2012 Annual Report Nisha Gupta,M.D. Too many times, it looked like Nisha Gupta’s battle  against hepatitis C would end badly. The Detroit-area  rheumatologist first contracted the chronic infection in  May 1990 when, as a medical resident, she drew blood  from an infected patient. Although she wore gloves, the  needle pricked her skin. Soon she experienced her first  symptoms and eventually was diagnosed with hepatitis C.  Dr. Gupta received treatments on and off ever since,  first to slow the infection’s advance and then mostly to  control symptoms like severe itching, fatigue and mental  confusion. “I worked until September 2009, when I found  out I had liver cancer,” Gupta recalls. “By then I was  prepared to die.” By her first liver transplant, she was suffering from hepatic  encephalopathy, a worsening of brain function when the  liver is no longer able to remove toxic substances in the  blood. Her remissions after two liver transplants were  short-lived, but her family and physician never lost hope.  Her hepatologist tried to obtain compounds then in clini - cal development from two manufacturers under the FDA’s  Today, Dr. Gupta is virus free and offers “a very special  thanks to Bristol-Myers Squibb and its compassionate  employees. They gave hope back to me and my family.” Eric Hughes, M.D., Ph.D., had just arrived at Bristol- Myers Squibb back in 2010. Among his responsibilities  was coordinating virology compassionate use inquiries. “Given Dr. Gupta’s dire straits, we believed the risk/ben - efit profile of providing early access to daclatasvir was  acceptable,” he says. Then the FDA suggested a third experimental therapy  from Bristol-Myers Squibb. Its investigational compound  was daclatasvir, currently in Phase III trials and not yet  approved. Bristol-Myers Squibb said yes, and daclatasvir  was given alongside two standard therapies. compassionate use program, where physicians can apply  for early access to experimental compounds for individual  patients who have no effective therapeutic alternative.  Concerned about drug interactions with their compounds,  the companies rejected the applications. Bristol-Myers Squibb  9 After a Long Struggle…Forever Grateful Pipeline sustainability ultimately  depends on other parts of our  approach to R&D, including a strategy  of creating backups for compounds in  development, expertise in key biologic  targets and a “follow the science”  philosophy in clinical development multiple myeloma cells, but minimally  expressed on normal tissue. It is  believed that this mechanism allows  the immune system to selectively kill  myeloma cells with minimal effects on  other cell types. It has shown promise  in mid-stage trials. that better characterizes both benefit  and risk and is willing – and able – to  challenge the current standards of  care for the benefit of patients. r For more information on other pipeline possibili- ties, see sections in this report on how our current  products are fueling growth and on groundbreaking  efforts in cardiovascular disease, immuno-oncology  and diabetes.