New Interim Results From European Patient Survey Add Weight to Expert Call for Greater Clinical Consensus on Breakthrough Cancer Pain

Experts concerned that inadequate treatment strategies make cancer patients suffer unnecessarily

GLASGOW, Scotland, June 10, 2010 - Further results from the European Survey of
Breakthrough Cancer Pain(1) were presented for the first time today at the 6th
Research Congress of the European Association for Palliative Care (EAPC) in
Glasgow.

The survey, which is the first international survey to look in detail at
breakthrough cancer pain (BTCP) from a patient perspective, show that up to
45% of cancer patients experiencing breakthrough pain do not adhere to
medication despite suffering from devastating episodes.

"The low adherence to drug therapy is a remarkable discovery and
demonstrates that current treatments aren't adequately meeting patients'
needs during these incapacitating episodes of pain," explained Dr. Andrew
Davies, Department of Palliative Medicine, Royal Marsden Hospital, UK and the
principal investigator of this survey.

The survey, moreover, found that up to 50% of patients seek additional
help from non-pharmacological methods such as heat, positional changes and
rest demonstrating the need for improved pain relief. When asked about the
ideal BTCP medication, patients wanted (in order of ranking)

    - A medication that relieves the pain completely

    - A medication that relieves the pain quickly

    - A medication that causes few side effects

    - A medication that is easy to use

    - A medication that can be given by a relative/carer

However, the results of the survey show that patients are not given a
medication that matches these needs. 90% of patients were receiving oral
opioids to manage their breakthrough pain. Studies have shown that the median
interval from onset to peak intensity of the typical BTCP episode is only
three minutes(2) and that the average episode lasts between 30-60 minutes
(3, 4). The time to peak analgesic effect of oral opioids is documented to be
approximately 60-90 minutes(5), long after a majority of the episodes have
ended.

"Breakthrough pain is a distinct problem, and requires specific
interventions including rescue medications that have an appropriately fast
onset of action. Unfortunately, many patients are being treated with
medications that are more suited to the management of persistent pain, and so
are not receiving the most appropriate treatment for their breakthrough
pain.," said Dr. Andrew Davies.

A systematic literature review conducted with the purpose of assessing
and classifying cancer breakthrough pain on behalf of the European Palliative
Care Research Collaborative (EPCRC)(6) likewise concludes that variations in
cancer pain intensity are highly prevalent, yet the phenomenon is not well
understood.

"There is no widely accepted definition, classification system or
well-validated assessment tool for cancer-related breakthrough pain, but
there is strong concurrence on most of its key attributes. An internationally
agreed upon definition and classification system for cancer-related
breakthrough pain, and a standard approach on how to measure it is required
in order to improve patient care and support research in this poor-prognosis
cancer pain syndrome," said co-author, Professor Stein Kaasa, Chair of the
European Association for Palliative Care Research Network (EAPC RN),
principal investigator of the European Palliative Care Research Collaborative
(EPCRC) and chair of the European Palliative Care Research Centre (PRC).

About Nycomed

Nycomed is a privately owned global pharmaceutical company with a
differentiated portfolio focused on branded medicines in gastroenterology,
respiratory and inflammatory diseases, pain, osteoporosis and tissue
management. An extensive range of OTC products completes the portfolio. Its
R&D is built to be open for partnerships as in-licensing is a cornerstone in
the company's growth strategy.

Nycomed employs 12,000 associates worldwide, and its products are
available in more than 100 countries. It has strong platforms in Europe and
in fast-growing markets such as Russia/CIS, and Latin America. While the US
and Japan are commercialised through best-in-class partners, Nycomed will
further strengthen its position in key Asian markets.

Headquartered in Zurich, Switzerland, the company generated in 2009 total
sales of EUR3.2 billion and an adjusted EBITDA of EUR1.1 billion.

For more information please visit www.nycomed.com

    Background Pain vs. Breakthrough Pain

    - Background pain - "constant or continuous pain of long duration"(7)

    - Breakthrough pain - "a transient exacerbation of pain that occurs
either spontaneously, or in relation to a specific predictable or
unpredictable trigger, despite relatively stable and adequately controlled
background pain"(8)

    About the survey

    - Combined results of an ongoing, multicentre observational survey

    - Interim results from nine palliative care centres in UK, Sweden,
Denmark, Germany

    - 320 patients with breakthrough cancer pain

    - Data collected on breakthrough cancer pain and treatment of
breakthrough cancer pain

    - The European Survey of Breakthrough Cancer Pain is continuing to
recruit patients in Ireland, Austria, Belgium, Czech Republic, Finland,
France, Greece, the Netherlands, Norway, Portugal, Spain and Switzerland

    - The survey is supported by an educational grant from Nycomed

References

1. Davies A et al. The Impact of Living with Breakthrough Cancer Pain -
Results of a European Survey of Oncology Patients. Data presented at EAPC
2010.

2. Portenoy RK et al. Breakthrough pain characteristics and impact in
patients with cancer pain. Pain. 1999;81:129-34.

3. Gomez-Batiste X et al. Breakthrough cancer pain: prevalence and
characteristics in patients in Catalonia, Spain. J Pain Symptom Manage.
2002;24:45-52.

4. Davies A et al. European survey of oncology patients' experience of
breakthrough cancer pain: UK, SE and DK results. Poster presented at EFIC
2009.

5. Davies A et al. The management of cancer-related breakthrough pain:
Recommendations of a task group of the Science Committee of the Association
for Palliative Medicine of Great Britain and Ireland. European Journal of
Pain 2009;13:331-338.

6. Haugen et al. Assessment and classification of cancer breakthrough
pain: A systematic literature review. Pain. 2010;149;3:476-482.

7. Ferrell BR et al. Use of routine and breakthrough analgesia in home
care. Oncology Nursing Forum, 1999; 26, 1655-61.

8. Davies A et al. The management of cancer-related breakthrough pain:
recommendations of a task group of the Science Committee of the Association
for Palliative Medicine of Great Britain and Ireland. European Journal of
Pain 2009; 13(4): 331-8.

Code: UK/IN/10/106; Date of prep: June 2010

For further information: Ulf Jonson, Senior International Brand Manager, Nycomed, +45(0)46-77-10-78 / +45(0)20-27-22-61; Mette Thorn Sorensen, Cohn & Wolfe: +45(0)33-1313-20 / +45(0)41-38-43-00