Shire and GalxoSmithKline have teamed up to promote Shire’s ADHD treatment Vyvanse to adults. The combined 1,200-person sales force will cover pediatricians and neuro-health physicians in an effort to reach as large a swathe of specialties as possible.  

The approval to market the two-year-old Vyvanse to adults was a huge boon for Shire, which faces generics competition to its popular ADHD drug Adderall XR. However, the drug firm was not sure it had the in-house sales force capacity to handle the increased consumer population. 

“One of the things that became clear to us when we were looking at marketing to adults was that our model doesn’t fit,” said Mike Yasick, senior vice president and therapeutic area lead for ADHD at Shire. “We have a model of small sales forces dedicated to specialty markets. But when you look at adult ADHD, [which is] poorly diagnosed and treated, you need to contact a lot more physicians.” 


GSK turned out to be a perfect candidate to come to Shire’s aid, with a strong CNS portfolio and an established neurohealth division. There was also little overlap with Shire’s sales force, making it easy to avoid redundant sales calls. 

Rather than outsource or fill new sales positions, GSK will reshuffle its existing neurohealth and primary care sales force, and add Vyvanse to the mix; it’s allotting 600 reps to the drug to supplement Shire’s existing 600-person team. The two companies will share an unspecified percentage of the drug’s profits. 

In anticipation of generics competition, Shire pulled promotions from Adderall XR a year and a half ago. Its sales force shifted to Vyvanse exclusively, and will continue to market the treatment to approximately 43,000 pediatricians and pediatric psychiatrists. 


Vyvanse is therapeutically inactive until it’s metabolized in the body. Unlike extended released products-such as Shire’s Adderall XR-the prodrug technology may help Vyvanse avoid the peaks and valleys of some ADHD treatments. Initially approved for children 6 to 12 years old, the drug was expanded in July 2008 for the treatment of adults over 17 for ADHD.

Whether Vyvanse will make a dent in the coming wave of generic Adderall clones remains to be seen. Shire is banking on the fact that neurologists will like the drug’s smooth release.

“Not only is it smooth, but it’s more consistent from patient to patient; physicians tell us they like Vyvanse because they aren’t surprised by how the drug is being received,” said Yasick. “Drugs that are released through PH or that depend on GI transit time can have a lot of inter-patient variability.”

Articles

Now that Vyvanse, Shire's innovative ADD drug, has been approved for adults, the company needs help to quickly roll out a complex message to neurologists. Its solution: a partnership that takes advantage of GSK's CNS muscle.

Shire Joins with GSK to Promote ADHD Drug

The number of patients abandoning their prescription drug treatments spiked 34 percent according to a Wolters Kluwer report released to 

Abandonment is measured when a pharmacist submits a claim to the insurer, the insurer pays the amount that it’s supposed to cover, but the patient never picks up the drug. As of the fourth quarter of 2008, the abandonment rate for prescription drugs was 6.77 percent, while the rate for generic drugs was 4.14 percent. 

“It’s usually financial implications, particularly around copays for out of pocket costs, that drive the abandonment rate more than anything else,” said Dea Belazi, practice leader, managed markets at Wolters Kluwer.

Copay rate plays a major role in the decision to abandon a drug, according to the report. Branded drugs that cost more than $30 are twice as likely to be ditched at the pharmacy, while drugs that cost less than $10 are only abandoned about 5 percent of the time.

To combat abandonment, drug companies have begun working with the insurance provider to negotiate a lower out-of-pocket cost for the patient. For example, if a drug is in a higher tier, the pharma company will try to get the drug on a lower tier. Coupon distribution and loyalty cards are also becoming more commonplace to help offset some of the costs. 

 that the rate abandonment also differs significantly between therapeutic categories. Biotech, for instance, has much higher copay rates, and in turn has a much higher abandonment rate. 

“The trend from 2006 has been edging higher because of increasing copays and economic conditions over the past 12 months,” Belazi said. 

Abandonment should also not be confused with compliance problems, which costs the drug industries billions of dollars each year. “Compliance is overall a larger issue that would include abandonment as a potential reason, but also includes side effects, cost, and forgetfulness,” Belazi said. 

Additionally, the number of denied prescriptions has increased 26 percent since 2006. Nearly 11 percent of branded medications were denied by health plans in the final quarter of 2008, up from an average of 8.6 percent in early 2006. 

News Analysis

Compliance woes and stingy insurance providers are walloping the pharmaceutical industry. But now another nuisance is rearing its ugly head, as a high number of patients are ignoring their doctor's orders and dropping their prescriptions on purpose.

Pharmaceutical Executive-04-02-2009

Shire Joins with GSK to Promote ADHD Drug

Prescription Abandonment Numbers on the Rise