Mature pharmaceuticals: Between challenges to overcome and solutions to be developed

The launch and use of new drugs has traditionally been at the core of pharmaceutical companies’ marketing efforts, as the first years of commercialization provide the opportunity to take advantage of the exclusivity associated with the drug’s patent. However, manufacturers are paying increasing attention to the challenges associated with mature products, which are key to the sustainability of their sales. Alcimed, a consulting firm specializing in innovation and new market development, has been investigating the challenges associated with maintaining sales of these mature products, as well as the levers to improve them.

The decrease in revenues from mature products, resulting from the launch of new drugs and generic/biosimilar drugs, as well as internal constraints related to limited marketing budgets are major challenges for most pharmaceutical industry players. Fortunately, there are innovative approaches such as effective product lifecycle management, portfolio strategy, legal and commercial actions or new ways of interacting with healthcare professionals which can be implemented.
Lifecycle management and portfolio management to manage new launches

Barriers to the sustainability of mature drug revenues are often associated with the launch of new molecules and new treatment lines. In this context, one of the possibilities for the use of mature drugs would be to target new and more specific patient populations. Based on well-thought-out life cycle management, pharmaceutical companies can also benefit from their product portfolio, which consists of extracting value from the potential combinations of drugs that they market.

Cancer treatment illustrates this well as the treatment pattern evolves from a predominance of chemotherapy to the rapid adoption of immunotherapies (with more than 1,000 drugs in clinical development, in the field or marketed worldwide[1]). This change should be taken into account when defining the strategy for established chemotherapies. For example, Roche’s Avastin®, marketed for different forms of cancer since 2004, continues to be one of the company’s key growth drivers with a 3% increase in sales in 2018. The company’s strategy for this drug includes obtaining new approvals for specific patient populations (e.g., a form of ovarian cancer) or in combination with immunotherapies (e.g., Tecentriq®[2]).
Anticipating the environment of biosimilars

In addition to new drugs, generic / biosimilar drugs are also involved, with increasing support from national health authorities aimed at reducing overall health care expenditures.

For example, in France, quotas are being set to allow hospitals to increase the proportion of biosimilars in prescribed drugs, with the overall objective of an 80% penetration rate of biosimilars by 2022[3]. As a result, sales of biosimilars increased by 71% in 2018 compared to 2017, mainly due to hospital prescriptions[4].

The arrival of biosimilars seriously compromises the sales of original drugs. Still, actions such as careful monitoring of environmental developments and patent protection measures can be implemented.

Two emblematic examples could be the two flagship products in the treatment of autoimmune diseases, Humira® by AbbVie and Enbrel® by Pfizer and Amgen (both of which are among the top five best-selling drugs in the world as of 2018[5]). Both companies were successful in obtaining a patent extension in the United States (both until 2023).

Another strategy adopted by some pharmaceutical companies is to launch their own biosimilars in order to take advantage of current trends. For example, Eli Lilly recently announced the launch of a biosimilar that is considerably cheaper than its insulin Humalog[6].
Innovative ways to interact with healthcare professionals

Mature products are the basis of the reputation of pharmaceutical companies and the image created for health professionals. It is therefore essential to continue to communicate with physicians about these products in order to ensure appropriate use and to take advantage of the results of clinical and observational studies conducted as part of the product life cycle management. However, marketing and sales budgets tend to be increasingly limited, especially for these types of products.

According to Séverine Robineau, Director of Alcimed’s Health Business Unit, “Pharmaceutical companies today want to maintain an optimized presence in the field and are increasingly turning to digital solutions to organize their sales efforts and interactions with healthcare professionals.”

Although physicians prefer face-to-face visits as an information channel to learn about new drugs, the relevance of this channel decreases when the drug has been on the market for years. One of the surveys conducted in the United States in 2018 showed that digital communication is more important for physicians than visits from medical representatives[7].

“In order to adapt to doctors’ lack of time and due to the greater accessibility of medical information online, pharmaceutical companies are introducing remote visits or considering combining the roles of medical sales representatives and MSLs,” comments Maryia Dvaretskaya, manager at Alcimed.

In conclusion, there are levers to overcome the barriers associated with mature pharmaceuticals. Manufacturers must closely monitor the environment, paying attention to the potential actions of regulators, payers and competitors, and the needs of healthcare professionals to anticipate the best evolution scenarios and define the best strategy

[1] Immuno-Oncology Development Trends and Opportunities, Global Data, November 2018
[2] Roche Annual Report 2018. https://www.roche.com/investors/annualreport18.htm#people
[3] Stratégie nationale de santé 2018-2022. https://solidarites-sante.gouv.fr/IMG/pdf/dossier_sns_2017_vdef.pdf
[4] http://www.medicamentsgeneriques.info/sites/default/files/press/document_presse_-_rencontre_du_17012019.pdf
[5] https://www.igeahub.com/2018/04/07/20-best-selling-drugs-2018/
[6] A Catalist for More Affordable Medicines. https://lillypad.lilly.com/entry.php?e=11295
[7] Tipping point? Digital communications from pharma finally get their due with doctors. https://www.fiercepharma.com/marketing/tipping-point-digital-communications-from-pharma-finally-gets-its-due-docs-study