Valeant looks to revive Xifaxan with primary care sales effort. Will it work?

Now that Valeant’s $10 billion talks to sell its Salix unit to Takeda have reportedly fallen through, the company is taking matters into its own hands with a “significant” GI sales force expansion. But whether that expansion can help get its lagging meds going remains to be seen.

The plan? Rev up growth in the underperforming GI business by adding reps who will focus on potential primary care physician prescribers of IBS-D med Xifaxan and oral opioid-induced constipation med Relistor, Valeant said this week. The way the company sees it, it can reach “a significant majority” of likely Xifaxan and oral Relistor PCPs with the effort, which it will roll out “over the coming weeks.”

As with many key Valeant products, wannabe blockbuster Xifaxan has been struggling lately. In building a primary care sales force, “our goal ... is to maximize opportunities for Xifaxan and Relistor to help our products reach full potential,” CEO Joseph Papa said in a statement.

It’s a new tack for Valeant, which was just about ready to let those moneymakers change hands until price squabbles scuttled a potential deal with Takeda, which has tried multiple times to acquire them. Now, Papa is calling the GI franchise a “core asset for future growth”—meaning it may no longer be part of the group of businesses Valeant’s willing to divest in order to pay down its debt load.

Meanwhile, though, Papa has blamed sales force woes for triggering Xifaxan’s poor performance to begin with. In June, the new skipper attributed the product’s slump to “sales force disruption” over the past 12 months—something the company said it had been working to address by inserting a new leader and putting a beefed-up  effort behind the med.

“We think that’s going to be an important part of the solution,” Papa told investors on the company’s Q1 conference call.

It’s a far cry from the sales force situation then-head honcho J. Michael Pearson touted when he first nabbed Salix in a 2015 bidding war. “We believe these customer-facing roles have played and will play a huge role in the success of the company," he said, promising to keep Salix army of experienced specialty reps intact.

But that all changed this April, when Pearson announced that various parts of Valeant’s GI corps would be merged, with “new opportunities for some of those affected to take on different roles within the company.”

Valeant, though, has never stopped expressing optimism that Xifaxan can make a comeback—especially considering its newest indication in hepatic encephalopathy, which the drugmaker thinks represents a $5 billion opportunity alone.

In IBS-D, though, it has some competition in Allergan’s Viberzi, a med the Dublin drugmaker has been working tirelessly to promote. Most recently, Allergan teamed up with world champion paratriathlete, motivational speaker and IBS-D sufferer Amy Dixon in an effort to spark and improve conversations about the disease between patients and their doctors; that move followed an October pact with population health management specialist SonarMD to develop tools meant to help doctors monitor and manage patients using the Viberzi, as well as the May rollout of, an online resource for patients complete with info on identifying symptoms, managing the condition and speaking with a doctor about IBS-D.