Biologic Superbowl: Inflammatory Bowel Disease Marketing

(note: Roger and Tony are fictional characters but the information they share is real)

Please welcome Roger Seco (RS) and Tony Ventris (TV). They will be assisting in segments on inflammatory bowel disease marketing. Not knowing what to do since the superbowl ended, they've decided to turn some of their free time toward watching the drug market for gut problems.

Roger, Tony, tell us what you've seen.

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RS: There's a battle ranging out there, everyone's fighting hard, trying to get a piece of the action. It's a potential gold mine. Remicade set the standard. They showed that every person out there with Crohn's or ulcerative colitis is potentially worth $30,000 year in treatment.

TV: Right. Every IBD patient is a mini-gold mine. The makers of Remicade, Humira, and Tysabri are wild west fighters, pulling out all stops to to stake claims. It's $30,000 for every man, woman, and child with IBD (and an intestine).

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RS: Unclaimed riches! Humira's only been out a short time and it's already generated $3.1 billion in 2007 sales--the sales include using Humira for arthritis as well as Crohn's.

TV: Gold mine! $30,000 a year, covered by insurance, covered by Medicaid. Every citizen can be put on the stuff.

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RS: Plus, there's almost no way these drugs are going generic.

TV: They're too complicated. No pill-popping here. With the injections and medical oversight needed for these treatments--the checks for tuberculosis and checks for injection reactions--the generic companies won't be taking this on any time soon--probably never.

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RS: But do these drugs work?

TV: They all have the FDA's black box warning. This is the FDA's strongest warning. These drugs suppress your immune system and in bad circumstances, they can kill you fast.

black box warnings: Remicade (Infliximab), Humira (Adalimumab), Tysabri (Natalizumab)

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RS: But can't most drugs kill you?

TV: All drugs have some side effects but not many get the black box warning--in the case of the biologic drugs for Crohn's, they can suddenly turn deadly.

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RS: But back to my question. Do these drugs work?

TV: They seem to help about half the people with IBD. After a year, Remicade stops working for 50% of the people. Short term, you'll get some relief. Long term, your body will be hammered.

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RS: So these marketers have their work cut out.

TV: These drugs are unbelievably expensive and potentially deadly--but they're selling fast.

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RS: In a way, these marketers are mavericks, real heroes in their ability to shape public and medical opinion.

TV: We haven't seen work this ground-breaking since Eddie Bernays.

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RS: Wow! They're that good.

RS: Next time we'll talk about Remicade's big win in last week's Lancet article. Their marketers are magicians: they made a $30,000 black box drug look better than a $4 drug with no black-box warning.