Diagnosing patients via telehealth calls can be challenging, but especially when it comes to movement disorders. For Neurocrine Biosciences, that discovery was a pandemic-era double whammy.
Two of its key drugs—Ingrezza for tardive dyskinesia and Ongentys, approved last April for Parkinson’s patients—can both be prescribed over video, but uncertainty pushed Neurocrine to get creative.
For Ingrezza, the company developed new tools designed to help physicians remotely diagnose tardive dyskinesia, which is caused by certain drugs. CEO and President Kevin Gorman said the drugmaker is working on several more to roll out this year.
Because antipsychotic drugs can trigger TD, Neurocrine focused those efforts on psychiatrists who not only switched to telemedicine in large numbers but also are a key audience for Ingrezza.
Ingrezza did have the advantage of several years' history on the market—20% of TD patients have now been diagnosed, versus just 3% when it was approved in 2017, Gorman said—but new patient starts still suffered initially, Gorman said.
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For Ongentys, with a first-ever FDA nod in April, Neurocrine had to start from scratch. Sure, neurologists are well-versed in identifying Parkinson’s patient movement disorders. But Ongentys is a follow-up to an older drug class called COMT inhibitors that came with some serious side effects, including serious liver damage, gastrointestinal issues and even drug-induced ulcerative colitis.
Like those older meds, Ongentys inhibits the enzyme catechol-O-methyltransferase, or COMT, which allows levodopa to work longer and extends symptom relief. But Ongentys doesn't carry the same risks, Gorman said. And the drugmaker had work to do in rinsing away the bad taste left by those drugs.
The older meds "really soured physicians on the entire COMT mechanism," Gorman said. "Fifteen years ago it was a really exciting mechanism that neurologists were really looking forward to. But those two drugs never fulfilled the promise of COMT inhibition."
To change doctors’ minds, and do so remotely, Neurocrine first launched an online educational campaign for them. “The Choice is Yours” points up Ongentys’ difference—a once-daily pill meant for early COMT inhibition. It also pitched Ongentys as a partner to standard Parkinson's drugs: In print ads, it was depicted as the third musketeer to levodopa and carbidopa.
Animated mechanism-of-action videos showed physicians the science behind Ongentys works, and the company started a widespread and generous sampling program.
“We’re trying to change behavior in physicians and that’s a tall order,” Gorman said.
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Neurocrine then took its messages to patients and caregivers. A digital branded campaign highlighted the potential benefits of taking Ongentys.
One ad showed two intertwined hands with the message: “Holding Hands. To steady your tremor or because your song just came on?” There's a checkmark by the song choice. The effort included tips for caregivers and resources such as doctor discussion guides.
Neurocrine also launched a secondary unbranded marketing program to encourage people with Parkinson’s to write out cards—and keep up handwriting exercises—to everyday heroes, including people working on the frontlines of the pandemic.
The effort “Parkinson’s Cards to Heroes” launched in July and will be rolled out more broadly in April during Parkinson’s disease awareness month.
The results? Ingrezza steadied by midyear and grew again as physicians adopted telemedicine tools and began to reopen. Its final sales for the year notched a 34% increase over 2019, Gorman said. While Ongentys' new patient starts were slower than Neurocrine anticipated after its late September launch—it picked up $1 million in sales during the fourth quarter—early physician feedback is “roundly positive,” he said.
Still, even with its 2020 successes, Gorman said both drugs won’t see their full potential until the pandemic flattens. More psychiatrists need to re-open and more older patients need to feel comfortable going back to physicians’ offices in person.
“Drug launches go slower during a pandemic,” he said. For Ingrezza already on the market, “the pace of adding new patients is what suffered. They’re been coming back, but it’s still going to take more progress in getting COVID under control.”