Eli Lilly has posted a strong set of figures for the fourth quarter, with the antidepressant/fibromyalgia blockbuster Cymbalta and the antipsychotic Zyprexa once again driving sales, though there is concern over the poor performance of its new blood thinner Effient.

Net income reached $915.4 million, compared with a loss of $3.63 billion a year earlier, when the firm took a $4.73 billion pretax charge related to the acquisition of ImClone Systems. Sales reached $5.93 billion, a rise of 14%, 3% of which was due to the impact of foreign exchange rates.

The most striking performances came from Cymbalta (duloxetine), up 15% to $830.8 million and the lung cancer drug Alimta (pemetrexed) which leapt 64% to $523.6 million. Lilly’s best-selling drug continues to be Zyprexa (olanzapine), which had turnover of $1.37 billion, an increase of 19%. Zyprexa’s rise in the USA (10% to $644.6 million), was driven by higher prices rather than demand, while sales abroad were boosted by the withdrawal of generic competition in Germany in early 2009.

Of Lilly’s other products, the insulin products Humalog and Humulin rose 16% and 4% respectively, to $530.8 million and $273.0 million. The chemotherapy Gemzar (gemcitabine) was down 25% to $310.5 million, due to generic competition outside the USA, though sales of the erectile dysfunction drug Cialis (tadalafil) were up 19% at $439.5 million. The osteoporosis drug Evista (raloxifene), which is also approved for the prevention of breast cancer for certain postmenopausal women, had revenues of $262.7 million, down 2%, while sales of Lilly’s other osteoporosis drug Forteo (teriparatide) increased 9% to $212.8 million.

The type 2 diabetes treatment Byetta (exenatide), which is sold in partnership with Amylin, had worldwide sales of $203.6 million, up 9%, and $120.5 million (+17%) of that was booked by Lilly. Erbitux (cetuximab), the cancer agent that the company got hold of through its acquisition of ImClone, brought in $95.0 million.

Most worrying was the sales of Effient (prasugrel) which is partnered with Daiichi Sankyo. They totalled just $3.8 million, compared to $22.6 million in the third quarter and while Lilly says it continues to make “good progress in gaining reimbursement and access for the product”, analysts are less convinced.

Tim Anderson at Sanford Bernstein issued a research note saying that “for all the attention this product has received over the past few years, the first six months of sales are very underwhelming”. However on a conference call, chief executive John Lechleiter said that “we feel just as good about Effient today as we did when we launched the product”.