Drugmakers eye growing IBS market with DTC push



One month after an animated intestine promoted Valeant's irritable bowel syndrome drug during the Super Bowl, two other drugmakers launched a new campaign aimed at promoting their own treatment for the gastrointestinal disorder.

Valeant, which manufactures Xifaxan, and Allergan and Ironwood, which are promoting Linzess, are making big pushes for their second-line treatments as they eye a massive market with few new prescription drug options.

“Two years ago, we wanted to help patients describe their symptoms — it was all about pain and constipation, and it was a functionally focused ad,” said Tom McCourt, Ironwood's chief commercial officer. “This ad really focuses on the frustration that patients feels, ‘I've tried laxatives, I've tried exercises, tell me something I don't know.”

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Ironwood and Allergan launched the Tell Me Something Different campaign (pictured) for Linzess, which is used to treat IBS-C. (IBS largely comes in two types: with diarrhea (IBS-D) or with constipation (IBS-C). Xifaxan is a treatment for IBS-D.)

IPG agency FCB Health helped develop the campaign.

The stop-motion advertisement shows a number of patients who have heard about all the typical treatments, asking to be told “something they don't know.” One man stands in a drugstore aisle, saying “tried laxatives, been there, done that.” Ironwood and Allergan spent $2.6 million on the spot with 328 national airings, according to estimates from iSpot.tv.

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Allergan is targeting primary care physicians through 1,200 sales reps while Ironwood is targeting the top prescribing gastroenterologists through 160 reps. 

Irritable bowel syndrome is often treated initially through changes to diet, stress reduction techniques, over-the-counter medicines, and antispasmodic agents, which are all aimed at relieving symptoms. Prescription drugs typically represent the next line of treatment—especially for patients experiencing abdominal pain.

The NIH estimates that 45 million Americans have the disease, a sizable patient population and one that may be growing in treatment demands. Market research firm GlobalData estimates the global market for IBS drugs will nearly triple in size from $589 million in 2013 to $1.5 billion by 2023.

Valeant's biggest TV push to date for Xifaxan was during the most recent Super Bowl—the third-most watched program in U.S. television history. The spot features an animated intestine who scrambles to the bathroom during a bout of abdominal pain at a sporting event. The drugmaker spent $12 million on the ad in 422 national airings, according to estimates from iSpot.tv.  

See also: Toenail fungus, IBS drugs headline pharma Super Bowl play

Xifaxan is the only prescription drug that treats IBS-D besides Viberzi and Lotronex. Lotronex, which is manufactured by Prometheus Laboratories, was pulled from the market in 2000 for two years due to safety concerns—but it is only available through a restricted marketing program and the FDA has said it should only be prescribed to a small subset of patients.

Allergan's Viberzi, which was approved the same month as Xifaxan, was just made available to patients in December 2015. It is also marketed with restrictions because Viberzi is considered a scheduled substance by the Drug Enforcement Administration.

Xifaxan generated sales of $220 million in the third quarter of 2015, up from $148 million in the second quarter of the same year. Valeant is expected to release its full 2015 financials next week.

Allergan gained the rights to Viberzi through its acquisition of Actavis. Its IBS-C drug, Linzess, was approved in 2012 and is one of two prescription drugs approved to treat IBS-C, along with Takeda's Amitiza, which came to market in 2006. Linzess brought in sales of $459 million in 2015, up 55% year over year. Its patent expires in 2026. Amitiza brought in sales of $248 million for the first three quarters of 2015 and faces patent expiration in 2020.

Xifaxan's list price is $1,832 for 60 tablets, or a month's supply, which costs significantly more than Linzess. That drug's list price is $304 for a 30-day bottle.

McCourt explained that the impact of Xifaxan's and Viberzi's approvals on Linzess sales are not yet clear, as the drugs treat different forms of the disease (Xifaxan/Viberzi for IBS-D, Linzess for IBS-C). He did note, however, that “noise overall is going to raise awareness for patients.”

Correction: An earlier version of this article misstated that Lotronex was the only prescription drug besides Xifaxan to treat IBS-D.