Aug. 23 (Bloomberg) -- Pfizer Inc. increased second-quarter revenue from its Lipitor cholesterol pill by convincing doctors to prescribe more-expensive doses of the drug, the world's best- selling prescription medicine.

The number of patients taking the highest doses of Lipitor in June rose by more than 10 percent compared with May, analysts said. A 10 milligram Lipitor pill costs $2.44, while the 40 mg. and 80 mg. doses are $3.33 each, or 36 percent more, said the Web site Drugstore.com.

Selling more of the higher-priced pills helped New York- based Pfizer raise Lipitor revenue last quarter by 2 percent to $3.1 billion, even though about the same number of patients took the drug. Pfizer, the world's biggest drugmaker, said it sent thousands of sales representatives to doctors' offices touting studies showing that higher doses cut the risks of heart attack, stroke and death better than other cholesterol drugs.

``I think that is a very smart and savvy strategy, and there is a good medical rationale behind that,'' said Chris Schott, an analyst with Banc of America Securities in New York, in an Aug. 17 telephone interview. Analysts said they didn't expect an increase in Lipitor revenue in the quarter.

Lipitor, with $12.2 billion in 2005 sales, is up against competition from new cholesterol-reducing products, such as Merck & Co. and Schering-Plough Corp.'s heavily advertised Vytorin. Insurance companies and employers are also encouraging doctors and patients to switch to cheaper generic copies of Merck's cholesterol pill, Zocor, which lost its patent in June.

40 Percent of Profit

The drugmaker's shares rose by 16 cents to $27.14 at 4 p.m. in New York Stock Exchange composite trading. The shares have gained 16 percent since Pfizer reported July 20 that second- quarter profit increased 10 percent on Lipitor sales.

Pfizer needs to keep Lipitor revenue growing as the drug generated about 40 percent of Pfizer's 2005 profits, estimated Deutsche Bank analyst Barbara Ryan.

In June, high-dose Lipitor prescriptions rose by about 10 percent, said John Boris, an analyst with Bear Stearns in New York. Prescriptions fell 10 percent for the lower dosage, which accounted for about 30 percent of sales last year, he said.

During the week of Aug. 11 prescriptions for the lowest dose fell 10.3 percent while the highest dose grew by 11.9 percent, said Chris Shibutani, an analyst with JP Morgan Securities Inc.

``We ought to be encouraging physicians to move their patients to the higher doses,'' Peter Brandt, head of Pfizer's U.S. drug division, said in a July 20 investor call.

$1 Billion in Studies

Pfizer has spent more than $1 billion studying Lipitor in more than 400 trials involving 80,000 patients since it came on the market in 1996, said Vanessa Aristide, a Pfizer spokeswoman. The studies help show the drug, in various dosages, was safer or more effective than competing drugs, she said.

In May, the American Heart Association and American College of Cardiology recommended doctors lower heart patients' so- called bad cholesterol, also known as LDL, to less than 100 milligrams per deciliter of blood. That recommendation benefits Lipitor's higher doses as they are better at bringing down blood cholesterol levels than the lower doses.

`The more aggressive goals will take higher doses to get to,'' said Steven Nissen, president of the American College of Cardiology and head of Cleveland Clinic's cardiology department.

Some heart experts say the company's promotion may spur doctors to prescribe higher doses for everyone, even though the majority of patients don't need them, said Steven Findlay, a health policy analyst for Consumers Union, a Washington, D.C.- based non-profit and publisher of Consumer Reports magazine.

Statins

Lipitor and Zocor, known as statins, work by blocking an enzyme that helps produce cholesterol in the liver. Statins may also help the body absorb some of the fatty lipids that have latched onto the artery walls.

A study published in April 2004 in the New England Journal of Medicine laid the groundwork of Pfizer's pitch for using higher Lipitor doses. The research, in people who had heart attacks or chest pain, found that reducing cholesterol as low as 65 mg. per deciliter of blood results in fewer heart ailments.

The American Heart Association says that people at moderate risk -- those whose cholesterol is elevated and who haven't suffered a heart attack or chest pain -- can use weaker drugs to meet the conventional target of reducing LDL cholesterol to below 130 mg.

Need

``Most people who take a statin and most of the people who need a statin do not need to be on a high dose, especially 40 or 80 milligrams,'' Consumers Union's Findlay said.

A second study found that those taking a high dose of Lipitor had lower cholesterol levels than people on a standard regimen of Zocor. The study said Zocor patients weren't more likely to die, have cardiac arrest or experience a heart attack.

``There is a cost factor here for society,'' Findlay said. ``This is the age-old dilemma for treating an individual patient. The doctors says, `Forget the costs, I just want to give them the best drug,' but society and insurers and the Medicare program have to ask, `Do we really need these people on 40 or 80 milligrams of Lipitor?'''

To contact the reporter on this story: Shannon Pettypiece in Washington at spettypiece@bloomberg.net

Last Updated: August 23, 2006 16:13 EDT