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Messaging in Anticoagulants Category ahead of Plavix Patent Loss

Manufacturers draw clear competitive delineations, make cases to garner market share available after Plavix loses patent

Millburn, NJ – April 30, 2012: The anticoagulants market is primed to experience a significant event in May 2012: the loss of patent protection for Plavix, a blockbuster with over $7 billion in sales reported by Bristol-Myers Squibb in 2011. With such a substantial market share newly available for competitors to seize, it is no surprise that manufacturers are drawing clear competitive delineations, crafting targeted messaging strategies for payers that highlight distinct competitive advantages. The Zitter Group’s Managed Care Message Monitor (MCMM) has been positioned to capture robust product messaging ahead of the upcoming patent loss, with strong volume observed for several products since October 2011. In particular, collected data shows obvious competitive messaging for Brilinta versus Effient and Pradaxa versus Xarelto, with manufacturers emphasizing different characteristics of their products in an effort to gain traction among payers.

Within the past six months, the MCMM has captured more messages for Brilinta than for any other product currently approved for acute coronary syndrome (64% of messages captured in the anticoagulant category), with a clear claim of superiority over Plavix. AstraZeneca strongly emphasizes Brilinta’s better efficacy in patients with acute coronary syndrome over clopidogrel, as well as a quicker onset of action. Further competitive messaging is focused on Effient as a direct competitor, stressing the fact that Brilinta has a more favorable safety profile, while highlighting bleeding risks seen with Daiichi Sankyo’s product. Effient messaging also claims superior efficacy and safety to Plavix, with particular emphasis on the former product’s effectiveness following stent insertion surgery. Both AstraZeneca and Daiichi Sankyo are touting their superiority to Plavix, but Brilinta messaging is also competitive towards Effient.

In contrast to Brilinta and Effient messaging, the strategy observed for Pradaxa and Xarelto is competitive, though not focused on Plavix, as neither agent has approval for use in acute coronary syndrome. Janssen is currently seeking approval for Xarelto use for this indication. Messaging for both agents is focused instead on comparisons to warfarin for atrial fibrillation and stroke prevention. While Xarelto has proven non-inferior to warfarin, Pradaxa can claim superior efficacy. Boehringer Ingelheim strongly emphasizes this fact, seemingly confident that reduced hospitalizations will lead to an overall reduction in medical costs and ultimately offset Pradaxa’s price. Pradaxa messaging posits that the product’s efficacy is superior to Xarelto, as well. Janssen’s messaging strategy appears meant to highlight Xarelto’s non-inferior efficacy compared to warfarin, but cannot claim that the agent is as efficacious as Pradaxa. Instead, Janssen highlights Xarelto’s more convenient dosing schedule compared to Boehringer Ingelheim’s product. Its multiple indications are also a point of emphasis, particularly as Janssen expects the product to receive approval for acute coronary syndrome in the near future, which may allow payers to expose Xarelto to a broader population than its competitors.

Competitive delineations have always been fairly clear within the market for anticoagulants based on product indication and usage. These dynamics have lately taken on new importance as the patent for Plavix is set to expire, with Bristol-Myers Squibb messaging urging payers to continue using its product in order to take advantage of price erosion as generics enter the market. Competitive messaging from AstraZeneca and Daiichi Sankyo suggests strong interest in the market share that will become available after Plavix loses its patent, as evidenced by their messaging strategies that claim different superiorities over Bristol-Myers Squibb’s blockbuster agent. Both manufacturers make the case that payers should prefer their agents over generic clopidogrel based on “proven superiority.” Boehringer Ingelheim and Janssen messaging also shows mutual competitiveness, downplaying each other’s products in different ways. It is probable that Janssen has its eye on Plavix market share if and when Xarelto receives an indication for acute coronary syndrome. The competitive stance of Janssen’s payer messaging strategy will likely evolve at that time, as has been observed consistently in the MCMM when products in other therapeutic categories have received new indications. Given the number of players in the anticoagulants market, it will be interesting to see which manufacturer’s strategy will most strongly influence payer management decisions after the Plavix patent loss.

ABOUT THE ZITTER GROUP The Zitter Group is a business intelligence firm that assists life science companies with issues related to product access, reimbursement, and managed markets. Founded in 1989, The Zitter Group provides data-driven business insights derived from the nation’s largest payer research panel. The company produces the largest and most detailed database on prior authorization policies, several of the largest syndicated studies on payer management of specialty and oncology drugs, and the only service tracking messages account managers provide to payers. For additional information on The Zitter Group, please visit

ABOUT THE MANAGED CARE MESSAGE MONITOR The Managed Care Message Monitor is a comprehensive database of drug manufacturer product messages and characteristics of representative meetings with 122 active payer panelists. This platform quantifies payer reactions to manufacturer payer marketing efforts, giving clients unique insight into the reception of their products and the likely evolution of therapeutic markets based on product entries and manufacturer representative activity.


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Posted: May 2012