Specialties take on greater role

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Beyond blockbuster brands like Viagra and Lipitor, Pfizer has the challenge of marketing a roster of specialty drugs, medications relied on by thousands, not millions, of patients and a handful of specialist physicians. For these drugs, Pfizer can't just depend on its storied skill at consumer marketing and reach among primary care physicians.

The specialty care "businesses are different," says Eric Sirota, VP-respiratory, allergy and specialty therapeutic group. "They're smaller, they have higher unmet needs and a more clinical orientation."

Marketing specialty products requires a more tactical and technical approach, so Pfizer draws on its expertise in patient education and assistance. In the process, Pfizer also burnishes its corporate brand within the medical community.

Pfizer's strategy, Mr. Sirota says, centers on understanding physicians and their interactions with patients.

"You can look at numbers and trends, and that's important," he says, "but it's really the `Why?' Why do things happen the way they happen? What insights can you glean from the research to understand motivations and impediments to effective treatment?"

Keeping patients informed also helps attack the major problem of compliance with prescribed drug regimens. In the HIV market, Pfizer fields a force of 11 community relationship managers, or CRMs, who work with patient associations and physicians to present patient education.

developing doctor alliance

"The doctors are really very busy, and often the patients presenting have a lot of [secondary symptoms]," says Veronique Cardon, U.S. senior director-group leader for anti-infectives/HIV/women's healthcare marketing. "The role of the CRM is really to ally with the physician."

Developing such alliances is crucial for smaller products, where effective marketing requires building relationships with community groups and patient advocates as well as physicians.

Pfizer partnered with the NAACP to produce and distribute a 25-minute educational film for African-American women living with HIV; the piece was disseminated through physicians on DVD and through Pfizer CRMs at "town hall" forums.

"You have to look at the patient in cultural context," Ms. Cardon says. "This is women talking to women in the language they're using."

Similarly, Ms. Cardon's group partnered with the National Institutes of Health, the Centers for Disease Control and the MetLife Foundation to produce a museum exhibition on women's health currently touring the U.S. Viewers interact with a kiosk designed to inform them of health risks that women face according to age and lifestyle.

Pfizer's "Prime of Our Life," a series of six workshops aimed at helping women over 45 identify issues ranging from menopause to mental health, has enrolled more than 800 women.

"They go to their doctors, they have a good dialogue and they get results," says Ms. Cardon. "These women have lost weight. They take care of their breast self-examinations.

"This is one way to communicate with the patient that's going beyond the product, helping them to take charge of their health and have the right dialogue with their physician."

the pricing issue

Specialty drugs don't come cheap, as pharmaceutical companies must recoup the costs of research and development through a smaller pool of patients. As high drug prices have become a serious public relations headache for the industry, Pfizer has stepped up a raft of patient assistance programs for low-income and uninsured Americans.

In August, Pfizer made headlines with the launch of its "Helpful Answers" program, providing sharp discounts on its prescription products to the uninsured. The pharmaceutical giant also offers specialized patient assistance for its specialty products, distributed through physicians.

The company's "RSVP" service offers patients treated with its anti-infectives Zyvox, for staph infections, and Vfend, for fungal infections, help with coverage and reimbursement issues through an 800-number, ensuring that an emergency room visit for a life-threatening infection isn't compounded by sticker shock.

Similarly, patients using Pfizer endocrine drugs Genotropin and Somavert can get help through the company's "Bridge" program, and HIV patients can call Pfizer's "HIV/AIDS Patient Assistance Program."

The "RSVP" program, says Ms. Cardon, is part of Pfizer's mission to support patients. "This is what a great company should be doing," she says. It also helps enhance the company's corporate brand with physicians in a way that no sales aid or ad campaign can.

Helping physicians help their patients might not move product, but it can have real benefits in shaping the relationship of doctors to the drug manufacturer.

challenging antibiotic use

Pfizer found that doctors often felt pressured to prescribe antibiotics like Zithromax for flu, even though such drugs are useless against viruses, because patients and parents of sick children expect to leave the doctor's office with a prescription.

"That's a real dilemma for a physician," says Mr. Sirota. Pfizer's Zithromax team developed a "script" pad with tear-off sheets explaining to patients and caregivers why they don't need an antibiotic; it also offers steps that they can take to speed their recovery.

Such a program doesn't immediately help Pfizer "from a business standpoint," Mr. Sirota says, "but long-term it's helping us be a provider of solutions to physicians and their patients."

"Our credo here is to do the right thing," Mr. Sirota says. That also means reassuring the medical community of Pfizer's commitment to continuing research and development in specialty areas. Much of Pfizer's specialty business was absorbed from Pharmacia following Pfizer's 2003 acquisition of the company, including most of the CORE group, incorporating cancer, ophthalmology, endocrine and respiratory care. Specialists working in those areas wondered whether a company known for its blockbuster brands could keep up with the research-intensive and far less profitable products that benefited their patients.

"There was some concern from the community in terms of what Pfizer was going to do with these products," says Mr. Sirota, "so we took it upon ourselves to jump out and talk to them."

The company launched an outreach PR and advertising effort, branding several of its specialty franchises and introducing Pfizer Ophthalmics, Pfizer Oncology and Pfizer Endocrine Care at medical society meetings.

The company also flew in key opinion leaders in these specialty areas to meet with senior management in New York, and announced its presence through sales aids and advertising in specialty journals.

"We took it as an opportunity to learn from them," Mr. Sirota says. "We really went around the country to talk to them and tell them who we are, what we're about and reassure them that we understand these businesses."

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