Somewhat lost amid talk of its major restructuring plans, AstraZeneca actually posted a reasonably healthy set of financials for the fourth quarter.

The Anglo-Swedish drugmaker posted flat revenues of $8.62 billion while core operating profit was up 4% to $2.87 billion. Its key products all sold well, notably the cholesterol blockbuster Crestor (rosuvastatin) which increased 11% to $1.77 billion.

Sales of the drug were up 12% in the USA and total prescriptions increased 4% while the overall statin market across the pond was flat. Speaking at AstraZeneca's press conference in London to announce the results, Tony Zook, head of global commercial operations, noted that Crestor is "holding up pretty well" since the arrival of generic Lipitor (atorvastatin) in the USA, acknowledging that "it is still very early days to be drawing firm conclusions". Still, he added that "despite the availability of many low cost options", patients are on Crestor "because their physician felt it was the right treatment".

Other big earners were the asthma combo Symbicort (budesonide and formoterol), which rose 13% to $839 million, while the antipsychotic Seroquel (quetiapine) was up 15% to $1.55 billion; that franchise was boosted by the performance of Seroquel XR (up 27% to $398 million).

Revenues for Nexium (esomeprazole) were down 13% to $1.07 billion and sales of the antiulcerant blockbuster in western Europe decreased 50%, due to generic competition, notably in France. As for oncology, Arimidex (anastrozole) fell 42% to $166 million, battered by patent expiries, while Casodex (bicalutamide) fell 9% to $142 million. Zoladex (goserelin) brought in $298 million (-1%), while Iressa (gefitinib) climbed 25% to $149 million. Faslodex (fulvestrant) leapt 35% to also reach $149 million.

The Onglyza (saxagliptin) diabetes franchise partnered with Bristol-Myers Squibb, brought in $71 million (+122%). However, the recently-launched antiplatelet drug Brilique/Brilinta ((ticagrelor) had sales of just $5 million, which raised some eyebrows.

Brilinta slow burn

Mr Zook explained that Brilinta has now been approved in 64 markets, with "the biggest event clearly the US approval in July". However, "regulatory approval is only the first step in the process" and reimbursement, formulary acceptance and adoption on hospital protocols takes a long time.

Starting at access to 58% of new cases in the aforementioned 64 markets, "when you get to access at the protocol level, we only have access to around 12% of the new acute coronary syndrome patients at this stage of the rollout", Mr Zook said. He added that "I am confident that we will steadily build on that figure. We knew it would be slow, and it has been predictably slow".

He went on to note that "we are farthest down this track in Germany, and Brilique is "on protocol in 70% of our 1,000 target hospitals". In those 'on-protocol' hospitals, Brilique is capturing 31% of new ACS therapy initiations, second only to Sanofi's standard of care Plavix (clopidogrel). "Our US launch is probably where Germany was six months ago," Mr Zook concluded.

When the question of acquisitions came up, chief executive David Brennan said "there are a number of opportunities out there that we look at that tend to be smaller in scale". However, "we are not looking at transformational types of activities…and we are not cash constrained".

Mr Brennan told PharmaTimes World News that AstraZeneca still sees growth opportunities in the emerging markets, which had fourth-quarter sales of $1.41 billion (+10%), though noted that revenues from Brazil were down due to generic competition to Crestor and Seroquel IR.