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Sanofi's Lantus Cancer Scare Shows How Enormous Power Lies With Few Experts

The cancer scare over Sanofi-Aventis' Lantus shows just how much power over a company's drug sales -- and its stock -- are now concentrated in the hands of a tiny number of experts. Sanofi CEO Chris Viehbacher came out of his corner swinging Monday, saying an article in Study of Diabetes journal Diabetologia that called for more research into a potential link between Lantus and cancer was "of poor quality." He also said that "quick and dirty" studies of the link were not the answer.

Although Sanofi's stock declined on Friday's news, Viehbacher may just have dodged the bullet on Lantus, a diabetes med. A note to investors from Leerink Swann's Seamus Fernandez and Kathryn C. Alexander said that Sanofi should not expect catastrophic damage to its stock unless the Cleveland Clinic's Steve Nissen or FDA's David Graham (or someone like them) get involved.

One bad word from the Nissens and Grahams of the world, and you can expect more than the 8 percent that Sanofi lost. The Leerink note added:

1) U.S. media scrutiny is limited so far,

2) results were provocative but far from convincing, and

3) the data are not being championed by a U.S. safety hawk like the Cleveland Clinic's Steve Nissen or FDA's David Graham.

Curiously, after Viehbacher dismissed small studies as the way to go for monitoring Lantus' safety risks, he dismissed larger studies, too:
A large randomised prospective study, however, would not be practical since it would take too long to produce a result, Viehbacher said. Instead, the company may collaborate with other research groups to provide a robust answer.
"Robust" meaning "will stand up to/defy scrutiny from investors, the media and the 'safety hawks,'" presumably.

Meanwhile, champagne corks are popping over at Novo Nordisk, whose Levemir analog stands as the main beneficiary of patients switching away from lantus. Its stock was up 6 percent on the news.

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