditions and diseases. 1% 32 Menopause CombiPatch 17.8 85% They say the ads make 1% 33 Antiarthritic Vioxx 17.1 87% 1% Fungicide Ditropan XL 15.8 88% people aware of potential 1% 35 Antiviral Denavir 15.5 89% treatment options and fa1% 36 Anti-anemia Procrit 15.2 89% cilitate dialogue between 1% 37 Wrinkle control Renova 13.4 90% 1% Antifungal Diflucan 12.1 91% doctors and patients about 1% 39 Antiarthritic Enbrel 10.4 92% diseases and conditions 1% 40 Benign prostate disease Flomax 10.1 92% that are widely under1% 41 Respiratory steroids inhaled ; Nasacort AQ 9.6 93% 1% Antiarthritic Synvisc 9.0 94% treated in the U.S. such 1% 43 Acne treatment Differin 8.7 94% as early heart disease, 1% 44 Fungicide Lamisil 8.1 95% diabetes, depression and 1% 45 Oral diabetes Rezulin 7.7 95% 1% Menopause Premarin 7.6 95% high blood pressure ; . 1% 47 Menopause Cenestin 6.9 95% A cause-and-effect 1% 48 Diabetes non-oral ; Humulin 6.9 95% relationship between DTC 1% 49 Pregnancy prevention Depo-Provera 6.2 95% 1% Oral diabetes Avandia 5.9 95% ads and the rise in drug 3% Rest of Market 50.3 5% prescriptions and pharmaceutical spending has not Total 1, 590.2 100% been firmly established. SOURCE: American Institutes for Research analysis of Competitive Media Reporting data as presented in June, 2000 Med Ad News But many observers infer billion in 1997. It rose to .4 billion in 1998, an 18.4 percent increase. It jumped again to 1.1 billion in 1999, a 19 percent increase over 1998. Expenditures per person rose from an average 0 in 1998 to 7 in 1999, up 17 percent.4 Recent studies project that prescription drug spending will increase on the order of 12 to18 percent. Flonase Ditropan XL, Vesicare pts 65 yrs still require to step thru generic oxybutinin ; Detrol LA Grandfathering: all patients with Detrol-LA claims in their most recent 3months dispensing history. Grandfathering period will be limited to 3 months from the time of provider notification.

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