For companies that make drugs for attention-deficit hyperactivity disorder, the U.S. has been a fertile market. The diagnosis keeps growing; drugs to treat it keep going blockbuster. But as Bloomberg reports, Europe is another story. And it's a story that Shire ($SHPG) has to change if it wants its latest drug in the ADHD lineup to succeed.
Shire has pinned big hopes on Vyvanse. The next-generation ADHD drug rolled out as a follow-up to the company's major blockbuster, Adderall, which is now off patent. So far so good; the drug broke the blockbuster barrier last year, with $1.03 billion in sales.
Now, the drug is approved for sale in the EU under the brand name Elvanse. Shire has launched it in four European countries so far. But unlike U.S. parents, teachers and doctors, their European counterparts are more skeptical. Many don't believe ADHD exists, period. There's a reluctance to use drugs to treat behaviors that Americans are trained to associate with the disorder.
The answer? European training, for one thing. Shire has been making the rounds of psychiatric conferences to make its case for ADHD, Bloomberg says. And as Elvanse rolls out in Spain, Finland, Sweden and Norway early next year, the push will continue. "The next year to two years is going to be a significant educational effort on our part," Shire CEO Flemming Ornskov told the news service. "The climate in Europe is a bit more negative. It will take us some time."
Another potential aid, Bloomberg points out, is the World Health Organization's (WHO) 2015 revision of its disease-definition document. If the WHO guidelines are revised to more closely resemble the diagnostic criteria in the U.S. Diagnostic and Statistical Manual of Mental Disorders, then that could help doctors buy in. It might also help ease the stigma associated with psychiatric drugs.
Not everyone thinks that would be a good thing, though. Critics say ADHD is overdiagnosed in the U.S., and that doctors and parents tag many kids who are simply more energetic and unruly than average. What's more, some say ADHD responds better to psychosocial therapy than to medication, but because of the time, effort and expense involved, medication is typically the first choice.
- read the Bloomberg story