Putting the Pressure On

Novartis is hoping to make a big splash with its newest hypertension drug, shaking up a sluggish market that has seen little innovation over the past decade. Tekturna (aliskiren), which boasts a novel mechanism of action, is one of two major launches coming out of the company's cardiovascular franchise this year. Debut number two is Exforge--which combines its best seller, Diovan (valsartan), with the generic version of Pfizer's Norvasc (amlodipine)--with a multifaceted third-quarter blitz including community outreach, disease awareness, and a celebrity spokesperson.

The Swiss giant is also pulling out all the stops for Tekturna. "Everyone should expect we'll have a competitive launch," said Mark Iwicki, vice president of the cardiovascular brand team. Without giving too much away, he noted that Novartis is contacting 85,000 physicians and preparing a comprehensive med-ed program. The company has added 1,000 sales reps in the US to support new-product launches, including Exforge and Tekturna, according to the company's annual report.

Tekturna is the first in a class of drugs called direct renin inhibitors, which have been 30 years in the making. While other drugs try to control the effects of renin, Tekturna blocks its production from the get-go. "It's been a hard mechanism to master and bring to market," Iwicki said. The promise, however, is a drug that could have better efficacy than those already available.

Yet Novartis will be introducing its newcomer into a field that is crowded with good generics. And it will also need to guard against the ever-present frustration of patient noncompliance, especially tricky for a silent killer like hypertension.

The firm is currently funding a number of "outcome" mega-studies that could one day allow it to market the drug for additional indications. In the meantime, it expects Diovan to remain its first-line therapy for hypertension, with Tekturna prescribed when patients need additional therapy--as most do. "This product can absolutely be used first line, [but] managed-care plans are really pushing generics right now," Iwicki said about Tekturna. "A large piece of the business will be in combination with other drugs."

Diovan, one of four hypertension drugs in Novartis' portfolio, grew 15 percent last year to $4.2 billion.

On the consumer front, patients who take Tekturna will be able to sign up for the company's BP Success Zone, a program that uses a number of tools to drive home the message of why it's important to stick to therapy. Doctors also get help--like 3-D images of the havoc high blood pressure wreaks inside the body--communicating the point.