Teaching an Old Market New Tricks

A company needs to be bold to launch a product in the hypertension market, a crowded category under pressure from generics and poor patient compliance. Undeterred, Novartis is gearing up to launch its newest combination therapy complete with a multi-brand marketing blitz boasting community outreach, disease awareness, and a celebrity spokesperson.

The Swiss drug giant is banking on its tentatively approved drug Exforge to pump up the sluggish high-blood-pressure market. The approval is tentative because Novartis must wait to launch the product until September, when key ingredient amlodipine (currently marketed by Pfizer as Norvasc) goes off patent. Exforge combines Norvasc with Novartis' own Diovan (valsartan), the two best-selling drugs in their categories. Taking the two drugs together not only has an additive effect but reduces the common side effect of edema, according to Mark Iwicki, vice president of the cardiovascular metabolic brand team.

Agencies Deutsch and Integrated Communications are teaming up with Novartis to kick off the Exforge campaign after the product debuts in the fourth quarter of this year. The company intends to keep busy until launch time introducing the drug to doctors at medical meetings.

The hypertension market grew by just 4.3 percent in 2005, and five-year forecasts aren't much brighter--mostly due to the intense generic competition and a lack of new R&D targets, according to market research firm Datamonitor. "Most of these products have run their course," said Laura Greenwood, an associate analyst. "You might say the hypertension market is reaching the end of its cycle. There's no unmet need."

As a result, companies are turning to combination therapies, one of the market's fastest-growing segments. With Exforge, Novartis is hoping to target the 70 percent of hypertensive patients who need at least two medications to control their blood pressure, according to Iwicki.

But compliance may be a higher hurdle than efficacy. While a two-in-one pill is a significant advance in convenience, no combo can alter the fact that without telltale hypertensive aches and pains interrupting their lives, many patients tend to skip doses or worse, especially when side effects show up. "It's quite common that they stop taking their products," Greenwood said.

The compliance conundrum is something Novartis has been addressing across its blood-pressure portfolio. Its BP Success Zone, which spans brands, is a campaign to raise awareness about hypertension--with NFL Hall of Famer Joe Montana as its celebrity persona. Patients on a Novartis' hypertension drug receive customized educational information each month. "We'd expect to do something similar with Exforge," Iwicki said.

Novartis in November also designed 3-D graphics illustrating the havoc that uncontrolled high pressure can wreak on the body; dubbed "Dialogues," these visual aids are meant to help doctors drive home the point about why it's important for patients to adhere to therapy. A Novartis-commissioned survey found, for instance, that while 85 percent of doctors believe they are fully explaining the risks of hypertension, only 50 percent of patients are taking their medications correctly.

Greenwood was conservative about Exforge's market potential. "We have forecasted that Exforge will be a popular drug but may not be a blockbuster," she said, noting that a Datamonitor analysis of Novartis' pipeline shows a recent shift away from the cardio market toward more lucrative fields, particularly oncology, where it can expect a greater return on investment.Iwicki disagreed with the projections. "This is a really robust market," he said. "We're in this for the long run."