Companies like Amgen and Johnson & Johnson have launched consumer awareness campaigns to help educate the large number of untreated psoriasis patients about the biologics available to them.

Most doctors treat the disease with the standard ladder approach, starting with a topical therapies and, if they fail, UV radiation as a second line and biologics only as a last resort. Amgen, for instance, estimates that only six percent of moderate to severe cases of the inflammatory disease are currently being treated with a biologic--a finding echoed by research firm Datamonitor, which cited the high dose required for efficacy as well as long-term safety questions as barriers to uptake.

Safety and efficacy are the two notes Amgen is striking in its latest one-two punch--a psoriasis-awareness initiative launched last summer followed in the fall by branded direct-to-consumer ads--to increase market share for Enbrel (etanercept), which has been losing ground to competitor products like Abbott's Humira (adalimumab). Enbrel currently has 78 percent of the US biologics market for dermatologic indications and 40 percent for rheumatology. But the product has also gotten a boost from strong Medicare Part D coverage.

Amgen reps declined to comment on the campaigns, but a 2006 earnings presentation listed "utilize multiple DTC channels" and "enhance the patient/physician dialogue" as key tactics. The company has also partnered with the National Psoriasis Foundation to encourage more aggressive treatment with the release of a study highlighting data that people with severe psoriasis tend to earn less than those with the mild form of the disease. The study also found that 57 percent of patients with severe psoriasis and 73 percent with moderate psoriasis are being treated only with topical drugs.

Less than two-thirds of psoriasis patients have been diagnosed, and marketing campaigns will be key to expanding the market, according to the Datamonitor report.

Johnson & Johnson unit Centocor is also going the unbranded disease-awareness route with a new 58-minute documentary screening in 14 cities. With an "Every journey begins with hope" tagline and a Web site at www.myinnerstate.com, Innerstate follows the twists and turns of three people coping with autoimmune inflammatory conditions, Crohn's disease, rheumatoid arthritis, and psoriasis. The film, which premiered in New York last week with a red carpet of D-List celebs like the winner of America's Next Top Model, is garnering mainstream coverage as the first-ever documentary financed entirely by a drug maker.

Centocor markets Remicade (infliximab) for the three conditions, a $3 billion injectable that saw 18.9 percent growth last year, largely due to approval for new indications, including--as you might guess--severe psoriasis.

Articles

Companies like Amgen, J&J launch DTC efforts to raise awareness of biologics.

Lights! Camera! Psoriasis!

Sex, money, fear, political intrigue. No, it's not Hollywood, but the increasingly high-volume back-story--or backlash--to the Gardasil rollout.

Last week, Merck's efforts to lobby local governments to mandate vaccination against the human papillomavirus (HPV) came under intense scrutiny, highlighting the minefield drug companies face when their big marketing and public-affairs budgets are used to sway uptake of new, expensive--and, above all, controversial--products. The uproar over Merck's lobbying efforts caused the company to halt its campaign last week--saying that its public involvement was doing more harm than good.

Taken together--along with the touchy issues of teen sex, parental rights, privacy and personal freedom--"you've got the perfect witches' brew," said Caren Turner, president of Turner Government and Public Affairs. "In general, people are mistrustful of new medicines. And anything involving children is going to involve an extra dose of caution."

A bizarre-bedfellows alliance--parents, the religious right, libertarians, and even obscure anti-vaccine advocates--were quick to bandy about the company's contributions to the likes of Texas Gov. Rick Perry's campaign and female lawmakers group Women in Government as a Gotcha! to protest mandatory-vaccination bills pending in several states and jurisdictions. Their grudges against Gardisal ran the gamut from fears that the vaccine might encourage promiscuity to the lack of long-term safety data to the slippery slope of government intrusion in personal liberty, especially because HPV cannot be spread in a school setting.

Merck's public-affairs tactics, according to its executives, have largely been educational: reaching out to groups that had concerns about the vaccine and providing clinical trial data to policymakers. Its DTC approach featured young girls pledging to be "one less" cancer statistic as well as an unbranded HPV awareness campaign to help women "make the connection."

But it was proof of money changing hands--Merck's political action committee gave $5,000 to Perry, for instance--that gave opponents the smoking gun that made the drug giant blink.

Turner estimated that the controversy could have a five-year chilling effect on sales volume. "It could have been avoided," she said. "This is a nation that was formed with a spirit of independence and a don't-tread-on-me philosophy. Merck might have been a little more patient. When companies push too hard, it backfires."

All pharma companies have government-affairs team--the key is to act with discretion and to start slow, perhaps not going straight to compulsory vaccination. "As with any new innovation, the political environment is very significant in determining the steps a company should take to launch the product," said Jeffrey Sandman, CEO of Hyde Park Communications, a public affairs firm. "Certain key stakeholders need a little more hand-holding."

Still, he largely defended Merck's efforts. "This is a dramatic innovation that will help save a significant number of lives," said Sandman, whose wife is a gynecologist. "If you think it's a ultimately a good thing--and I believe, absolutely--then you have to ask, 'What's wrong with the lobbying campaign?'"

Merck ends controversial lobbying campaign for HPV vaccine, but was it the right move?

A Game of Gotcha! Over Gardasil

As companies struggle with how to increase patient compliance and provide better disease information, AstraZeneca has given the American Cancer Society (ACS) $10 million to fund a program that connects underserved patients with medical resources. The grant--one of the largest corporate gifts ACS has ever received--will bankroll a near doubling of the group's Patient Navigator Program, currently linking patients with cancer educators at 60 sites nationwide who connect them with resources that range from the financial to the emotional.

Compliance remains a challenge even for oncology patients, who often face a life-threatening disease. A report from the Compliance Strategic Initiative, which includes ACS, found that 17 percent of breast cancer patients stopped taking tamoxifen (which AstraZeneca markets as Nolvadex) during the first two years of treatment, and 50 percent discontinued it by the fourth year. Social, medical, and educational support are among the factors contributing to increased compliance.

"Some patients don't know where to turn--there are just so many questions that they have," said Lisa Schoenberg, vice president of specialty care at AstraZeneca. "We have the opportunity to impact cancer care on a national scale."

The program is unbranded, and the educators--dubbed "navigators"--will not distribute information on the company's seven oncology products, which include blockbusters Arimidex (anastrozole), Casodex (bicalutamide), and Zoladex (goserelin). ACS will handle site selection, recruitment, and training for volunteers.

AstraZeneca, with US headquarters in Wilmington, Delaware, has had an ongoing relationship with local ACS chapters, according to Schoenberg. It has also supported such groups as the American Heart Association, whose services correspond with its other therapeutic areas. Even though the program isn't a strict marketing effort, better-educated patients are more compliant and tend to have better outcomes, Schoenberg noted. "At the very core of [our business], what we have at heart is the patient," she said. "Products are just one component of patient care."

The top-four corporate givers were pharmaceutical companies, according to the 

, a biweekly newspaper. But the industry tends to donate products rather than cash. For instance, Pfizer was the largest corporate philanthropist, donating $1.6 billion--but about 94 percent was in the form of drugs. Merck, Bristol-Myers Squibb and Johnson & Johnson also topped the paper's list, which looked at the Fortune 150. Corporate giving is expected to remain steady among pharma companies.

Unbranded effort with American Cancer Society will bolster patient education, compliance.

Pharmaceutical Executive-02-28-2007

Lights! Camera! Psoriasis!

A Game of Gotcha! Over Gardasil

AstraZeneca's Gift for Cancer Care