Launch Excellence in the Diabetes Market: Lessons from - IMS Health

More documents

Recommendations

Info

WHITE PAPER | DIABETES LAUNCH EXCELLENCE PHARMERGING MARKETS: A DIFFERENT GAME The dynamics for first-to-market products are less rigid in the Tier 1 and Tier 2 pharmerging markets than we’ve observed in developed markets. In Brazil, Russia, and India, for example, Merck’s Januvia was launched before Novartis’s Galvus. Nevertheless—and unlike mature markets—Novartis’s family of products accounted for more than 50 percent of the DPP-IV market in 2011. (See Fig. 3) Most of this success is attributable to Eucreas, which has outperformed Janumet considerably. Meanwhile, Galvus has held its own against Januvia; its uptake has been comparable to that of Januvia in Brazil and Russia, and greater than Januvia in India. FIGURE 3: SPLIT OF DPP-IV CLASS VALUE SALES BY COUNTRY 2011 IN US$* Share of Market 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 6% 35% 36% 3% 20% EU5 1% 2% 10% 23% 63% 1% 9% 4% 1% 10% • In Brazil Galvus and Eucreas launched at the same time; 21% 24% 17% Janumet lagged Januvia • Galvus embarked on a 16% 16% 17% broader effort to promote than Januvia 15% 38% 55% USA Brazil Russia India Tradjenta Kombiglyze XR Onglyza Janumet Januvia Galvus Eucreas *Galvus launched Jan 2012 in China so no sales data as yet. Galvus and Eucreas not launched in USA. Indian sales include local branding of Jalra, Jalra-M, Zomelis, Zomelis-M, Istamet and Istavel assigned accordingly to Galvus, Eucreas, Januvia and Janumet. A number of interacting factors cause the differences in market dynamics between mature and pharmerging markets. The first is that companies may focus on mature markets at the expense of pharmerging markets based on assumptions about where the best return on investment may be achieved. It is time to revisit these assumptions, considering that in 2011, combined sales for non-insulin anti-diabetics across BRIC were higher than they were in each of Germany, France, or the UK. What is more, these pharmerging markets experienced an average annual growth of 26 percent for diabetes products from 2007-2011—a rate that is expected to continue. Although generic products currently dominate the pharmerging markets, growth of branded product sales is stellar, at 38 percent between 2010 and 2011. Local issues and local knowledge are also likely to have a big impact on the relative success of different DPP-IVs in the pharmerging markets. Novartis’s vildagliptin family of products gained the upper hand in Brazil for a number of reasons. Novartis promoted Galvus more heavily than Merck promoted Januvia, and Novartis launched its two vildagliptin-based products together (whereas Merck launched Janumet after Januvia). These factors combined to help Novartis achieve sales for its family of DPP- IVs that were 40 percent higher in 2011 than Merck’s were for the Januvia family. IMS HEALTH | LAUNCH EXCELLENCE IN THE DIABETES MARKET 6 27% 29% 100% China
WHITE PAPER | DIABETES LAUNCH EXCELLENCE Another opportunity is to employ different approaches to commercialization: winning in pharmerging markets is driven by adaptation to the local environment, not by the precedent of mature market success. In pharmerging markets, the importance of local knowledge means that “going it alone” may not be an effective strategy. This is illustrated in the different approaches and outcomes for Novartis and Merck in India. In late 2008, Novartis joined forces with a local partner, USV, to co-promote Galvus and Eucreas. Local branding of the products as Jalra and Jalra-Met and a large sales force led to fast market penetration. In contrast, Merck did not capitalize on its firstto-market position, but waited until after Novartis launched Galvus to increase its sales force. Eventually, three years after launching Januvia and more than two years after the Novartis/USV agreement, Merck partnered with Sun Pharma. Together they launched local brands, Istamet and Istamel, in 2011. This was too late to unseat Novartis’s products, however. In 2011, Novartis’s family of products had secured 56 percent of the Indian DPP-IV market, compared with 34 percent for Merck’s family of products. DIFFERENTIATION: HOW MUCH IS ENOUGH? IMS’s research with Key Opinion Leaders, providers, and payers suggest that recent DPP-IV launches have lacked clear and meaningful points of differentiation in the eyes of prescribers and patients, despite manufacturers’ efforts to the contrary. IMS Therapy Forecaster interviews suggest that physicians tend to believe that “all DPP- IV inhibitors are the same”. That is, they do not see the differentiation that exists as being clinically meaningful. Onglyza, for example, is more potent than Januvia and Galvus, but the lower doses required with this product do not improve efficacy or safety. The distinction, therefore, doesn’t register with physicians. Patients, too, are difficult to sway. Kombiglyze XR is taken once daily, compared with twice daily for Janumet. From the uptake of Kombiglyze XR in the U.S., however, it would appear that patients do not value this additional convenience enough to switch medications. Given the size of the global diabetes market, segments of the diabetes population represent valuable opportunities, and new products can be targeted to capture them. But, this strategy, too, is fraught with challenges. Boehringer Ingelheim targeted a niche patient segment—those with renal impairment—with Tradjenta because the product is not excreted via the kidneys, unlike other DPP-IV inhibitors at the time. Although it remains to be seen if this product will be successful in the U.S., it is experiencing slow uptake in Europe following two blows. First, Onglyza received supplementary approval for the same patient group. Second, the German Institute for Quality and Efficiency in Health Care (IQWIG) failed to find that Tradjenta provided an added benefit and ruled that it should be compared not only against other DPP-IV inhibitors, but against other diabetic agents. This resulted in Boehringer Ingelheim choosing not to launch in Germany rather than accept a sub-optimal price, with wider European ramifications. IMS HEALTH | LAUNCH EXCELLENCE IN THE DIABETES MARKET 7
Page 1 and 2: Launch Excellence in the Diabetes M
Page 3 and 4: WHITE PAPER | DIABETES LAUNCH EXCEL
Page 5: WHITE PAPER | DIABETES LAUNCH EXCEL

Launch Excellence in the Diabetes Market: Lessons from - IMS Health

Create successful ePaper yourself

Delete template?

Save as template?