With all the excitement about Novartis' ($NVS) new heart failure drug Entresto, the usual question that follows an FDA approval--how will they actually sell it--might seem irrelevant. But the former LCZ696's path to blockbuster sales isn't without its obstacles, and the Swiss drugmaker isn't leaving much to chance.
|Novartis pharma chief David Epstein|
It's covering the basics, of course: In the U.S., Novartis figures Entresto will be started almost exclusively by cardiologists, pharma chief David Epstein said in April, with about 10% of internists also writing initial scripts.
"Our plan is to launch initially to exactly that target audience," Epstein said.
In fact, sales rep emails to doctors went out as soon as Entresto had the FDA go-ahead, with copies showing up on Twitter ($TWTR) soon after. After all, what good is trial data showing reduced hospitalizations, not to mention a survival advantage, if doctors don't know about it? The physician website also includes info on Entresto Central, a program that doctors and patients can use to wrangle with insurers for coverage, and get free-trial supplies and co-pay support.
Meanwhile, the company has been laying groundwork with payers--and given the drug's $12.50-per-pill price and the cheap generics that are now the standard of care, that's key. The company already has its huge clinical trial program--the PARADIGM study covered more than 8,400 patients--and its impressive results to back up its Entresto case. But it's also working on a couple of new-and-innovative approaches, albeit with mixed success so far.
Epstein said last month that Novartis would be experimenting with pay-for-performance pricing on its newly minted med, with refunds for below-target results and bonus payments if the drug beats its outcomes goals. Those sorts of programs are difficult to administer, however, and Express Scripts ($ESRX) CMO Steve Miller said last week that he's skeptical.
Then there's the sort of pill-plus-services model that many drugmakers have been talking about--and consultants urging pharma to try--but few have actually implemented. CEO Joe Jimenez told McKinsey & Co. that Novartis is partnering up with digital tech companies to remotely monitor patients as part of an outcomes-based approach.
"A perfect example is what we would potentially do with our new heart-failure drug," Jimenez told the consulting firm in an interview. "By partnering with companies that could monitor some patients remotely, we look for vital signs that would tell us whether they should go to the hospital."
The idea is to position Novartis as a partner in pushing overall patient-treatment costs downward. That way, the price of the pill buys a tool for cost control. About 20% of potential Entresto patients would fall under the private insurance umbrella, and this group is the obvious target for piloting remote-monitoring programs.
The company is covering its bases with patients, too, of course. Novartis has said that it's looking for $5 billion-plus in eventual Entresto sales, with analysts concurring, and some big spending on marketing will be necessary along the way. "[W]e're pretty excited about the campaign we're putting together," Epstein said in a conference call, "the use of social media, the use of other approaches to get the word out."
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