And then there is this article found on Braintalk, to consider:

Reuters article of reluctance to use Tysabri

--------------------------------------------------------------------------------

By Toni Clarke

BOSTON, Oct 23 (Reuters) - Doctors are proving more leery than many had expected about prescribing the multiple sclerosis drug Tysabri, which was relaunched in July after being suspended because of safety concerns.

Over the past month or so, analysts have drawn down their 2006 sales forecasts as it becomes clear that doctors wary of the risk of the rare but potentially fatal brain disease PML are reserving the drug as a treatment of last resort.

The drug, which is made by Biogen Idec Inc. (BIIB.O: Quote, Profile, Research) and Irish partner Elan Corp. Plc (ELN.I: Quote, Profile, Research) (ELN.N: Quote, Profile, Research), had been expected by some analysts to generate sales this year of more than $100 million, but those figures have dropped dramatically.

Ian Hunter, an analyst at Goodbody stockbrokers in Dublin, said on Monday that he has cut his full-year Tysabri forecast to $25.7 million from $78 million, in part because of continuing safety concerns and the complexity of reimbursement systems in Europe.

A survey of 63 neurologists conducted by Reuters Primary Research indicates that in 2006 Tysabri will be used in less than 1 percent of multiple sclerosis patients -- translating into revenue of under $30 million.

Since July, only 47 of more than 8,500 patients treated by the physicians surveyed by Reuters had used Tysabri, even though more than 700 patients had discussed using it, according to the report.

And more than 75 percent of the patients who had used Tysabri prior to its 2005 suspension have decided not to use it since its reintroduction, the survey showed.

In taking the rare decision to allow a withdrawn drug back onto the market, the U.S. Food and Drug Administration was partially influenced by calls from patients who said they were willing to take the risk of contracting progressive multifocal leukoencephalopathy, or PML, because of the potential benefits of the drug"It turns out in real life that a lot of patients and doctors are taking a wait-and-see attitude," said Ben Weintraub, author of the Reuters survey.

About 250,000 to 350,000 Americans have been diagnosed with MS, a degenerative disease of the nervous system that can lead to muscle weakness, blurred vision and, ultimately, disability. Many benefit only partially from current treatments, which include Biogen's drug Avonex.

Tysabri's ultimate sales potential will depend, to an acute degree, on whether there are any more cases of PML, analysts say. Most of the respondents to the Reuters survey said they would stop using Tysabri altogether if two new PML-related deaths were associated with Tysabri.

"Most people say its going to be a $1 billion drug eventually," said Steve Brozak, an analyst at WBB Securities. "But more time is needed. Time buys you information." (Additional reporting by Paul Hoskins in Dublin)

© Reuters 2006. All Rights Reserved.