2004 Will Be Pivotal Year in Determining Winners and Losers in $6 Billion ARB Hypertension Market

January 22, 2004

Campbell Alliance, the leading management consulting firm specializing in the pharmaceutical and biotech industries, today released key findings from its recently completed multi-client study on the managed care environment for antihypertensives.

The study conducted with decision makers at virtually all leading national and regional managed care organizations and with the nation’s highest-prescribing physicians, reveals increasing use of angiotensin II receptor blockers (ARBs) at 86% of MCOs.  It also shows a growing tendency among physicians to prescribe ARBs as first-line treatment for hypertension, despite the availability of lower-cost alternatives such as diuretics and generic ACE inhibitors.

“We are about to see the world change pretty dramatically for companies promoting antihypertensives, and many will be caught off guard,” said Brian Levy, a Campbell Alliance consultant who co-authored the report.  “To date, managed care has not aggressively managed ARB utilization, but with the huge spend in the category and new evidence to work with, managed care is primed and ready to drive utilization to preferred brands.  The trajectories of many products will be set or reset during 2004 and early 2005,” Levy added.

Highly concerned about growing utilization in this expensive drug class, managed care decision makers say they are eager to end the pain.  They will look to results from ongoing clinical studies to differentiate products now viewed as clinically interchangeable.  While these results will mean increased managed care access and reimbursement for some products, many others will be relegated to niche status.

Pricing will become a defining issue for ARBs in 2004, as Sankyo’s contracting efforts to support the launch of Benicar have put price back on the table in this hyper-competitive class.  “Extremely favorable product perceptions among both physicians and managed care—as well as an aggressive pricing strategy—have placed Benicar in a very favorable position,” noted Levy.  “It is the fastest growing ARB on the market, often gaining market share at the expense of Merck’s Cozaar, which managed care decision makers view as particularly vulnerable due to the drug’s propensity for dose creep.” 

Other products vulnerable to greater managed care restriction, according to the study, include Boehringer Ingelheim’s Micardis, AstraZeneca’s Atacand, and Biovail’s Teveten.

As clinical studies and price begin to narrow the field of viable players, managed care will also press pharma to conduct successful pull-through of their ARB products.  The ability to effectively and appropriately pull through a drug once favorable formulary status has been established will, according to managed care decision makers, be a critical determinant of success.  “We need pharma companies that can not only offer an attractive price, but can effectively and appropriately influence provider behavior,” says one pharmacy director with a top 10 HMO.  “In 2004 we will be selecting a partner in this category who can do both.” 

The consulting report provides strategic assessments of numerous antihypertensive drugs, including Pfizer’s (PFE) Norvasc, Merck’s (MRK) Cozaar, AstraZeneca’s (AZN) Atacand, Sanofi-Synthelabo (SNY) and Bristol-Myers Squibb’s (BMY) Avapro, King Pharmaceuticals (KG) and Wyeth’s (WYE) Altace, Novartis’ (NVS) Diovan, Abbott Laboratories’ (ABT) Mavik, Biovail’s (BVF) Cardizem LA and Teveten, Sankyo and Forest Laboratories’ (FRX) Benicar.  

The reports are available exclusively to clients of Campbell Alliance.  Multi-client consulting studies are conducted each year to cost effectively gather definitive information on the managed markets landscape.  Campbell produces these “Definitive Reimbursement Reports” annually, covering hypertension, cholesterol, depression, and diabetes and adds a number of categories each year. 

Campbell Alliance serves some of the world’s leading pharmaceutical and biotech companies throughout the US, Europe, and Japan.  It currently has offices in Raleigh, NC, and Parsippany, NJ. 


inVentiv Health Consulting offers world class healthcare consulting services.

Media Contact:

Stephanie Koenig