FiercePharma news, curated by the crowd

It's the time of year when the days are short and dark, bears are hibernating, fires are burning and people are exclaiming, "Where did the year go?" Alas, we can't answer that question. What we can offer are a few hints about how the year went. Five hints, to be exact, in the form of FiercePharma's 5 best-read stories of 2013. It's the year's top news, as selected by readers around the world.

The top 5 roundup covers a few of the year's top trends. In first place, we have layoffs. With generic competition looming for its top-selling drug Cymbalta, Indianapolis-based drugmaker Eli Lilly ($LLY) decided to lay off a big hunk of the sales force repping its neuroscience, cardiovascular and men's health products. That was in April. By May, the company had said 1,000 sales reps, both full-time and contract workers, would be let go, and another 560 jobs would be "reallocated" elsewhere in the company. Companywide salary freezes followed.

Lilly's cost cuts would soon be eclipsed by more than 5,000 layoffs at AstraZeneca ($AZN), 8,000-plus at Merck ($MRK), and another 5,000 at Teva Pharmaceutical Industries ($TEVA). Sanofi ($SNY) continued to wrangle with the French government over ongoing job cuts there, and Novartis ($NVS) shaved a few hundred jobs from its vaccines unit and another few hundred at its over-the-counter drugs plant in Lincoln, NE. Meanwhile, one small company after another scaled back for one reason or another. Dendreon ($DNDN), for instance, hunkered down with another 15% cut to its workforce as sales of its cancer drug Provenge continued to disappoint. But that first Lilly layoff story is still bringing in new FiercePharma readers.

Job cuts are a perennial theme in the pharma industry, though. The story in second place illustrates a more recent phenomenon: the pharma split-up. After selling off its Capsugel capsule-making unit to KKR and its baby-formula business to Nestlé--not to mention spinning off its animal health business, Zoetis--Pfizer ($PFE) said in late July that it would divide its internal operations into three units, each with its own management and financial reporting. Last month, CEO Ian Read said that investors will get their first peek at those numbers with the company's first-quarter 2014 report. Will the internal restructuring lead to an actual split? Read says the numbers will tell the story, and Pfizer will act accordingly.

While Pfizer was prepping for its three-way internal split, Novartis began a "strategic review" of its businesses and has zeroed in on animal health, OTC drugs, vaccines and diagnostics for potential changes--build up, sell off, maybe even spin off or partner out. GlaxoSmithKline ($GSK) has sold off consumer health products and drinks brands, and it's looking at separate financial reporting for a group containing its older products.

In third place we have the kind of story that pops up on our best-read lists now and again. It's another bit of Pfizer news--the FDA flagged its popular Z-Pak antibiotic for potentially fatal heart rhythm problems. Zithromax isn't on patent anymore, so it has plenty of generic competition. But its sales still amounted to $435 million in 2012, so it's still a solid product for the company. Thousands of consumers landed on the story within two hours of publication for another reason, though: It hit Google News.

And then there's No. 4: If reps can't get in doctors' front door, try alternate routes. It was a variation on a theme common over the last 5 years, as physicians began backing away from face-to-face contact with pharma salespeople. Pressed for time and worried about some high-profile pharma payment scandals, some doctors barred their doors, while others started requiring up-front appointments. Meanwhile, companies were laying off sales reps and looking for alternate ways--less expensive ways, particularly--to promote their products. So, cue the demand for information about what doctors want, when they want it, and where they want it. Published in late September, this fourth-best-read story of 2013 focused on a study from CMI/Compas showing that doctors do want information from drugmakers. They just may not want it in the ways pharma companies expect. And some specialists really do want face time with reps, while others would prefer anything else. Even direct mail.

Finally, in fifth place, a story that ran just a few days after No. 4. It, too, was a variation on a theme--in this case, pricing pressure. While we're accustomed to covering price cuts in Greece and Spain and Italy, and skeptical cost-effectiveness regulators in Germany and the U.K., in the United States, we're more likely to write about price hikes. Not this time: Express Scripts, the big pharmacy benefits manager, for the first time introduced a formulary that excludes 48 products. The PBM took a look at the clinical data on some branded drugs, checked out their cost, and decided to kick some of them off its National Preferred Formulary. Effective, less expensive alternatives to these 48 excluded products are available, Express Scripts argues. And unless a doctor makes a case for medically necessary deviation from the rules, Express Scripts won't pay for those excluded products. Since then, some drugmakers have hinted that managed care groups might eschew the restrictive formulary, but that remains to be seen. Until then, pharma companies have to contemplate whether more U.S. payers will make similar moves.

Your year in 5 nutshells? If not, find more depth--and details--in the roundup below of our best-read special reports of 2013. And stay tuned for more to come in 2014. Topics we've left uncovered? Ideas for special reports you'd like to see? Let us know. -- Tracy Staton (email | Twitter)

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