Drug Marketing

Can Merck boost Singulair sales?

Tracy Staton — Thu, 07 Aug 2008 11:13:09 -0400

One of the shining stars over at Merck has been Singulair, the allergy and asthma med that pulled in some $4.4 billion last year. Well, for the most recent quarter, sales actually slipped by 1 percent as patients have defected to the new over-the-counter Zyrtec sold by Johnson & Johnson. Plus, the FDA's March announcement of a probe into a potential link between Singulair and suicidal behavior--and a fairly mild spring allergy season--didn't help. Merck acknowledged the flattening sales, lowering its forecast to a range of $4.4 billion to $4.6 billion from its previous estimate of $4.6 billion to $4.8 billion.

What can Merck do to turn it around? The company is offering $20 coupons for Singulair on its website, and it extended its spring ad campaign into the summer. "[W]e are taking additional steps to further support the brand," the company said late last month. Third-quarter sales figures will show just how successful those efforts turn out to be.

- read the story in CNN Money

FDA enters (fake) advertising business

Christe Bruderlin-Nelson — Wed, 06 Aug 2008 10:32:54 -0400

The FDA might be creating some faux direct-to-consumer commercials for a pretend blood pressure medication, which it plans to follow with an internet survey of 2,400 adults to gauge the response of consumers aged 40 and older to the ads.

The agency wants to test whether the safety warnings it requires in ads take a backseat to the images in the ads, and says it issues warnings to multiple companies every year about misleading ads and ads that overstate a products safety or efficacy.

If approved, the fake ads will have various images and text onscreen while a narrator reads warnings. Then the follow-up surveys will attempt to gauge viewer attitudes and perceptions regarding the adds. The FDA submitted the study to its Office of Management and Budget for approval. Stay tuned.

- read the Pharmalot blog post
- get the story at the Star-Ledger

Study: Psychiatrists choose drugs over therapy

Christe Bruderlin-Nelson — Wed, 06 Aug 2008 10:27:06 -0400

A new study in the Archives of General Psychiatry seems to say incentives from managed care and more choices for psych drugs means psychiatrists increasingly turn to the prescription pad rather than the therapy couch.

While some type of psychotherapy is recommended for many conditions--including depression, bipolar disorder and post-traumatic stress disorder--visits did not include such therapy when the patient was under a managed care provider.

The study found that while psychiatry visits involved psychotherapy for 44 percent of visits in 1996 and 1997, only 29 percent of office-based visits did so in 2004 and 2005. Some say the fact that a few quick medication-monitoring visits pay much better than a longer psychotherapy session conducted in the same amount of time could be the reason for the switch, while others say the cornucopia of new meds on the market might be the cause.

- read the Pharmalot blog post
- see the study

Justice probes biliary stent marketing

Tracy Staton — Tue, 05 Aug 2008 10:39:02 -0400

The U.S. Department of Justice has launched a probe of the bile-duct stent market, trying to determine whether companies such as Abbott Laboratories, Boston Scientific and Johnson & Johnson improperly promoted the devices. The U.S. Attorney's Office in Massachusetts has been subpoenaing stentmakers about their marketing practices, according to SEC filings. The companies have reported that Justice wants to know whether they've promoted the biliary stents for other uses, such as propping open leg arteries.

The U.S. Attorney's office wouldn't comment on the investigation, and the companies themselves wouldn't either, beyond saying that they're cooperating.

- read the Dow Jones story at CNN Money

FDA flubs off-label enforcement

Tracy Staton — Tue, 29 Jul 2008 10:24:58 -0400

When it comes to policing off-label marketing, the FDA is no SWAT team, a new report from the government's auditor shows. It's more like the Keystone Cops, ill-equipped to crack down even on blatant marketing abuses, the Associated Press reports. There's no staff exclusively assigned to monitor off-label marketing, and when the staff that monitors all prescription-drug advertising manages to catch a drugmaker promoting off-label uses, it takes an average of seven months for them to issue a warning--and an average of four more months for the company to fix the problem.

The agency tries to focus its attention on misrepresentations that could affect human health, the report found, but it lacks a system to track all the information it receives.

The General Accountability Office investigated off-label marketing enforcement at the request of Sen. Chuck Grassley, who, as you know, has been hounding drugmakers on various marketing-related issues all year. Whether the report will lead to any action--or just another set of hearings--remains to be seen.

- see the AP story

Sales breaches cost Pfizer, Roche, Glaxo

Tracy Staton — Mon, 28 Jul 2008 11:20:43 -0400

Drugmakers were hit with a record $1.8 million in fines by Australia's industry self-regulator, some for slamming rivals' products, and others for putting on lavish "educational" presentations for doctors. Pfizer got the dubious honor of the largest fine, a record in itself at $200,000. Sales reps apparently told doctors that cholesterol-lowering drug from AstraZeneca could cause kidney damage; the company said reps may have made those statements, but Pfizer managers didn't know anything about it.

Some fines were the result of tattle-taling by other drugmakers: Roche was hit with a $110,000 penalty after GlaxoSmithKline complained that the Swiss drugmaker had sent out media releases promoting products for unapproved uses. GSK, for its part, had to pay $100,000 after rivals told regulators that it was distributing deceptive promo materials.

GSK also had to pay a total of $210,000 in fines for two doctors' conferences at luxury hotels in Sydney. One of the events cost $102,970 to stage, with almost 90 percent of that spent on lodging, food, entertainment, and the like--and "less than five hours of actual education was provided." Solvay Pharmaceuticals paid $100,000 for two events, one of which included an overnight in wine country, with a $217-a-head dinner--and just two hours of education.

- get more from The Age
- see the post at Pharmalot

Docs like hearing from reps, survey says

Tracy Staton — Thu, 24 Jul 2008 10:47:07 -0400

Pharma reps have been getting a tough shake lately, what with massive layoffs and a new industry code that curtails some tried-and-true sales techniques. Not to mention efforts to ban them altogether from various academic institutions and even require licensing in the District of Columbia. Now, though, a new study offers a welcome respite: More than three-fourths of doctors say they're willing to see reps any time of day, and only one-fourth require an appointment.

True, 17 percent of the 230,000 medical practices surveyed said they don't admit reps at all. Some 30 percent of hospital-owned practices bar reps, and another 40 percent require appointments. But still, that leaves 83 percent of docs open to sales-rep input.

Meanwhile, a PhRMA survey found that the "vast majority" of physicians like getting info from reps about drug interactions, new meds, and patient assistance programs--but only 11 percent say that info greatly affects their prescribing decisions. You can read that last number a couple of ways. It's either more bad news for reps, if companies think docs aren't using their input to make choices. Or it could be the kind of figure companies can use to legitimize their sales calls; if reps don't have undue influence, then maybe they shouldn't be viewed with such a jaded eye.

- see the doc survey at Pharmalot

Psych docs mull ties with drugmakers

Tracy Staton — Mon, 14 Jul 2008 10:08:56 -0400

Last week, the pharma industry set out new guidelines for marketing to doctors. This weekend, psychiatrists will take a look at drugmaker-doctor ties from the other direction--and if a preview in the New York Times is any indication, it's likely to be a contentious meeting. Psychiatry and pharma have been working closely on clinical trials and drug education for some 20 years now, and while some in the specialty are convinced that docs need to "come clean on these industry deals, and soon," others say partnerships with drugmakers benefit patients, and as long as researchers follow their institutions' conflict of interest rules, that should be enough.

Of course the American Psychiatric Association is going into this meeting with a case of upset equilibrium, now that Sen. Chuck Grassley has demanded an accounting of the organization's finances, claiming that its members are too tight with drugmakers. Plus, the senator has been calling psychiatrists to task for failing to report all their pharma-releated earnings. Not to mention the fact that last week, when Vermont released its numbers on drugmaker payments to doctors, it was psychiatrists who took in the most--a good one-fifth of the total drugmakers spent in the state.

- read the New York Times story

Lilly tops VT's doc-marketing list

Tracy Staton — Fri, 11 Jul 2008 09:14:14 -0400

If you want a microcosmic view of pharma marketing to doctors, take a look at the numbers in Vermont. Over 12 months ended June 30, 2007, drugmakers spent $3.1 million to promote their meds through education and marketing mostly to physicians. That's a hike of nearly $1 million over their spending two years before.

Five companies accounted for more than half of that spending: Eli Lilly spent the most, followed by Pfizer, JCB, Novartis, and Merck. And the lion's share of that $3.1 million went to just 100 doctors, psychiatrists in particular. Eleven psychiatrists together took in more than $625,000 in drug company payments. Cardiologists were second in line with almost $313,000--and that was divided between only two prescribers.

Not surprisingly, the spending was focused mostly on a few drugs. Twenty meds accounted for 62 percent of spending, but were only 7 percent of the number of drugs listed in the disclosures. The top 10 drugs by spending? Here you go:

Strattera, ADHD, Eli Lilly
Metadate CD, ADHD, UCB
Januvia, Type 2 Diabetes, Merck
Lexapro, Depression, Forest Laboratories
Cymbalta, Depression, Eli Lilly
Lantus, Diabetes, Aventis Pharmaceuticals
Seroquel, Antipsychotic, AstraZeneca
Namenda, Alzheimer's, Forest Pharmaceuticals
Vytorin/Zetia, Cholesterol, Merck/Schering-Plough
Benicar, Hypertension, Daiichi Sankyo

You'll recall that Vermont is one of only two states to require disclosure of drug-company payments to doctors, in this case, gifts of more than $25 in value. PhRMA's new marketing code calls on drugmakers to set internal limits for doctor payments and to set up a system for disclosing them. Meanwhile, in Congress, a sunshine bill is making its way through channels; it would only require disclosure of payments $500 and above, though--and would supersede state disclosure laws like Vermont's.

- see the Vermont AG's release
- check out the Burlington Free Press story

New code bans logo-strewn tchotchkes

Tracy Staton — Thu, 10 Jul 2008 09:48:17 -0400

They're not the costliest items pharma gives doctors, but they're certainly the flashiest--and now they're no longer allowed. Under a new policy announced today by the Pharmaceutical Research and Manufacturers of America, drug reps won't be allowed to hand out logo-covered pens, prescription pads, mugs, clocks, mouse pads, and other freebies at physician's offices. That should cut down on the barrage of logos patients see when they walk into the office. The new marketing code will also ban individual reps from wining and dining doctors at restaurants.

But the code will allow reps to bring food along when they offer "informational presentations" in doctors' offices, according to PhRMA's press release. And it won't limit the millions of dollars spent on speaking and consulting fees--but will require companies to set their own internal limits and track those payments. The latter requirement could be helpful when/if federal legislation forces companies to disclose the amounts they're paying doctors.

Will this voluntary policy satisfy the industry's critics? Some, such as Sen. Herb Kohl, applauded the measure in the New York Times. Others called it a sham designed to forestall "doing anything that's serious." Given the amount of back-and-forth over pharma marketing in recent months, we expect PhRMA's conduct code to prompt plenty of debate.

- check out PhRMA's release
- read the New York Times article
- see the Wall Street Journal Health Blog's take