Clock Watchers

After the termination of clinical trials for torceptrapib, Pfizer's hold out for softening the blow of losing patent protection on mega-blockbuster Lipitor, the company is fighting to hold onto its reputation as the industry's most enviable marketing powerhouse.

In typical Pfizer fashion, the company has amplified marketing and promotional efforts around the world's best-selling drug--despite cost cutting in sales and operations that began late last year and will almost certainly accelerate in light of the torceptrapib news.

For the second consecutive quarter, Pfizer was one of the most aggressive contractors for preferred formulary status with managed care organizations (MCOs) and pharmacy benefit managers (PBMs)--and Lipitor (atorvastatin) was the brand that came up in negotiations again and again, according to consulting firm Cognet-X, which conducts weekly surveys of MCO and PBM executives.

Respondents revealed that Lipitor and Exubera (Pfizer's much-hyped inhaled insulin product) were the most heavily promoted brands in the third quarter.

The addition of generic simvastatin to the statin category this year left not only Pfizer but also AstraZeneca fighting tooth and nail to retain market share. But unlike Crestor (rosuvastatin) and Vytorin (Merck/Schering-Plough's ezetimibe, simvastatin combo), Lipitor experienced a downturn in the number of formularies that listed the drug on a preferred tier.

Pfizer executives "don't want to lose market share to the generics now," said Sharon Bender, executive director of strategic initiatives at Cognet-X. "That's their flagship product; they have the most riding on it. Its importance to Pfizer cannot be overstated."

Even in its defensive position, Pfizer is still playing hardball--battling not only for preferred status but also to eliminate restrictions like step therapy and prior authorization that can keep patients off the drug. The company also has been offering rebates for other Pfizer products when Lipitor was given preferred formulary status.

But Bender noted that the company is likely to face greater hurdles next quarter. With the loss of torceptrapib, Pfizer's desperation is well noted. "I wonder if there will be a perception in managed care that it's a buyer's market," she said.

But contracting is just one area where Pfizer is focused. The company in April launched a new advertising campaign for Lipitor, the theme of which highlighted its benefits and cost-effectiveness. The company has also conducted additional post-marketing studies on Lipitor, in order to differentiate it from its competitors.

Yet with Pfizer's plan to cut 20 percent of its sales force--a figure that could likely increase--the company's in-house and agency marketers are questioning whether there could be reverberations on their side of the business as well. After the first round of sales force cuts last year, Pfizer cut its promotional budget 15 percent, perhaps foreshadowing things to come in 2007.

But John Kain, vice president of marketing at ImpactRx, noted that Pfizer is not about to pull promotional support from its biggest earners or most promising new brands. The company might actually increase its journal adverting or consumer outreach to make up for lost detailing opportunities. "They're not just going to go quietly into the night," Kain said. "They're just too smart to do anything really blunt."

The company itself has pledged to maintain "strong" sales support for Lipitor, Celebrex, Geodon (ziprasidone), Lyrica (pregabalin), Exubera, Chantix (varenicline), and Sutent (sunitinib).

On the advertising side, Pfizer remains dedicated to its mature brands. This year, it launched new direct-to-consumer campaigns for Viagra (sildenafil), Celebrex (celecoxib), and Zyrtec (cetirizine).