The Lifecycle of Cipro - Pharmaceutical Executive

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The Lifecycle of Cipro
A cross-functional team of medical, clinical, marketing, and regulatory experts has kept Cipro's lifecycle going for an impressive 17 years--and counting.


Pharmaceutical Executive


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.

Fund Everything 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.


This Drug's Life. Reinvented, repositioned, and relaunched, Cipro lived long, and Bayer prospered.
"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."

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 people."


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