Crestor has had the science on its side, but the brand has also benefited from savvy marketing, helping to vault sales of the drug 19% for the first half of 2008, according to IMS Health.
The AstraZeneca statin continues to trail Lipitor and simvastatin by a wide margin in dispensed scripts, but is making steady progress. The drug's US market share was a hair short of 10% as of June, with total dispensed scripts up 6% over the first half of 2007 despite the encroachment of generic Zocor on the market.
The gains come thanks to a series of impressive clinical trials and a new indication, followed by deft communication of the drug's benefits with lighting-fast execution.
That's by design, says AstraZeneca, which pairs marketing and development leaders to head up all of its brands—in the case of Crestor, executive director, commercial operations Lisa Nanfra and James Blasetto, MD, VP, US strategic development.
In 2000, the company established its GALAXY clinical trial program. “We looked at it from three different perspectives,” says Dr. Blasetto.
In November 2007, the drug won an indication for use in slowing the progress of atherosclerosis on the back of results from the METEOR trial. A year later, the company unveiled the results of its JUPITER trial at the American Heart Association, showing a 44% reduction in major cardiovascular events compared to placebo among patients with elevated CRP but low to normal cholesterol levels on 20 mg doses of Crestor. Blasetto said the company will file for a new indication based on that data in the first half of 2009.
AstraZeneca wasted no time getting up branded and unbranded advertising touting the drug's atherosclerosis-fighting power and raising awareness of the disease, and the claim was added to the brand's core LDL-lowering, HDL-raising message. The educational effort took the form of “Us Against Athero,” a campaign incorporating advertising, PR, interactive and events. The company deployed the Artery Explorer, a trailer screening animation aimed at taking patients and reporters inside corroded arteries.
“One of the things we learned early on from some of the market research with patient groups was that if they could visualize atherosclerosis, they had kind of an ‘Ah-hah' moment, so that's been a key element of our work,” says Julia Walker, senior director, brand corporate affairs for cardiovascular.
The brand got a timely boost from Merck/Schering-Plough's ENHANCE study, that backfired on Vytorin but spotlighted atherosclerosis.
In response to increased interest from physicians, AstraZeneca recently inked a co-promotion deal with Abbott for the drug, thereby extending its reach without expanding its sales force.
“We've always focused on patients who are at cardiovascular risk,” says Nanfra, “really focusing in on a segment of patients who have two or more risk factors, because they need a really effective therapy to not only lower their LDL but also raise HDL. Once we got the indication for atherosclerosis, we could help physicians see that by impacting the atherogenic lipid profile, you could have a significant effect on the progression of atherosclerosis.
So, that's been the focus: redefining success as lowering LDL, raising HDL and having an impact on the disease.”