Don’t Blame Race-Based Medicine Or Marketing For BiDil’s Failure
Last week Jim Edwards of BrandWeek reported on the lackluster sales of NitroMed�s flagship medication, BiDil. This drug, developed for “self-identified” African American patients with heart failure, has been a disappointment. Last quarter it only racked up $3.2 million in sales.
BiDil received a great deal of publicity when it was launched because it was the first drug approved by the FDA for the treatment of a specific racial group. Edwards suggests that BiDil’s woes cast “doubts on race-based medicine.” He argues this is because blacks may not be as black (genetically) as many may think.
John Mack, who writes Pharma Marketing Blog, disagrees. He blames NitroMed’s failed marketing campaign for BiDil’s woes. He says that the real problem with BiDil sales may “have more to do with inadequate or ineffective marketing than with less-black-than-you-think genes. It is notoriously difficult to market to minorities and I don’t believe the pharmaceutical industry knows how to do it well or invests enough time or effort figuring out how to do it. You don’t see, for example, very many industry conferences devoted to the subject.”
I know at least one person who would agree. In an interview I conducted with noted researcher Dr. George Bakris, who has done a lot of work with minority populations, Bakris gave the pharmaceutical industry a D on its communications efforts. He believes “drug firms spend more time educating on the product rather than the disease.”
While their arguments about the failure of BiDil are compelling, neither Edwards or Mack are correct. BiDil failed because it is simply a new formulation of two generic medications with a tedious dosing schedule. Dr. Keith Ferdinand, who helped to study BiDil, had this to say when I asked him whether marketing was to blame for BiDil’s poor performance:
“I do not believe that the slow uptake of BiDil (isosorbide dinitrate/hydralazine HCl) can be attributed to weak or inappropriate marketing. Perhaps clinicians were reluctant to use a branded medication when generics are available. Another barrier may have been the fact that patients must take the medication three times per day when they already have complex medical regimens.”
There you have it. Despite compelling clinical evidence and pressure from the NAACP, NitroMed has not been able to sell BiDil because it is hard to convince physicians (and insurers) to use a medication that has an equally effective generic counterpart. The company is currently developing an extended release, once daily formulation of BiDil. It remains to be seen whether the drug will be approved or successful.
Rather than focusing on race or marketing, BiDil’s failure can be traced to economics 101. It’s all about price.
May 7th, 2007 at 11:11 pm
Fard has given a lot more thought to his post than i gave to mine. Still, i didn’t exactly say that the drug’s failure was only due to the self-identified factor. Rather, I said it was “One possible factor.” Regardless, this post is a useful one. Nonetheless, I maintain that ‘race’ is the one of the least well-defined (and mostly useless) bioligical ‘categories’ ever devised.
May 9th, 2007 at 10:37 am
Jim:
Thanks for visiting and commenting. You might be interested in a series I did last year on race-based medicine where scientists, communicators and others tackle this issue.