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The Biosimilar Age: Adoption, Perceptions and
Implications for Marketing
Steve Gullans and Gregory Gallo

617.558.0210 | info@activatenetworks.net | www.activatenetworks.net
1 Newton Executive Park, Suite 100 | Newton, MA 02462
What does that mean?

Not a Brand….

Not a Generic..

It’s a Biosimilar!

© 2013 Activate Networks

2
Transition from Biologics to Biosimilars
Today in U.S.

© 2013 Activate Networks

3
In the Bulls Eye

© 2013 Activate Networks

4
Biologics Patent Cliff

http://www.mdpi.com/1424-8247/5/12/1393

© 2013 Activate Networks

5
Major Biosimilars in Development
2012 Sales
$Billions

Total in
Development

Rituxan/Mabthera

$ 6.45

22

Enbrel

$ 7.97

17

Neuogen

$ 1.26

14

Neulasta

$ 4.09

12

Epogen

$ 3.40

10

Herceptin

$ 6.15

9

Avastin

$ 5.54

8

Aranesp

$ 2.70

7

Humira

$ 9.26

7

NovoSeven

$ 1.54

5

Reference Product

http://www.firstwordpharma.com/node/1118043#axzz2fSPfYLQL
© 2013 Activate Networks

6
Transition from Biologics to Biosimilars
Future

© 2013 Activate Networks

7
Slow Start with Great Potential

2010 sales:
$250 million

2017 sales:
Estimated
$3.9 billion

© 2013 Activate Networks

8
Low Price Is the Driver

Relative Price (%)

100
-20-30%

75

50
-50-80%
25

0
Brand
Drug

Generic

Biologic

Biosimilar
© 2013 Activate Networks

9
But….
Concerns and Issues:

• Efficacy and equivalence
• Safety
• Manufacturing

• Regulatory approval process in U.S.
• Adoption
― Substitution
― Initiation
― Interchangeability
© 2013 Activate Networks

10
Product/Manufacturing Challenge
EPO Brazil – Case Study of A Biosimilar
• Analyzed 12 Biosimilar Epoetins from 5 manufacturers
• Potency varied 68% to 119% of label
• Isoform variations observed
• Bacterial endotoxins found in 3 products1
• Brazil Regulatory suspended import of 2 epoetins2,3

1Schmidt,

CA et al. Arq Bras Endocrinol Metabol, 2003: 47, 183.

2 http://e-legis.bvs.br/leisref/public/showAct.php?id=9210
3 http://e-legis.bvs.br/leisref/public/showAct.php?id=8151

© 2013 Activate Networks

11
Price Matters…
• Price sensitivity is different for new vs. existing patients
Price Reductions Required to Mandate Biosimilar Use

New Patient
Existing Patient

© 2013 Activate Networks

12
EU Biosimilar Use Increasing
- Adoption varies by Country

http://www.sec.gov/Archives/edgar/data/310158/000095012311097292/y93336exv99w1.htm

© 2013 Activate Networks

13
Will We Really Trust a Look Alike?

© 2013 Activate Networks

14
Auto Industry Analog
Brands

Generics

Biosimilars

© 2013 Activate Networks

15
Evolution in the Pharmaceutical Industry
Brands

Generics

Biosimilars

?
?

© 2013 Activate Networks

16
Back to Where We Started…
• Is it a generic?

• Is it a brand?
• Or somewhere in between?

More important, how can you optimize resources to
defend or if you’re launching a biosimilar, succeed?

© 2013 Activate Networks

17
Attaining Success in Biosimilars
• Which companies will successfully navigate:
― Manufacturing costs higher than generics
― Price competitiveness with brands will not be as big an
advantage
― Promotion & Education
• HCP’s and Patients
– Physician access
– Multi channel resources but limitations

• Developing a “brand” identity
• Payer relations

© 2013 Activate Networks

18
Maximizing Investments and
Available Resources
Identify essential HCP’s with outsized influence
• Identify physicians with
central role in network
and their connections
• Target more efficiently
• Accelerate
knowledge flows

• Drive behavior faster
and more efficiently

© 2013 Activate Networks

19
Prescribers of Statins, 2009

Adopting
Crestor + Generics

© 2013 Activate Networks

20
Prescribers of Statins, 2012

Adopting
Crestor + Generics

© 2013 Activate Networks

21
Change in Market Share
- Following Introduction of Alternatives
Lipitor
Crestor
Generics

© 2013 Activate Networks

22
Market Performance Varies by
Community of Practice

Trend Lines
~ Blue- Lipitor
~ Yellow- Crestor
~ Green- Generic

© 2013 Activate Networks

23
Influencers Make the Difference
- Loyalty to Lipitor
January 2012

January 2009






months

One central key influencer
stays loyal to Lipitor
Community remains loyal
More market share retained
by Lipitor
© 2013 Activate Networks

24
Influencers Make the Difference
- Rapid Adoption of Alternatives
January 2012

January 2009





months

Key influencers are early
adopters of Crestor or generics
Most of the community
switches to Crestor or generics
© 2013 Activate Networks

25
Case Study:
Early Adopters vs. Influencers
Months Since
Launch

5
24

Few adopters in this
Early Adopter is not
cluster due to a lack
influential in cluster
of influential earlyadopters

Influential Early
Early Adopter isin
Adopters result
highly connected
widespread
and is highly
adoption in this
influential in cluster
cluster

© 2013 Activate Networks

26
Factors Impacting Patient Access

Interchangeability
• Approval path
• Patient’s ability
to switch

Prescriber
Confidence

Price Difference

• Comfort with new
patients

• Expect small price
difference in US
like the EU

• Willingness to
switch patients

• Fewer payer
mandates

Payer
Requirements

Product &
Manufacturing

• Reimbursement
restrictions

• Efficacy / safety
• Costs, QC

• Coverage
restrictions

• Patient co-pay

• Post-market
surveillance

© 2013 Activate Networks

27
Patients Will Have Questions …
“Is this medicine really the same?”
“Are you sure the FDA approved this?”
“Bio-what?”
Gee, I’ve never heard of Ponzi Pharmaceuticals.”

© 2013 Activate Networks

28
Branding of Therapeutics

© 2013 Activate Networks

29
Social Networks for Branding
• Facebook, Twitter, etc.

© 2013 Activate Networks

30
Monitoring Brand Awareness

“Name Dropper” Game
• Addictive
• Word association
• Prompt with relevant
and irrelevant words
• Thousands of people
• Known demographics

© 2013 Activate Networks

31
Nexium vs. Abilify
- Awareness of Drug’s Purpose

Heartburn

Depression

© 2013 Activate Networks

32
Nexium vs. Abilify:
- Brand Awareness

© 2013 Activate Networks

33
Nexium vs. Abilify
- Attributes
Effective
Miracle cure
Nausea
Addictive
Effective
Life saver
Sleep
Addictive
© 2013 Activate Networks

34
Takeaways
• Don’t be lulled by slow start in the US
― Market potential is great

• Multiple barriers will raise the game for everyone
• Efficient resource utilization will be critical
― Development & approval
― Promotion and marketing

• Just like advances in the science of drug
development, advances in optimizing promotion
resources will need to deployed to achieve success

© 2013 Activate Networks

35

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CISummit 2013: Steve Gullans & Gregory Gallo, The BioSimilar Age: How to Promote a Biosimilar and Defend a Franchise from a BioSimilar Attack

  • 1. The Biosimilar Age: Adoption, Perceptions and Implications for Marketing Steve Gullans and Gregory Gallo 617.558.0210 | info@activatenetworks.net | www.activatenetworks.net 1 Newton Executive Park, Suite 100 | Newton, MA 02462
  • 2. What does that mean? Not a Brand…. Not a Generic.. It’s a Biosimilar! © 2013 Activate Networks 2
  • 3. Transition from Biologics to Biosimilars Today in U.S. © 2013 Activate Networks 3
  • 4. In the Bulls Eye © 2013 Activate Networks 4
  • 6. Major Biosimilars in Development 2012 Sales $Billions Total in Development Rituxan/Mabthera $ 6.45 22 Enbrel $ 7.97 17 Neuogen $ 1.26 14 Neulasta $ 4.09 12 Epogen $ 3.40 10 Herceptin $ 6.15 9 Avastin $ 5.54 8 Aranesp $ 2.70 7 Humira $ 9.26 7 NovoSeven $ 1.54 5 Reference Product http://www.firstwordpharma.com/node/1118043#axzz2fSPfYLQL © 2013 Activate Networks 6
  • 7. Transition from Biologics to Biosimilars Future © 2013 Activate Networks 7
  • 8. Slow Start with Great Potential 2010 sales: $250 million 2017 sales: Estimated $3.9 billion © 2013 Activate Networks 8
  • 9. Low Price Is the Driver Relative Price (%) 100 -20-30% 75 50 -50-80% 25 0 Brand Drug Generic Biologic Biosimilar © 2013 Activate Networks 9
  • 10. But…. Concerns and Issues: • Efficacy and equivalence • Safety • Manufacturing • Regulatory approval process in U.S. • Adoption ― Substitution ― Initiation ― Interchangeability © 2013 Activate Networks 10
  • 11. Product/Manufacturing Challenge EPO Brazil – Case Study of A Biosimilar • Analyzed 12 Biosimilar Epoetins from 5 manufacturers • Potency varied 68% to 119% of label • Isoform variations observed • Bacterial endotoxins found in 3 products1 • Brazil Regulatory suspended import of 2 epoetins2,3 1Schmidt, CA et al. Arq Bras Endocrinol Metabol, 2003: 47, 183. 2 http://e-legis.bvs.br/leisref/public/showAct.php?id=9210 3 http://e-legis.bvs.br/leisref/public/showAct.php?id=8151 © 2013 Activate Networks 11
  • 12. Price Matters… • Price sensitivity is different for new vs. existing patients Price Reductions Required to Mandate Biosimilar Use New Patient Existing Patient © 2013 Activate Networks 12
  • 13. EU Biosimilar Use Increasing - Adoption varies by Country http://www.sec.gov/Archives/edgar/data/310158/000095012311097292/y93336exv99w1.htm © 2013 Activate Networks 13
  • 14. Will We Really Trust a Look Alike? © 2013 Activate Networks 14
  • 16. Evolution in the Pharmaceutical Industry Brands Generics Biosimilars ? ? © 2013 Activate Networks 16
  • 17. Back to Where We Started… • Is it a generic? • Is it a brand? • Or somewhere in between? More important, how can you optimize resources to defend or if you’re launching a biosimilar, succeed? © 2013 Activate Networks 17
  • 18. Attaining Success in Biosimilars • Which companies will successfully navigate: ― Manufacturing costs higher than generics ― Price competitiveness with brands will not be as big an advantage ― Promotion & Education • HCP’s and Patients – Physician access – Multi channel resources but limitations • Developing a “brand” identity • Payer relations © 2013 Activate Networks 18
  • 19. Maximizing Investments and Available Resources Identify essential HCP’s with outsized influence • Identify physicians with central role in network and their connections • Target more efficiently • Accelerate knowledge flows • Drive behavior faster and more efficiently © 2013 Activate Networks 19
  • 20. Prescribers of Statins, 2009 Adopting Crestor + Generics © 2013 Activate Networks 20
  • 21. Prescribers of Statins, 2012 Adopting Crestor + Generics © 2013 Activate Networks 21
  • 22. Change in Market Share - Following Introduction of Alternatives Lipitor Crestor Generics © 2013 Activate Networks 22
  • 23. Market Performance Varies by Community of Practice Trend Lines ~ Blue- Lipitor ~ Yellow- Crestor ~ Green- Generic © 2013 Activate Networks 23
  • 24. Influencers Make the Difference - Loyalty to Lipitor January 2012 January 2009    months One central key influencer stays loyal to Lipitor Community remains loyal More market share retained by Lipitor © 2013 Activate Networks 24
  • 25. Influencers Make the Difference - Rapid Adoption of Alternatives January 2012 January 2009   months Key influencers are early adopters of Crestor or generics Most of the community switches to Crestor or generics © 2013 Activate Networks 25
  • 26. Case Study: Early Adopters vs. Influencers Months Since Launch 5 24 Few adopters in this Early Adopter is not cluster due to a lack influential in cluster of influential earlyadopters Influential Early Early Adopter isin Adopters result highly connected widespread and is highly adoption in this influential in cluster cluster © 2013 Activate Networks 26
  • 27. Factors Impacting Patient Access Interchangeability • Approval path • Patient’s ability to switch Prescriber Confidence Price Difference • Comfort with new patients • Expect small price difference in US like the EU • Willingness to switch patients • Fewer payer mandates Payer Requirements Product & Manufacturing • Reimbursement restrictions • Efficacy / safety • Costs, QC • Coverage restrictions • Patient co-pay • Post-market surveillance © 2013 Activate Networks 27
  • 28. Patients Will Have Questions … “Is this medicine really the same?” “Are you sure the FDA approved this?” “Bio-what?” Gee, I’ve never heard of Ponzi Pharmaceuticals.” © 2013 Activate Networks 28
  • 29. Branding of Therapeutics © 2013 Activate Networks 29
  • 30. Social Networks for Branding • Facebook, Twitter, etc. © 2013 Activate Networks 30
  • 31. Monitoring Brand Awareness “Name Dropper” Game • Addictive • Word association • Prompt with relevant and irrelevant words • Thousands of people • Known demographics © 2013 Activate Networks 31
  • 32. Nexium vs. Abilify - Awareness of Drug’s Purpose Heartburn Depression © 2013 Activate Networks 32
  • 33. Nexium vs. Abilify: - Brand Awareness © 2013 Activate Networks 33
  • 34. Nexium vs. Abilify - Attributes Effective Miracle cure Nausea Addictive Effective Life saver Sleep Addictive © 2013 Activate Networks 34
  • 35. Takeaways • Don’t be lulled by slow start in the US ― Market potential is great • Multiple barriers will raise the game for everyone • Efficient resource utilization will be critical ― Development & approval ― Promotion and marketing • Just like advances in the science of drug development, advances in optimizing promotion resources will need to deployed to achieve success © 2013 Activate Networks 35

Editor's Notes

  1. The overall pattern of Market Share changes during this time is a decline in the use of Lipitor, but with it remaining the dominant StatinCrestor and Other Statins steadily gained market share, but they were much more successful in certain communities of the networkDeviations from these market share values in small areas of the network can be triggered by influential physicians and their behaviors
  2. NEW SLIDE