FOCUS: HEALTH PR - Top drug brands face a bitter pill/What happens to popular brand name drugs, such as Prozac, when their patents run out and the generic competitors move in? Nick Purdom reports

It is estimated that one third of drugs in the US will be coming off patent in the next five years. For manufacturers this has serious implications. In the UK, for example, 47 per cent of AstraZeneca’s drug sales come from two products - Zestril and Losec - both of which go off patent in 2002.

It is estimated that one third of drugs in the US will be coming

off patent in the next five years. For manufacturers this has serious

implications. In the UK, for example, 47 per cent of AstraZeneca’s drug

sales come from two products - Zestril and Losec - both of which go off

patent in 2002.



’Patents last for 20 years and it generally takes eight to ten years to

bring a drug to market, so you’ve usually only got around 12 years of

patent life, when you want to get as much from the product as possible,’

explains Glaxo Wellcome communications manager, Phil Thomson.



’It takes pounds 200 million on average to bring a drug to market, so

every day you fight for is going to make a difference.’



Despite the huge sums invested, pharmaceutical companies often take the

view that loss of market share is inevitable once a drug goes off

patent.



They accept that generic versions of their leading drugs come in and

undercut prices, and consequently do little to defend their market

position.



But some in the PR industry believe that PR could be playing a much

greater role in the battle for market share when drugs go off

patent.



’The only companies willing to take PR seriously when it comes to these

situations are companies that have blockbusters,’ says Ketchum director

Paul Blackburn. ’But companies wouldn’t have to spend that much on PR to

get a significant return on investment on other drugs that may not be

blockbusters, but still have USPs.’



Various tactics have been used to protect drugs when they come off

patent, but according to Ralph Sutton, healthcare practice leader at

Burson-Marsteller, the key to success is branding. ’I believe strongly

that pharmaceutical companies need to focus more on branding - something

that traditionally they have not been very good at,’ he says.



’Companies need to work on strengthening branding from the start, so

that when patents expire they have developed brand loyalty and can feel

the benefits.’



Sutton adds: ’Having a strong brand name makes it easier to work

directly with patients after a brand goes off patent. If you have got

high patient involvement then you can use tactics like patient advocacy

groups, where you can highlight the values and unique properties of a

brand.’



Angie Searle, executive director of healthcare at Cohn and Wolfe,

agrees.



’You need to talk to patient groups and get them on your side,’ she

says.



Searle says it is particularly important to build on relationships with

patients who have become emotionally reliant on a brand and to get

across the message to all patients that they are not just getting any

drug, but the ’real thing’.



Sutton adds that targeting doctors is just as important: ’You can’t have

a consumer push unless you’ve got the support of the medical

profession.



The emotional pull is not as strong as with consumers, but doctors must

feel comfortable with the rational arguments for a brand,’ he says.



However, convincing doctors to prescribe brands can be difficult,

because the NHS encourages them to prescribe generic medications, which

tend to be cheaper. However, there are certain disease areas where it is

easier to gain doctors’ support for a branded drug.



’Doctors are more wary about using generic medications for certain

conditions, such as epilepsy,’ says Countrywide Porter Novelli director

of healthcare, Caroline Ashe. ’Some companies have successfully managed

to get across the message that some conditions are just too dangerous to

play around with.’



At Ketchum, Blackburn has experience of working on an epilepsy drug

where the patent came to an end. ’Patients receiving generic products

seemed to have breakthrough seizures. We worked with third party

organisations on raising concerns about the generic alternatives and

promoting the branded product,’ he says.



In such instances the developer of the drug can play on the idea that

theirs is a ’cleaner’, premium product. Another tactic used to

differentiate branded drugs from generics is to add value.



’This is an area where PR can really help,’ says Wyeth corporate affairs

manager, David Hall. ’A lot of companies run added value programmes, by

producing patient information packs, for example, which are not

necessarily about the brand but about the therapy area.’



Adding value is a tactic that Anna Korbing, account director at Ketchum

has used before. ’The idea is to tie in additional services around a

brand so that it comes to be of great value to a patient, and they feel

they’re getting a whole package of support.’



These packages can include measures like a nurse support outreach

programme, telephone support and newsletters. ’You can build up the

perception of a product using all of these tools,’ says Corbin.



Such programmes are not cheap to run, and consequently are beyond the

budget of generic drug manufacturers, giving brand manufacturers an

important tactical advantage.



There are other tactics used by pharmaceutical companies to maximise

revenue which may make use of PR, such as taking a product OTC

(Over-The-Counter). ’Taking a product OTC is a way of branding it more

strongly,’ says Peter Holden, managing director of healthcare at

Grayling.



The idea is a good one, but in practice there are only a limited number

of conditions that the Department of Health feels can be treated by

self-medication and products it is prepared to give an OTC licence

to.



Margot James, chief executive of the Shire Hall Group, says: ’What

you’ve got to do when switching to OTC is to make the latent market -

the one that is not doing anything to treat the condition, or is doing

the wrong thing - aware of the new product. That group is far more

likely to go to the pharmacy than to a doctor. But a lot of ethical

companies are not set up to market OTC products and don’t really

understand that market or like the costs involved.’



Profit margins can be another reason for reluctance to go OTC. ’The

margins are not as good on OTC products because the cost of marketing is

higher and it is only a strategy to follow to reduce the downside,’ adds

James.



Attack is often the best form of defence and the primary tactic used to

defend a patented product is line extension. ’Patent expiry often

coincides with more research and data coming out and this usually

enables a company to succeed in getting new indications, so there’s a

big push to maximise the potential a drug has across a lot of different

indications,’ says James.



For instance, Zestril, which started as a drug for heart disease is now

used as an indication for diabetic complications and kidney

problems.



When there is data this is also an opportunity to do meetings programmes

and attend international conferences, according to Gill Markham,

managing director of Holmes and Marchant. The agency is working on a

meetings programme for a client with a drug that has gone off patent in

order to maintain a presence in front of opinion leaders.



Protecting a patent and the investment made in it is an important issue

for many pharmaceutical companies, but with the rapid pace of change in

the industry it has to be accepted that most products have a finite

life.



After manufacturers have done as much as they can to extend interest in

their products once they go off-patent, the real opportunities for

healthcare PRs still lie in working on new introductions.



’There is nothing like having a good portfolio of drugs to replace ones

where the patent is running out. Companies with strong R&D capabilities

and the right relationships with biotech companies will bring products

to market that offset the losses due to patent expiry,’ says James.



ALTERNATIVE APPROACH BREATHES NEW LIFE INTO OLD PRODUCTS



Napp Pharmaceuticals has made its name by taking drugs that have gone

off patent and reformulating them.



Napp itself has developed a patented controlled release mechanism for

the release of drugs into the body called Continus. This mechanism has

been applied to drugs used to treat a number of conditions including

high blood pressure, angina and asthma.



Theophylline has been used to treat asthma for more than 50 years. Napp

had already put theophylline in its controlled release Continus

mechanism, but then decided to explore the potential of the product

further by embarking on some original work on theophylline’s mode of

action.



Theophylline had been recognised as a symptomatic treatment which

relieves the bronchospasm that causes an asthma attack. However, doctors

now understand that the fundamental mechanism that causes asthma is

inflammation.



Napp’s research demonstrated that at low doses theophylline actually had

an anti-inflammatory effect. This meant the drug could be used to treat

the cause, as well as the symptoms, of asthma.



Armed with these findings Napp appointed Grayling to promote its branded

theophylline product, Uniphyllin, and conduct a programme of image

enhancement, opinion leader development and media relations.



To enhance its image Napp was encouraged to attend a series of major

national and international meetings. These included the British Thoracic

Society meeting, the American Thoracic Society meetings in Boston and

Seattle, and the European Respiratory Society meeting in Barcelona.



Napp’s presence enabled it to lobby influential clinicians and make

presentations on its new research.



Grayling used its media relations skills to publicise the data in

relevant medical and pharmacy journals, including General Practitioner,

Pulse and the Royal Pharmaceutical Society’s Pharmaceutical Journal.



At the beginning of the campaign the theophylline market was in serious

decline. But as the campaign gathered momentum, sales of Uniphyllin

began to increase.



Grayling managing director of healthcare, Peter Holden says just because

a drug has reached the end of its patent, it does not mean that it has

reached the end of its useful life, provided it is given a little more

investment and some PR support.



’The research conducted by Napp changed medical opinion about this

off-patent drug and breathed new life into a very mature brand,’ he

says.



BATTLE OF THE BRANDS TO STAVE OFF GENERIC COMPETITION



Branded drugs face a tough time when they go off patent, and most fail

to achieve a decent market share in the face of fierce competition from

cheaper generic products.



But in the past few years there have been a number of success

stories.



One of the most significant drugs to go off patent in recent years has

been Glaxo Wellcome’s ulcer treatment Zantac.



’When a product goes off patent you’re looking to maintain what you’ve

got rather than increasing it. PR is more around issues management and

communicating the benefits of the product to prescribers,’ says Glaxo

Wellcome communications manager, Phil Thomson.



Cohn and Wolfe executive director, healthcare, Angie Searle, who worked

on Zantac, says Glaxo Wellcome put a lot of effort into targeting

brand-loyal prescribers, and emphasised the added value of having a

branded, rather than a generic, product. The agency focused on driving

brand mention in the consumer and medical press.



Zantac was able to build from a position of strength. ’Zantac was very

well recognised and there was tremendous brand loyalty,’ says

Thomson.



’When Zantac went off patent the generic prescribing rate didn’t

increase as sharply as we’d thought.’



An important factor in keeping the Zantac name front of mind was taking

it OTC. ’This meant a completely different type of PR because we could

talk to consumers,’says Thomson. The PR strategy focused on targeting

different groups who suffered from indigestion, such as businessmen, and

older people, who were reached via the publications they read.



’Zantac is an important brand and promotion work is still going on

now.



Some exciting things will be happening in the future,’ says Thomson.



When SmithKline Beecham’s ulcer treatment Tagamet went off patent three

years ago, PR agency Shire Hall worked with the company to take it

OTC.



’Many in the potential market were not consulting their doctor for

conditions like heartburn and dyspepsia and these were the people we

needed to communicate with,’ says Shire Hall Group chief executive,

Margot James.



The other issue was price, because Tagamet was more expensive than

products like Rennie. We had to get across the message that Tagamet was

designed to treat more than Rennie, and had to make people understand it

was worth paying a premium for these benefits.’



Shire Hall also worked on Bayer’s treatment for vaginal thrush,

Canesten, when it went off patent. ’We ran a campaign to educate people

about thrush,’ explains James. ’We did a survey of what women did to

treat it and found that some actually made the condition worse, so we

publicised that and got the message across about what thrush was and why

it needed a product like Canesten to treat it.’



With some big products due to come off patent soon, it will be

interesting to see whether manufacturers have learnt from previous

success stories and what new strategies they might employ. Eli Lilly’s

patent for Prozac, for example, will expire in January 2000 and the

company is believed to have studied the work on Zantac with great

interest.



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