Healthy Skepticism Library item: 6350

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Whalen J.
How Glaxo Marketed a Malady to Sell a Drug TV-Ad Blitz, Physician Onslaught Are Unleashed To Inform About Little-Known Disorder
The Wall Street Journal 2006 Oct 25

Full text:

WHEN DRUG GIANT GlaxoSmithKline PLC launched a new medicine for
restless-legs syndrome last year, few people had heard of the
affliction, and some physicians were skeptical that it even existed.

Today, the drug, Requip, is on track to post sales of $500 million
this year, making it one of the fastest-growing drugs in Glaxo’s
portfolio.

Behind Requip’s sales boom is Glaxo’s marketing machine, which has
persuaded many consumers and physicians to accept restless-legs
syndrome, or RLS, as a real condition warranting treatment. Glaxo
began its blitz by advertising the disorder to doctors in medical
journals months before the company had regulatory approval to begin
selling Requip for RLS. Then, it sent specialists to discuss the
disease with general practitioners, who usually see RLS sufferers
first. It so heavily advertised the drug directly to consumers that
some doctors accuse Glaxo of disease mongering.

Glaxo declined to discuss specifics about its marketing campaign. A
spokeswoman for the United Kingdom company said Glaxo is “sharing
medical information on a wide variety of conditions, including RLS,
which is what we see as our mission.”

Pharmaceutical companies, under pressure to increase sales amid
pressure from generic rivals, are seeking to treat an ever-expanding
range of illnesses and to find additional afflictions in which their
drugs can be used. As a result, they increasingly need to combat
skepticism about a disease, just as Glaxo did with RLS. Novartis AG,
for example, which makes drugs for both attention-deficit disorder
and irritable-bowel syndrome, has used the Internet to overcome doubt
and spread information on the conditions and treatments, Novartis
Chief Executive Officer Dan Vasella said in an interview.

Restless-legs syndrome causes uncomfortable sensations in the legs
and an uncontrollable urge to move. In mild cases, the disorder makes
it difficult for a person to sit still. In severe cases, it can keep
sufferers up all night.

Glaxo didn’t set out to find a drug for RLS. It invented Requip — a
compound that regulates the brain chemical dopamine, which is
responsible for controlling body movements — to treat Parkinson’s
disease. Glaxo realized Requip’s potential in RLS after some doctors
began prescribing it off-label for the disorder.

GlaxoSmithKline CEO Jean-Pierre Garnier says that the company had “a
terrific quarter,” based in part on the value of GSK’s drug delivery
pipline.
This year, less than half of Requip’s expected $500 million in sales
are expected to come from Parkinson’s disease; the rest should come
from RLS, a Citigroup Inc. research report estimates.

Riding on Glaxo’s RLS push, rivals are following suit. Germany’s
Boehringer Ingelheim GmbH, maker of Parkinson’s drug Mirapex, has
asked the Food and Drug Administration to approve the drug for
treating RLS. And Belgium’s UCB SA plans to seek RLS approval from
the FDA for its Parkinson’s drug.

Glaxo, the world’s second-biggest drug company by sales after Pfizer
Inc., knew it faced obstacles as it prepared to launch Requip as an
RLS treatment. Glaxo-funded research had shown many RLS sufferers
bounce from doctor to doctor for years without a proper diagnosis,
the company said. “This was a disorder that was generally overlooked
by most physicians and individuals,” says John Winkelman, an
assistant professor at Harvard Medical School who treats sleep
disorders.

Glaxo began telling doctors about the disorder in 2004 with ads in
medical journals. One in the New England Journal of Medicine in
October 2004 showed a woman tossing and clutching her legs in bed. At
the bottom was Glaxo’s logo and the slogan: “GlaxoSmithKline: A
Leader in RLS Research.”

Soon after the FDA approved Requip as an RLS treatment in May 2005,
Glaxo hired an army of sleep-disorder specialists and invited general
practitioners to dinner at fancy restaurants across the U.S. to hear
them speak about Requip, some specialists say.

Philip Becker, medical director of the Sleep Medicine Institute at
the Presbyterian Hospital of Dallas, says he has delivered about a
dozen such talks in Texas. Dr. Becker, who has treated RLS for 25
years, says he thinks his talks have persuaded some doctors to take
the disorder more seriously and to try Glaxo’s drug.

To accompany this physician blitz, Glaxo began reaching out to
consumers through TV ads. It spent $36 million on consumer ads for
Requip last year, according to Nielsen Monitor-Plus.

The first ads, in the spring of 2005, described the symptoms of RLS
without mentioning the drug. Later ads began mentioning Requip, as well.

Awareness of the syndrome rose within months of Glaxo’s first TV ads,
says the Restless Legs Syndrome Foundation, in Rochester, Minn. It
had about 2,600 visitors a day to its Web site before the Glaxo ad
campaign. Two months later, about 4,500 people a day were visiting,
says Georgianna Bell, executive director of the foundation.