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According to Surveyed Physicians, Oral Vancomycin and Optimer/Cubist/Astellas’ Dificid are the Top Performing Drugs in the

  According to Surveyed Physicians, Oral Vancomycin and
  Optimer/Cubist/Astellas’ Dificid are the Top Performing Drugs in the
  Treatment of CDAD

       BioTrends Research Group and Arlington Medical Resources Release
       TreatmentTrends^®:Clostridium difficile Infections (U.S.) Report

Business Wire

EXTON, Pa. -- December 17, 2012

BioTrends Research Group and AMR in their TreatmentTrends^®: Clostridium
difficile Infections (U.S.)  report find that metronidazole and oral
vancomycin continue to be the workhorse drugs for the treatment of Clostridium
difficile-associated diarrhea (CDAD), but metronidazole is likely to lose
market share, owing to metronidazole treatment failures. Furthermore,
physicians perceive both oral vancomycin and Optimer/Cubist/Astellas’ Dificid
(fidaxomicin) as the leading performers in areas that are important to
prescribing practices for CDAD, including lower risk for relapse, efficacy in
severe CDAD, and efficacy in recurrent infections. Moreover, about half of
surveyed physicians indicate that fidaxomicin, Salix’s Xifaxan (rifaximin),
and fecal transplants stand to gain from increases in physician use in the
next 12 months.

Surveyed physicians also note that a notable segment of the CDAD patient
population is unable to take oral capsules, and approximately 40 percent of
CDAD patients are administered therapies via alternative routes, including IV,
enema, and nasogastric tube. Indeed almost all physicians report using IV
metronidazole in the past 12 months for CDAD, but, nearly one-third have also
used Pfizer’s IV Tygacil (tigecycline) for this indication.

“In addition to the overall need for effective therapies with high cure rates,
therapies that prevent CDAD recurrences, and for those that have proven
efficacy in recurrent infections, effective IV CDAD therapies also have a
place in the CDAD market, specifically among patients that cannot tolerate
oral therapies,” said Associate Therapeutic Class Director of Infectious
Diseases Brenda Perez-Cheeks, Ph.D. “This is an area where tigecycline, which
has potent activity against C. difficile and is emerging as a salvage therapy
for CDAD, could gain patient share and differentiate itself from the
competition”

With respect to emerging CDAD therapies, physicians generally have low
awareness of agents in development for treatment of CDAD; approximately 10
percent of physicians are aware of Merck’s 3415A and Cubist’s CB-315, while
only 4 percent are aware of Actelion’s ACT-179811 (cadazolid).

About TreatmentTrends

TreatmentTrends: Clostridium difficile Infections (US) is an annual report
that analyzes the usage and uptake of therapies and fecal transplantations for
the treatment of CDAD. TreatmentTrends is a syndicated report series that
provides longitudinal information on market dynamics, including insight into
practice patterns, attitudes and perceptions, unmet needs, and projected and
current use of antibiotics in the hospital.

About BioTrends Research Group

BioTrends Research Group provides syndicated and custom primary market
research to pharmaceutical manufacturers competing in clinically evolving,
specialty pharmaceutical markets. For information on BioTrends publications
and research capabilities, please contact us at (610) 321-9400 or
www.bio-trends.com. BioTrends is a Decision Resources Group company.

About Arlington Medical Resources

AMR (www.AMR-data.com) serves the market intelligence needs of the
pharmaceutical and diagnostic imaging industries. Research includes clinical
inpatient and hospital databases that directly link anti-infective drugs with
indication/procedure, formulary and stocking status tracking studies, drug
purchasing audits and diagnostic imaging procedure volume/contrast media usage
audits. AMR is a Decision Resources Group company.

About Decision Resources Group

Decision Resources Group is a cohesive portfolio of companies that offers
best-in-class, high-value information and insights on important sectors of the
healthcare industry. Clients rely on this analysis and data to make informed
decisions. Please visit Decision Resources Group
atwww.DecisionResourcesGroup.com.

    All company, brand, or product names contained in this document may be
                   trademarks of their respective holders.

Contact:

BioTrends Research Group, LLC
Brenda Perez-Cheeks, Ph.D., 610-908-7255
bperez@bio-trends.com
or
Decision Resources Group
Christopher Comfort, 781-993-2597
ccomfort@dresources.com