But this time it was. Within six months of launch, Cipro was on 99 percent of hospital formularies, and by year end, the forecast
had proven true.
In the 1980s, Bayer put Cipro in the hands of a project team with membership from the key clinical functions, preclinical
functions, and marketing. Cross-functional teams always sounds good but often fail. For Marc VanUnen, the current director
of anti-infective marketing for Cipro/CiproXR, what made the approach work was accountability.
"In the old model," explains Harris, "if it's a marketing objective, it still comes back to marketing—'Oh, it's marketing's
fault.' Cipro's model is: Get everyone in a room, and if you cannot come to a decision or cannot do it because of a guideline,
you find a way that fits the guidelines or the timelines or the restrictions. If a medical person says they cannot do it,
it's not, 'Oh, you're going to do it.' Rather, it is, 'Let's find a way of making it work.'"
In a sense, though, the team also included the substantial participation of the global community of microbiologists and infectious-disease
specialists. Key thought leaders came to Bayer with ideas for new indications and formulations, and the company funded everything
that came its way—including preclinical studies. At one point, according to Westwood, every hospital in the United Kingdom
was testing Cipro for one thing or another. "I had something like 60 studies running," he says. "In the US, we blanketed the
country, clinical and preclinical, in vitro, animal models, pharmacokinetics, and pharmacodynamics.
"Cipro was a very hands-on experience for many physicians. They understood how it worked. They recommended it in the hospital
environment and then transferred that endorsement to community use. At one meeting in 1986, there were 113 presentations about
Cipro—just to give you an idea of how many people were involved."
This Drug's Life. Reinvented, repositioned, and relaunched, Cipro lived long, and Bayer prospered.
The Case for Quinolones
Almost from the start, Cipro used its research base to add indications: typhoid fever, chronic bacterial prostatitis, intra-abdominal
infections, sinusitis, febrile neutropenia, and of course the disease that added the drug's name to the vocabularies of late-night
comedians: anthrax. The drug dominated the field of UTIs, but in 1996–1997, the team wanted a larger share of the respiratory
market. That was doubly important, because of another upcoming Bayer quinolone, Avelox (moxifloxacin), which was expected
to do well in the respiratory arena. By building the case for quinolones in RTIs, Bayer could pave the way for Avelox.
The result was the Cipro Oral Launch Team (COLT) campaign. The team built pulmonary advisory boards and collected "a ton"
of publications. "Without that, it would have been difficult," says Harris. "A lot of physicians were like, 'Wait a minute—Cipro
effectively covers strep?' The reps were not just pulling out reprints of one clinical study, they were pulling out four and
five. They had slide kits and other support material. We had unbelievable support from top pulmonologists and infectious-disease