Effient worldwide sales slid to a tiny $3million Q4 09

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Anonymous said:
This is an epic surprise. Absolutely no one predicted this. Obviously this is the fault of our lackluster salesforce, NOT!!!!!!
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It clearly is meeting more resistance than predicted, however, it will be fine. Keep in mind, the product just got approved in most hospitals in november time frame. December most reps not working. Thus Jan was the first time full sales force could be targeting top ic's with a consistend message, towards usage.

Also as time goes, more and more hospitals are doing IPA testing not only to see simply how many of their patients are leaving with out necessary IPA, but also cardio surgeons want to know how quickly they can get their patient in to doing a surgery.

If there was a lot of time, Effient would be a blockbuster, as IPA testing will be refined and more and more patients up to 50% of them would be reloaded with effient. However, the testing will still be done, but AZ's drug if approved will be a major challenge if all the data pans out. I have heard some health issues with their drug, could seriously delay their drug.

Effient will start to uptake, I am seeing it in my hospital. Our biggest issue is plavix going generic in 2011.
 






Anonymous said:
It clearly is meeting more resistance than predicted, however, it will be fine. Keep in mind, the product just got approved in most hospitals in november time frame. December most reps not working. Thus Jan was the first time full sales force could be targeting top ic's with a consistend message, towards usage.

Also as time goes, more and more hospitals are doing IPA testing not only to see simply how many of their patients are leaving with out necessary IPA, but also cardio surgeons want to know how quickly they can get their patient in to doing a surgery.

If there was a lot of time, Effient would be a blockbuster, as IPA testing will be refined and more and more patients up to 50% of them would be reloaded with effient. However, the testing will still be done, but AZ's drug if approved will be a major challenge if all the data pans out. I have heard some health issues with their drug, could seriously delay their drug.

Effient will start to uptake, I am seeing it in my hospital. Our biggest issue is plavix going generic in 2011.
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You are so wrong! The effient ship has sunk. Physician interest has come nd gone. The dabblers have been stung by nose bleeds all the way to fatal bleeds...that gets around. Sales of E are sliding
Iy is foprgotten and will never be....thank God , for the patient's sake!
 






Anonymous said:
It clearly is meeting more resistance than predicted, however, it will be fine. Keep in mind, the product just got approved in most hospitals in november time frame. December most reps not working. Thus Jan was the first time full sales force could be targeting top ic's with a consistend message, towards usage.

Also as time goes, more and more hospitals are doing IPA testing not only to see simply how many of their patients are leaving with out necessary IPA, but also cardio surgeons want to know how quickly they can get their patient in to doing a surgery.

If there was a lot of time, Effient would be a blockbuster, as IPA testing will be refined and more and more patients up to 50% of them would be reloaded with effient. However, the testing will still be done, but AZ's drug if approved will be a major challenge if all the data pans out. I have heard some health issues with their drug, could seriously delay their drug.

Effient will start to uptake, I am seeing it in my hospital. Our biggest issue is plavix going generic in 2011.
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There is where you are wrong. Margin should have reflected at least 22 million in followup scripts. For some reason those patients were switched once they left the table and went to the doctor's office.
 






Have you really begun to see sales "increase" or is it just a small blip in the DDD and IMS data? It seems most hospitals that I know of won't use prasugrel due to the saftey (increase bleeds) and number needed to kill compared to clopidogrel. Some P&T committes have even gone to the extent of not allowing prasugrel in the door. And no, I don't work for SA. It just seems very difficult to justify the cost of prasugrel since clopidogrel will be generic in a few months. What are you hearing from your upper level management on that aspect?
 






Anonymous said:
Have you really begun to see sales "increase" or is it just a small blip in the DDD and IMS data? It seems most hospitals that I know of won't use prasugrel due to the saftey (increase bleeds) and number needed to kill compared to clopidogrel. Some P&T committes have even gone to the extent of not allowing prasugrel in the door. And no, I don't work for SA. It just seems very difficult to justify the cost of prasugrel since clopidogrel will be generic in a few months. What are you hearing from your upper level management on that aspect?
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PLAVIX will not be generic until next year. Also, this must be a plavix rep, to talk about the number needed to kill, as this is false when used on patients with no prior tia or stroke, less than 75 ys or over 60 kg
 






First off... why would a Plavix rep post that? If the med is going generic (which it did 3 years ago by a Canadian company, although the patent was upheld and the generic delayed) why would they even be posting on prasugrel. So, again, not a rep. I actually have a degree in the healthcare field and am licensed. Looking at the TRITON-TIMI 38; fatal bleeding (0.4% vs. 0.1%; P=0.002) prasugrel vs clopidogrel arms. NNK =1/(0.004-0.001). Therefore, for every 333 people you treat with prasugrel, one will die due to fatal bleeding. That was my only point. I was simply trying to find out why this hasn't been a blockbuster drug... There was so much hype in 2008 before the interim safety analysis was presented on that it seemed SA was going to get their ass kicked, which hasn't been the case. So again, not bashing, not saying the reps at Lilly can't sell, not saying the drug is crap. I'm simply asking what has been said around the data why this isn't being used as much as the company obviously thought. Again, I know hospitals will not put this on their formulary and am wondering why.
 






Anonymous said:
PLAVIX will not be generic until next year. Also, this must be a plavix rep, to talk about the number needed to kill, as this is false when used on patients with no prior tia or stroke, less than 75 ys or over 60 kg
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Also, where are you getting your data? The TRITON-TIMI 38 trial does not agree with this opinion. Are you looking at a review article?
 






Anonymous said:
It clearly is meeting more resistance than predicted, however, it will be fine. Keep in mind, the product just got approved in most hospitals in november time frame. December most reps not working. Thus Jan was the first time full sales force could be targeting top ic's with a consistend message, towards usage.

Also as time goes, more and more hospitals are doing IPA testing not only to see simply how many of their patients are leaving with out necessary IPA, but also cardio surgeons want to know how quickly they can get their patient in to doing a surgery.

If there was a lot of time, Effient would be a blockbuster, as IPA testing will be refined and more and more patients up to 50% of them would be reloaded with effient. However, the testing will still be done, but AZ's drug if approved will be a major challenge if all the data pans out. I have heard some health issues with their drug, could seriously delay their drug.

Effient will start to uptake, I am seeing it in my hospital. Our biggest issue is plavix going generic in 2011.
Click to expand...

Are you out of your fucking mind? I have now been saying this for over a year and will continue until the drug gets pulled for the fact that sales wont cover its costs - this drug is crap, the docs dont like it and Brilinta is the problem for that not generic plavix. Have you spoken to any cards lately? CURRENT did some major damage to Effient, but the BRILINTA trial killed it dead. In the mind of IC's it is a cleaner, safer drug which is reversible - whether it has other issues is irrelevent to them at this point, they just compared it to the Effient bleeding profile and suddenly Effient wasn't cool any more. Drug success can be determined within 6 months by sales trajectory. Effient is a DISASTER and is finished. Trust me on this (you should because I said the same thing in 2008 and 2009) - IC's are going to use Plavix until Brilinta comes along. Effient will get some use in tricky cases (plavix failures and STEMI diabetics), but it is a niche drug.
 






Anonymous said:
Are you out of your fucking mind? I have now been saying this for over a year and will continue until the drug gets pulled for the fact that sales wont cover its costs - this drug is crap, the docs dont like it and Brilinta is the problem for that not generic plavix. Have you spoken to any cards lately? CURRENT did some major damage to Effient, but the BRILINTA trial killed it dead. In the mind of IC's it is a cleaner, safer drug which is reversible - whether it has other issues is irrelevent to them at this point, they just compared it to the Effient bleeding profile and suddenly Effient wasn't cool any more. Drug success can be determined within 6 months by sales trajectory. Effient is a DISASTER and is finished. Trust me on this (you should because I said the same thing in 2008 and 2009) - IC's are going to use Plavix until Brilinta comes along. Effient will get some use in tricky cases (plavix failures and STEMI diabetics), but it is a niche drug.
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The only docs using effient are fucking whores - mostly paid speakers that would sell their sister for $50. The drug is shit - with Brillinta in hosp and generic plavix outpatient, its over.
 






Anonymous said:
Are you out of your fucking mind? I have now been saying this for over a year and will continue until the drug gets pulled for the fact that sales wont cover its costs - this drug is crap, the docs dont like it and Brilinta is the problem for that not generic plavix. Have you spoken to any cards lately? CURRENT did some major damage to Effient, but the BRILINTA trial killed it dead. In the mind of IC's it is a cleaner, safer drug which is reversible - whether it has other issues is irrelevent to them at this point, they just compared it to the Effient bleeding profile and suddenly Effient wasn't cool any more. Drug success can be determined within 6 months by sales trajectory. Effient is a DISASTER and is finished. Trust me on this (you should because I said the same thing in 2008 and 2009) - IC's are going to use Plavix until Brilinta comes along. Effient will get some use in tricky cases (plavix failures and STEMI diabetics), but it is a niche drug.
Click to expand...

First off, look at the sales numbers once the next quarter sales come out. I have seen the uptake starting. Secondly, plavix reps, who are gettin on here trying to act like they are lilly reps, What is the major bleeding rate between the two drugs on patients less than 75, no stroke and greater than 60 years of age. Is this major bleeding statisically significant.

My hospital is contemplating changing protocal to loading all on Effient who are less than 75, greater than 60 and no stroke after testing 30 patients for IPA once loaded with plavix, and over 20 of them did not have sufficient IPA, thus they deemed instead of running these test after the fact, just load with effient, unless they meet the patients that fit the type WE DO NOT WANT.

Also, plavix reps have done a great job dominating the conversation and confusing the issue. All you have to do is is simply point out the plavix reps are trying to draw attention to bleeding in the overall arm which includes patients we do not want you to use effient on.

Also how many patients do the physicians have the come back in on Plavix. My docs are automatically switching these patients over, and I guarantee you with in 3 months, they will start simply us plavix second line is PCI patients, as many of them have indicated they agree that they should, but just because of habit, they have not started as many.

We will never replace plavix, but Effient is clearly the better drug. Plavis goal is totally confuse the IC's and if you let them then that is your fault. I asked several physicians a pretty basic question. What was the improved risk reduction rate and increase of bleeding rate that plavix plus aspirin had over aspirin alone. Now compare that to the rates in timi 38. The difference is we got a box warning because approved in 2009, if plavix came out in 2009 it would have a box warning.

Plavix going generic is the biggest issue and yes AZ new drug. However AZ drug has issues too. It is a year away from approval, and has some heart issues that makes its approval interesting. Also Effient has CV death benefits too, especially in recurrent MI's. So if physicians are loading on the table, then what benefit does using a reversable offer. NONE. If they preload, then yes a reversable is great.

Effient Reps, learn how to be more specific about what your asking the physician to do, and to overcome all the BS that Plavix reps are putting out there. The uptake is slow, what was the uptake on Plavix in the 1st 6 months? HMMMM
 






Anonymous said:
First off, look at the sales numbers once the next quarter sales come out. I have seen the uptake starting. Secondly, plavix reps, who are gettin on here trying to act like they are lilly reps, What is the major bleeding rate between the two drugs on patients less than 75, no stroke and greater than 60 years of age. Is this major bleeding statisically significant.

My hospital is contemplating changing protocal to loading all on Effient who are less than 75, greater than 60 and no stroke after testing 30 patients for IPA once loaded with plavix, and over 20 of them did not have sufficient IPA, thus they deemed instead of running these test after the fact, just load with effient, unless they meet the patients that fit the type WE DO NOT WANT.

Also, plavix reps have done a great job dominating the conversation and confusing the issue. All you have to do is is simply point out the plavix reps are trying to draw attention to bleeding in the overall arm which includes patients we do not want you to use effient on.

Also how many patients do the physicians have the come back in on Plavix. My docs are automatically switching these patients over, and I guarantee you with in 3 months, they will start simply us plavix second line is PCI patients, as many of them have indicated they agree that they should, but just because of habit, they have not started as many.

We will never replace plavix, but Effient is clearly the better drug. Plavis goal is totally confuse the IC's and if you let them then that is your fault. I asked several physicians a pretty basic question. What was the improved risk reduction rate and increase of bleeding rate that plavix plus aspirin had over aspirin alone. Now compare that to the rates in timi 38. The difference is we got a box warning because approved in 2009, if plavix came out in 2009 it would have a box warning.

Plavix going generic is the biggest issue and yes AZ new drug. However AZ drug has issues too. It is a year away from approval, and has some heart issues that makes its approval interesting. Also Effient has CV death benefits too, especially in recurrent MI's. So if physicians are loading on the table, then what benefit does using a reversable offer. NONE. If they preload, then yes a reversable is great.

Effient Reps, learn how to be more specific about what your asking the physician to do, and to overcome all the BS that Plavix reps are putting out there. The uptake is slow, what was the uptake on Plavix in the 1st 6 months? HMMMM
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you are either delusional or a liar....the "dabblers" in my area either have had minor(nose) or major (ICU) bleeds with Effient and said forget it, Plavix has been great for 11 years ...why switch?.........next quarter 3.8 million will be less
 






Effient was not covered by almost all medicare part D programs until Jan 1. Also, most commercial insurance did not cover Effient until the Jan 1. For most outpatients Effient was not covered by insurance until this month... Those that covered Effient often had a prior authorization by the physician required. Opportunity to sell this drug in the US was very limited until this month.

Worldwide sales suck.

Plavix generic date is not set in stone. Sonofi is actually going to be one of the manufacturers of the "generic". Generic cost is not expected to be very much cheaper, ($20 less is what I have heard).

I haven't heard of any bleeding complications from my hospital. (I did hear of two nosebleeds in outpatients.)
 












Anonymous said:
you are either delusional or a liar....the "dabblers" in my area either have had minor(nose) or major (ICU) bleeds with Effient and said forget it, Plavix has been great for 11 years ...why switch?.........next quarter 3.8 million will be less
Click to expand...

So i am delusional or a liar because I my physicians have identified that the IPA on patients taking plavix, in general is not sufficient, and have a meeting 2/8 to vote on switching all patients in house that get an OAP to get effient, and have loading restricted to the cath lab, removing the risk of loading a patient that will go to cabg and does not fit our criteria.

I think if you sit back and look at the facts, and not get caught up in what Plavix reps are trying to say to distort the truth, you will see that effient is a better drug than plavix in 80% of the patients taking these drugs.

Whats funny is that many effient reps let plavix reps out detail them on their own study (timi 38). If you knew the FACTS surrounding the study, you would know that major bleeds in our group vs the plavix showed 0 statistical significance. 0! however in many areas we are allowing plavix reps to paint this picture that our bleeding is so serious. Yes in those patients that go to cabg, or in the patients older than 75, who had a previous stroke, or less tha 60 yes. The key is I negotiated with my hospitals to have it restricted to these patients to take the guess work out of this for the physicians. In the short run my manager thought i was giving away scripts, now he loves me for it.

Finally. IPA IPA IPA. You win if you repeatedly show them how weak Plavix IPA is, and compare it to Effient, then point out the recurring mi's that patients come back with. If you were a patient, would you want to be put BACK, on the same oap that you had a recurring mi on and that has shown to not be as effective as Effient, and I could be one of those non-responders that plavis reps are trying their hardest to minimize.

Effient reps, you have to stop losing your own battle. We have a superior drug, for 80% of the patients, plavix is not the issue, Time is the issue. In time we would over take plavix, but our pricing and plavix going generic is the challenge. Sooner or later almost all hosptials will start some type of ipa or genetic testing, Cardio vascular surgeons want it, ic's are starting to want it. When they do, they will realize how effient not allows loading on the table and not use as much integrellin or reopro and not as much angio max, saving them money, but also they get mich higher platlet inhibition IMMEDIATELY.

Plavix reps, great job distorting the truth nationwide. Great job getting physicians to think of the bleeding, and think this applyes to all patients. great job getting them to ignore all the recurring mi's that patients continue to have on your product, or the weak IPA. Great job getting them to ignore the repeated fda warnings, updated the heart. org's update showing the non-responders is real. Great job! However in my area it is not working.
 






Anonymous said:
So i am delusional or a liar because I my physicians have identified that the IPA on patients taking plavix, in general is not sufficient, and have a meeting 2/8 to vote on switching all patients in house that get an OAP to get effient, and have loading restricted to the cath lab, removing the risk of loading a patient that will go to cabg and does not fit our criteria.

I think if you sit back and look at the facts, and not get caught up in what Plavix reps are trying to say to distort the truth, you will see that effient is a better drug than plavix in 80% of the patients taking these drugs.

Whats funny is that many effient reps let plavix reps out detail them on their own study (timi 38). If you knew the FACTS surrounding the study, you would know that major bleeds in our group vs the plavix showed 0 statistical significance. 0! however in many areas we are allowing plavix reps to paint this picture that our bleeding is so serious. Yes in those patients that go to cabg, or in the patients older than 75, who had a previous stroke, or less tha 60 yes. The key is I negotiated with my hospitals to have it restricted to these patients to take the guess work out of this for the physicians. In the short run my manager thought i was giving away scripts, now he loves me for it.

Finally. IPA IPA IPA. You win if you repeatedly show them how weak Plavix IPA is, and compare it to Effient, then point out the recurring mi's that patients come back with. If you were a patient, would you want to be put BACK, on the same oap that you had a recurring mi on and that has shown to not be as effective as Effient, and I could be one of those non-responders that plavis reps are trying their hardest to minimize.

Effient reps, you have to stop losing your own battle. We have a superior drug, for 80% of the patients, plavix is not the issue, Time is the issue. In time we would over take plavix, but our pricing and plavix going generic is the challenge. Sooner or later almost all hosptials will start some type of ipa or genetic testing, Cardio vascular surgeons want it, ic's are starting to want it. When they do, they will realize how effient not allows loading on the table and not use as much integrellin or reopro and not as much angio max, saving them money, but also they get mich higher platlet inhibition IMMEDIATELY.

Plavix reps, great job distorting the truth nationwide. Great job getting physicians to think of the bleeding, and think this applyes to all patients. great job getting them to ignore all the recurring mi's that patients continue to have on your product, or the weak IPA. Great job getting them to ignore the repeated fda warnings, updated the heart. org's update showing the non-responders is real. Great job! However in my area it is not working.
Click to expand...

Hmm.. Well considering that the TOP REP IN THE NATION has just over 200 NRX scripts prescribed since launch... I'd say the challenge is that our drug isn't that good and you haven't sold enough product to even cover your expenses much less your salary.

You guys have less then 6 months before you see some major layoffs in your sales division. Lilly priced the drug way out of line and this is going to hurt us big time.
 






Anonymous said:
So i am delusional or a liar because I my physicians have identified that the IPA on patients taking plavix, in general is not sufficient, and have a meeting 2/8 to vote on switching all patients in house that get an OAP to get effient, and have loading restricted to the cath lab, removing the risk of loading a patient that will go to cabg and does not fit our criteria.

I think if you sit back and look at the facts, and not get caught up in what Plavix reps are trying to say to distort the truth, you will see that effient is a better drug than plavix in 80% of the patients taking these drugs.

Whats funny is that many effient reps let plavix reps out detail them on their own study (timi 38). If you knew the FACTS surrounding the study, you would know that major bleeds in our group vs the plavix showed 0 statistical significance. 0! however in many areas we are allowing plavix reps to paint this picture that our bleeding is so serious. Yes in those patients that go to cabg, or in the patients older than 75, who had a previous stroke, or less tha 60 yes. The key is I negotiated with my hospitals to have it restricted to these patients to take the guess work out of this for the physicians. In the short run my manager thought i was giving away scripts, now he loves me for it.

Finally. IPA IPA IPA. You win if you repeatedly show them how weak Plavix IPA is, and compare it to Effient, then point out the recurring mi's that patients come back with. If you were a patient, would you want to be put BACK, on the same oap that you had a recurring mi on and that has shown to not be as effective as Effient, and I could be one of those non-responders that plavis reps are trying their hardest to minimize.

Effient reps, you have to stop losing your own battle. We have a superior drug, for 80% of the patients, plavix is not the issue, Time is the issue. In time we would over take plavix, but our pricing and plavix going generic is the challenge. Sooner or later almost all hosptials will start some type of ipa or genetic testing, Cardio vascular surgeons want it, ic's are starting to want it. When they do, they will realize how effient not allows loading on the table and not use as much integrellin or reopro and not as much angio max, saving them money, but also they get mich higher platlet inhibition IMMEDIATELY.

Plavix reps, great job distorting the truth nationwide. Great job getting physicians to think of the bleeding, and think this applyes to all patients. great job getting them to ignore all the recurring mi's that patients continue to have on your product, or the weak IPA. Great job getting them to ignore the repeated fda warnings, updated the heart. org's update showing the non-responders is real. Great job! However in my area it is not working.
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Great Pep talk.

You must be one of those home office training douches who has no clue what is being talked about in the field.

Go tell your biggest IC that Plavix doesn't work and see how they respond to you.

Get a clue Douche!
 






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