The drug: Anacetrapib
The disease: Cardiovascular
The developer: Merck
Peak projections: $10 billion-plus (David Maris, a Credit Agricole Securities analyst)

Before Roche goes collecting any $10 billion in annual sales, the pharma giant may well have to contend with Merck, which has its own dreams about the sales potential that can be delivered in this field.

Its prospects shot up a year ago when Merck reported the drug spurred a 138% increase in good cholesterol and a 40% drop in bad cholesterol among patients taking statins. "The lipid effects are jaw dropping in both directions," declared Dr. Christopher Cannon, the study's lead investigator from Brigham and Women's Hospital in Boston.

However, like Roche, Merck knows that after Pfizer's torcetrapib disaster--a billion-dollar bust in the clinic--developers who expect to get anywhere with the FDA and European regulators will need a mother lode of data to back them up on the safety side. That could mean a wait of several years as more late-stage data is compiled. One false step in the clinic could threaten to ruin everything.

When analysts look at the potential of these next-gen cholesterol drugs, they think about the $11 billion franchise that Pfizer has for Lipitor. They think of a projected $19 billion market. They think big.

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