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Commercial Insight: Osteoarthritis and Rheumatoid Arthritis - New Growth In A Mature Market
Datamonitor, July 2003, Pages: 129

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TABLE OF CONTENTS
CHAPTER 1 EXECUTIVE SUMMARY 3
Scope of the analysis 3
Datamonitor insight into the arthritis market 4
Despite facing adversity in the past year, including continued negative publicity surrounding the cardiovascular side-effect profile of Vioxx and the delayed launch of key second-generation product Arcoxia, Merck will remain a strong competitor for Pfizer/Pharmacia in the future and the COX-II inhibitor class will continue to flourish through 2011. 5
The alleviation of Enbrel’s supply shortage through the FDA approval of a new manufacturing facility in early 2003 will enable Amgen to regain a significant portion of sales lost to J&J’s Remicade although Humira is presenting formidable competition for both of these market leaders; Enbrel sales were $802m in 2002, representing growth of 5% from 2001 sales, while Remicade sales were $1,513m, representing year-on-year growth of 78%. 7
Summary 9
Key metrics 11
CHAPTER 2 MARKET SEGMENTATION AND DEFINITION 21
Strategic scoping and focus 21
Market definition 21
Celebrex: the gold standard in osteoarthritis 22
Associated pharmaceutical markets 24
Enbrel: the gold standard in rheumatoid arthritis 24
Associated pharmaceutical markets 26
CHAPTER 3 GLOBAL MARKET OVERVIEW 27
Key findings 27
Global arthritis market analysis 28
Global market forecast 31
Forecast scenario analysis 33
NSAID class analysis 33
NSAID class market performance 33
Company reported vs. IMS reported growth 36
NSAID market forecast 36
Growth of first-generation COX-II inhibitors Celebrex and Vioxx, launch of second-generation COX-II inhibitors Bextra and Arcoxia 37
Cardiovascular concerns 37
DTC advertising 37
R&D drugs in the NSAID class 40
Celebrex (celecoxib) analysis 40
Celebrex: 12-month event screen 41
Celebrex strategic analysis 41
Celebrex forecasts to 2011 43
Bextra (valdecoxib) analysis 46
Bextra: 12-month event screen 46
Bextra strategic analysis 47
Bextra forecasts to 2011 49
Vioxx (rofecoxib) analysis 52
Vioxx: 12-month event screen 52
Vioxx strategic analysis 53
Vioxx forecasts to 2011 54
Arcoxia (etoricoxib) analysis 56
Arcoxia: 12-month event screen 57
Arcoxia strategic analysis 57
Arcoxia forecasts to 2011 58
Mobic (meloxicam) analysis 60
Mobic: 12-month event screen 60
Mobic strategic analysis 61
Mobic forecasts to 2011 62
DMARD class analysis 64
DMARD class market performance 64
Company reported vs. IMS reported growth 65
DMARD market forecast 66
DMARD class market forecast events to 2011 68
R&D drugs in the DMARD class 68
Enbrel analysis 69
Enbrel: 12-month event screen 69
Enbrel strategic analysis 70
Enbrel forecasts to 2011 72
Remicade analysis 75
Remicade: 12-month event screen 75
Remicade strategic analysis 76
Remicade forecasts to 2011 78
Kineret analysis 81
Kineret: 12-month event screen 81
Kineret strategic analysis 82
Kineret forecasts to 2011 84
Arava analysis 86
Arava: 12-month event screen 86
Arava strategic analysis 87
Arava forecasts to 2011 89
Humira analysis 92
Humira: 12-month event screen 93
Humira strategic analysis 93
Humira forecasts to 2011 95
HA viscosupplement class analysis 96
HA viscosupplement market forecast 97
Synvisc (hylan G-F 20) analysis 99
Synvisc: 12-month event screen 100
Hyalgan (sodium hyaluronate) analysis 101
Supartz (sodium hyaluronate) analysis 102
CHAPTER 4 PORTFOLIO AND LIFECYCLE MANAGEMENT 104
Key findings 104
Portfolio management 105
Market attractiveness 105
Comparative attractiveness of the arthritis market 105
Class attractiveness in the arthritis market 107
Positioning of the major arthritis players 109
Portfolio analysis 112
Pfizer/Pharmacia 114
Merck 116
Amgen 118
Johnson & Johnson 120
Novartis 122
Aventis 124
Lifecycle management in arthritis 125
The arthritis product lifecycle 125
Osteoarthritis 125
Rheumatoid arthritis 126
Launch strategy and market penetration 127
Case study: unsuccessful vs. successful strategies for the early phase of a me-too arthritis drug’s launch 128
Optimizing peak sales 130
Large marketing investment early on enables Vioxx to stay strong in the face of negative publicity 130
Remicade: biologic DMARDs maximize sales through expanded indications 132
Revenue protection strategies 135
Novartis’s Voltaren: revenue protection through product reformulation 136
CHAPTER 5 STRATEGIC PRODUCT POSITIONING 139
Key findings 139
Physician-focused product positioning 140
Physician targeting strategies 140
Brand positioning for key products in the osteoarthritis market 142
Celebrex 142
Vioxx 142
Bextra 143
Case study: Celebrex – the most successful launch in history 144
Targets of Celebrex promotion 144
Messages 144
Lifecycle 145
Product 145
Promotional mix 145
Competition 145
Budget 146
Conclusions 146
Brand positioning for key products in the rheumatoid arthritis market 147
Enbrel 147
Remicade 148
Kineret 148
Humira 149
Case study: Enbrel – promotion is meaningless in the face of poor market-sizing evaluations 149
Road to success 149
Success stunted by supply shortages 150
Remicade profits from Enbrel’s mistakes 151
Humira learns from Enbrel’s mistakes 152
Patient targeting and influence 153
Patient sub-group positioning analysis 153
Brand imaging: osteoarthritis 153
Celebrex: “the number 1 prescribed arthritis pain medication” 153
Vioxx: “one pill for 24-hour relief” 154
Bextra: “this powerful pill will change the way arthritis pain is treated” 154
Summary 154
Patient advocacy initiatives 155
Brand imaging: rheumatoid arthritis 156
Enbrel: “the first and only TNF inhibitor approved … and it can be used alone” 157
Remicade: just the facts 157
Kineret: “successfully manage RA through new scientific thinking” 157
Humira: “RA changed your life, now you can change it back” 158
Summary 158
Patient advocacy initiatives 159
Pricing and reimbursement 160
Health economic considerations 160
NSAIDs 161
DMARDs 161
Pricing strategies: osteoarthritis 162
Pricing data for key products in the osteoarthritis market 162
Case study: why are COX-IIs twice as expensive in the US than in Europe? 163
Treatment cost analysis: osteoarthritis 166
Pricing strategies: rheumatoid arthritis 167
Pricing data for key products in the rheumatoid arthritis market 169
Treatment cost analysis: rheumatoid arthritis 170
APPENDIX A – MARKET DATA 172
Global arthritis market data 172
NSAID market data 173
DMARD market data 175
HA viscosupplement market data 177
Antirheumatic steroid market data 179
APPENDIX B 180
List of tables 180
List of figures 183
About Datamonitor 186
About Datamonitor Healthcare 186
Datamonitor Healthcare’s research and analysis methodologies 187
Datamonitor Healthcare’s therapy area capabilities 187
About the arthritis analysis team 188
Datamonitor Healthcare’s Consulting expertise 189
Datamonitor’s Therapeutic Consulting expertise 190
Key therapy team members 191
Simon Wright, Director Immune Disorders and Inflammation 191
Disclaimer 192



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