Merck Vaccine Market Takes Center Stage

On Tuesday, Merck gave a rundown of the state of its vaccine business, informing analysts of its latest campaign results and announcing a reimbursement program for physicians.

Margaret McGlynn, president of Merck's vaccine and infectious disease division, said that the company has achieved fourfold growth in revenue in its vaccine business since 2005, due largely to the launch of Gardasil, RotaTeg, ProQuad, and Zostavax.

"Understanding vaccine revenue curves is extremely complex," McGlynn said. "It's very different from pharmaceutical or specialty products, where you can monitor weekly and monthly prescriptions and have people on chronic therapies. In the case of vaccines, you have to deal with questions of forecasting, for example, what the peak penetration will be."

As for patient compliance, Merck has seen that 75 percent of patients who take the first dose of Gardasil take the second dose, and about 50 percent complete the three-dose regimen. Merck said that it has had trouble penetrating the later age Gardasil market in the 19-to-26 age bracket. To combat the problem, the company launched a new DTC campaign to drive young adults to ask their doctors about Gardasil and the human papillomavirus, as well as a viral marketing program to get patients to send links to their friends.

Reimbursement
To get OB/GYNs to understand how to become vaccinators, Merck has had to change the way it reimburses for Gardasil, by rolling out a helpline and sending specific materials to OB/GYNs to help them understand reimbursement, while providing information to patients to learn if their health plans reimburse for the drug.

"Even though we have all these programs in place to help patients understand reimbursement, there is still anxiety with OB/GYNs over whether or not they can be reimbursed," McGlynn said.

After a lot of market research, Merck has taken a simple approach to solve the problem. Now, if an OB/GYN files a claim and the patient had insurance that would not reimburse the doctor, Merck will replace the dose so that there isn't an economic outlay for the physician.

"We've had significant buy-in with this concept, and we really believe that this is an effective approach to address concern about reimbursement" McGlynn said. "Many physicians have told us that as a result of having this program available, they will convert to same-day vaccination rather than making patients check with their insurance company first."