Today brings good news to Quebecers with type 2 diabetes - Quebec is the first province to list JANUVIA(TM) on drug insurance plan

    MONTREAL, Sept. 30 /CNW Telbec/ - The province of Quebec has taken the
lead by announcing that, effective October 1st, it will cover, under some
reimbursement criteria, prescriptions for Canada's first and only dipeptidyl
peptidase-4 (DPP-4) inhibitor, JANUVIA(TM) (sitagliptin), on the List of
Medications covered by Quebec's basic prescription drug insurance plan. Merck
Frosst will work closely with the Government of Quebec to ensure that
JANUVIA(TM) (sitagliptin) is being prescribed in accordance to the
reimbursement criteria for type II diabetes patients in combination with
metformin when a sulphonylurea is contra-indicated, is not tolerated or is not
    "Thanks to the Government of Quebec, today marks a new milestone for the
thousands of Quebecers with type 2 diabetes who now have access to a new and
different approach for treating type 2 diabetes," said Pierre MacNeil,
Director, Policy and Reimbursement, Eastern Region, Merck Frosst Canada Ltd.
"With this announcement, the Government of Quebec is demonstrating its support
to innovation brought forward by the research-based pharmaceutical industry.
It is our hope that other governments will follow Quebec's lead by making
sitagliptin available for type II diabetes patients in their provinces."

    Control is needed(1)

    "Diabetes cannot be cured but only controlled through a healthy diet,
regular exercise and medication," said Dr. André Fréchette, Family Medicine
Group, St-Vallier, Quebec. "Today more than ever type II diabetes patients and
their treating physicians need access to effective new treatments, with a
better tolerability profile in order for patients to achieve control."
    It is estimated that diabetes affects an estimated 550,000 Quebecers.
Type 2 diabetes accounts for 90 per cent of all diagnosed cases and it has
been estimated that about one third of adults with type 2 diabetes are unaware
of their condition. One in two Canadians being treated for type 2 diabetes
does not achieve the targeted blood glucose level (as measured by HbA1c(*)) of
(less than or equal to)7 per cent as per the 2008 Canadian Diabetes
Association Guidelines.(2)
    The rising numbers of people living with diabetes will have a major
impact on society, especially since 30 per cent will suffer debilitating, even
deadly, complications. Diabetes is one of the primary causes of blindness,
non-trauma amputations, kidney failure, and is an important factor in heart
disease and stroke. The social and financial burdens from diabetes are
enormous - an estimated $2 billion a year in direct and indirect costs for
Quebec society.

    About JANUVIA(TM)

    Sitagliptin is a highly selective, once-daily DPP-4 inhibitor that
enhances a natural body system, called the incretin system, to help regulate
blood sugar. The discovery of this endocrine system that led to the
development of sitagliptin by Merck, was made by independent Canadian
researchers. Incretins are hormones produced in the gut in response to a meal.
When blood sugar is elevated, incretins work in two ways to help the body
regulate high blood sugar levels. They trigger the pancreas to increase the
release of insulin and signal the liver to reduce its production of glucose.
Sitagliptin keeps these hormones active for a longer period of time by
preventing their breakdown. Sitagliptin has a tolerability profile comparable
to placebo and is weight neutral with a low risk of hypoglycemia.
    Last year sitagliptin was awarded the Prix Galien for the Best
Pharmaceutical Agent in the United States. This award recognizes outstanding
achievement in the pharmaceutical industry in the development of new

    About Merck Frosst

    At Merck Frosst, patients come first. Merck Frosst Canada Ltd. is a
research-driven pharmaceutical company discovering, developing and marketing a
broad range of innovative medicines and vaccines to improve human health.
Merck Frosst is one of the top 25 R&D investors in Canada, with an investment
of close to $110 million in 2007. More information about Merck Frosst is
available at

    Forward-Looking Statement

    This press release contains "forward-looking statements" as that term is
defined in the Private Securities Litigation Reform Act of 1995. These
statements are based on management's current expectations and involve risks
and uncertainties, which may cause results to differ materially from those set
forth in the statements. The forward-looking statements may include statements
regarding product development, product potential or financial performance. No
forward-looking statement can be guaranteed, and actual results may differ
materially from those projected. Merck undertakes no obligation to publicly
update any forward-looking statement, whether as a result of new information,
future events, or otherwise. Forward-looking statements in this press release
should be evaluated together with the many uncertainties that affect Merck's
business, particularly those mentioned in the cautionary statements in Item 1A
of Merck's Form 10-K for the year ended Dec. 31, 2007, and in its periodic
reports on Form 10-Q and Form 8-K, which the Company incorporates by

    (*)  HbA1c is a measure of a person's average blood glucose over a
         two-month to three-month period.

    (TM) Trademark of Merck Frosst Canada Ltd., used under license

    (1)  Diabetes Québec, What is diabetes? (accessed at
    (2)  Harris SB, Ekoé J-M, et al. Glycemic Control and Morbidity in the
         Canadian Primary Care Setting (Results of the Diabetes In Canada
         Evaluation Study). Diabetes Research and Clinical Practice.
         October 2005.

For further information:

For further information: Martine Drolet, Manager, Public Affairs, Merck
Frosst Canada Ltée, (514)428-3037; Mélissa Maloul-Cohen, Cohn &
Wolfe/Montréal, (514) 845-2257, poste 228,;
Marie-Michelle Crevier, Cohn & Wolfe/Montréal, (514) 845-2257, poste 226,

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