With an FDA and European Commission green light for Januvia in late 2006 and early 2007, respectively, and with Janumet soon
to cross the finish line as well, Merck did what Big Pharma is still in a position to do best: funnel substantial resources
into myriad channels. Educational outreach around Type 2 diabetes helped seed the market before drug approval was secured.
With approval, branded materials and a rich promotional platform followed, online and off, including healthcare professional
training programs, engagement of KOLs, celebrity appearances, DTC advertising and a sales force stretching across the globe.
Merck tapped former NBA star Earl "The Pearl" Monroe to share his story with patients, including tips about healthy eating
and advice on ordering food at a restaurant.
El-Dada says Januvia's initial approval, in Mexico in August 2006, provided a testing ground for the larger launch effort.
"We could take what we learned from the launch in Mexico and apply it elsewhere, where it made sense," he says. A drug's performance
in the market is often foretold by it's performance at launch, and Merck "put a significant investment into making sure that
we had rapid access, and that meant both the earliest possible launch in as many markets as we could get," while at the same
time "making sure that we had rapid reimbursement and, in the United States, that we had rapid approval on managed care plans
to provide access for patients," says El-Dada, adding that the therapeutic area helped, too. "I think the payer community
realizes that diabetes accounts for roughly 15 percent of their total costs if you include the cost of treating the complications,
so it's a pretty well-covered category."
Merck got an early start with physicians, educating not only on Type 2 diabetes in general, but on incretins and the incretin
pathway, "since this is the mechanism through which [sitagliptin] worked," says El-Dada. "We started with scientific leaders,
and then we expanded to the specialist community, and then we expanded from there to office-based physicians" prior to approval
Post approval, branded campaigns commenced, in addition to a continuous, non-branded educational push around the importance
of healthy living, and the potential for long-term complications resulting from uncontrolled diabetes. Merck funded a program
called "Journey for Control," which provided resources to certified diabetes educators to have a series of small-group interactions
with patients, and the company partnered with the American Diabetes Association (ADA) and the American College of Endocrinology,
the latter for an educational campaign called Blood Sugar Basics, which provides information to patients about managing diabetes.
Music industry veteran, Type 2 diabetic and American Idol judge Randy Jackson participated in Merck's "Taking Diabetes to
Heart" campaign, to "drum up" awareness of serious complications, and to urge patients to "get in tune" with the disease.
NFL defensive tackle, and Emmy-winning ESPN broadcaster Mike Golic joined the unbranded Blood Sugar Basics campaign. For Diabetes
Restaurant Month, former NBA star Earl "The Pearl" Monroe, in videos now posted on YouTube, offers tips for diabetics ordering
food in a restaurant, where ingredients and portions aren't as controlled as homemade fare.
http://Journeyforcontrol.com/ has become Merck's centralized hub for consumer information on diabetes, and the site includes downloadable tools for patients,
quizzes, educational resources, doctor discussion guides, and more, in addition to an interactive "conversation map" created
through a partnership with the ADA and Healthy Interactions, a company that facilitates face-to-face, dialogue-driven sessions
guided by a trained facilitator around a disease. The unbranded conversation map program features a Candy Land-esque map that
patients can navigate for a more immersive educational experience. Industry onlookers have lauded Merck's online activities
in support of Januvia; a Manhattan Research survey in 2009 found that
http://Januvia.com/ had more US-based physician visitors than any other site in the endocrinology category.
Merck has also reached out to the Hispanic community in the United States, with culturally relevant marketing materials as
well as community and pharmacy-based outreach. El-Dada says Merck piloted these programs in areas with large Hispanic populations,
like Los Angeles, and the company is expanding into other places, like Texas. "As the brand matures, you start to look for
more and more micro-marketing types of opportunities," says El-Dada.