TID with 2 hours infusions!

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Anonymous said:
please....do not waste your time on folkes that are very negative towards this drug. TID dosing is going to be a problem. Give me a break.
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I agree that the TID dosing won't be a problem in the hospital. But for outpatient it will be a huge probelm. Many of the docs will not use one drug in the hospital only to have to switch it when the patient is discharged to homecare or an outpatient infusion clinic. This is particularly true if the homecare companies will not administer "first dose". With all of the other MRSA agents available such as Zyvox, Tygacil, and even vancomycin that are dosed BID and Cubicin which is dosed QD, why would hospitals rush in to put ceftobiprole on formulary? Expect this to be a long and painful launch, this could take years to catch on if ever.
 






Anonymous said:
What a blow hard you are. I bet you feel so big sitting behind your computer screen spewing forth all of this like you are the end all. You seem to sit there and think that those of us aboard have no ID experience. You will be pleasantly surprised the wealth of experience that they have brought aboard. We are not new to the industry or new to ID and selling in hospitals. Give me a break. We WILL be proving you wrong.
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I don't feel big or all knowing or what ever you suggest - nothing at all like that. I write the above quote from my experience. Which, I can say, is thirty five years of antibiotic sales in half as many states and then working as pharmacist in several regional hospitals till I was done and could just play golf with then rather then work with them. Yep, I'm done now, retired and have seen many changes to the way the ID's use antibiotics. Been friends with many and spoken to them honestly when they are doing what they can to save a life. Often they are trying to save the neck of the surgeon or the critical care MD, not the patient. You see, it's a team approach and they work to protect each other. Do you understand that?

That is why I'm telling you that your drug will take time. That is why I'm suggesting that you should not compare to Zosyn.

OK, enough. GO have some fun. It does not matter what the hell you do as your ID will do it his way 99% of the time anyway and the industry will finally realize this and stop paying you your over weighted salary. Ta ta.
 






and again my point is that companies that are placing reps as hospital reps should seriously consider Rph, RN, LPN, PAs to copromote with us. Pharma is tough these days, the more credibility the better take some time to find the best people...I just want to make some $$$.
 






Anonymous said:
I beg to differ as I am in the hospitals daily and I will be your partner. Some hospitals, you are correct, are closed...then your're at the mercy of P&T etc. But when it comes to representatives, credentials hold the key to more access, nurse rapport and correct use of product. That is what so many companies just don't get....pharmacists etc are "one of them"...others are outsiders. With the current state of "Pharma" this is just a current and important observation.
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Not so...in the Pac NW alone Wyeth has several RNs and RPhs and even a couple of PharmDs all with hospital experience in their fields now selling various hospital drugs and they are all seen as simply drug reps. Though the credentials may impress a few initially they do no better than the rest of us accesswise or performancewise.
 






Anonymous said:
Let me tell you shmucks something about antibiotics. QD is where it's at and anything else is a disadvantage. Period. Specially in the MRSA market where you need to be easy. And please, your not going in the ICU any time soon so remember that your not Zosyn, and you will not be for about fifteen years. You think your gonna walk in there rand get patients treated for HAP in the ICU. Right! Don't do and say it's ok for Zosyn so it's ok for us. Your brand new, remember? Do you know what that means in antibiotics? You haven't been in sales long enough and gotten your ass kicked by ID long enough to even come close to understanding how many times ID has gotten burned on new antibiotics. If you have been around in antibiotic sales for any time you will understand that ID's will use everything, and I mean everything that is out before going to your new cephalosporin that will develop resistance before it's infused. Speaking of infusion, the 2 hour infusion is also a total negative. Get real. Now, go back to selling oral meds in the office.
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Even selling Zosyn we had our asses kicked by management for the first 7 or 8 years before it really began to take off. It didn't even sell $500M/yr in the US until a couple years ago and it's been on the market now for about 13 or 14 years. I have been selling it for 10 of those years and I can tell you from personal experience its been slow, hard going...and that is coming from what eventually became a multiple award winning territory. IDs do indeed want to save the big guns for last. Why?...because their attendings told them to back in med school.
 






Anonymous said:
Even selling Zosyn we had our asses kicked by management for the first 7 or 8 years before it really began to take off. It didn't even sell $500M/yr in the US until a couple years ago and it's been on the market now for about 13 or 14 years. I have been selling it for 10 of those years and I can tell you from personal experience its been slow, hard going...and that is coming from what eventually became a multiple award winning territory. IDs do indeed want to save the big guns for last. Why?...because their attendings told them to back in med school.
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Ceftibiprole is a great drug with good coverage and a TID dosing regimen that is very, very familiar for both hospital and home infusion. TID is not a major problem for home infusions long as the stability and vial are home infusion friendly. Outpaitient use could be limited but the high use of Zosyn and other products with similar admin regimens proves that hospitals can adapt once they are comfortable with the drug. By the time patients hit the ICU they are often in full fulminating sepsis and most intensivists want to see some protocols recommending your drug before they start using it themselves, and that takes time and studies. They will become rapidly disinterested if you continue to press them and you will lose credibility. If you staff your salesforce with experienced hospital reps you will have a nice head start but that won't guarantee a quick painless blockbuster launch. Learn from the experience of other broad spectrum antibiotic launches. Mercks Invanz was supposed to be huge with its supposedly perfect profile of broad spectrum, all important QD administration, and easy to remember dosing but is still struggling 5 or 6 years later with only a couple percentage points of the market. Wyeths Tygacil brand team completely ignored its own companys valuable experience with Zosyn and fully expected that Tygacil, the biggest of big guns, would do in 7 months what it took Zosyn 7 years to do. They had to repeatedly downgrade expectations and goals to better fit their own 13 years of valuable IV antibiotic experience that had been staring them in the face since day one. The pressure to meet fantastically unrealistic goals created horrible embarrassment for the brand team and managment and awful, terrible morale problems in the field where reps who had succesfully launched Zosyn IV, Amiodarone IV, and Protonix IV actually had to sell the stuff using strategies that did not take customer needs into account. Follow the launches of any of the real broad spectrum antibiotics and iwth most you will see a very similar path of slow, steady growth. These were not easy sells when access and attitude toward our industry was good. Its a tough market with an awful lot of very good drugs in an increasingly hostile environment. You have to have a lot of dedication and tenacity to stick with it.
 






Anonymous said:
I don't feel big or all knowing or what ever you suggest - nothing at all like that. I write the above quote from my experience. Which, I can say, is thirty five years of antibiotic sales in half as many states and then working as pharmacist in several regional hospitals till I was done and could just play golf with then rather then work with them. Yep, I'm done now, retired and have seen many changes to the way the ID's use antibiotics. Been friends with many and spoken to them honestly when they are doing what they can to save a life. Often they are trying to save the neck of the surgeon or the critical care MD, not the patient. You see, it's a team approach and they work to protect each other. Do you understand that?

That is why I'm telling you that your drug will take time. That is why I'm suggesting that you should not compare to Zosyn.

OK, enough. GO have some fun. It does not matter what the hell you do as your ID will do it his way 99% of the time anyway and the industry will finally realize this and stop paying you your over weighted salary. Ta ta.
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My decade of experience selling IV antibiotics leads me to agree with you completely. A positive attitude is great as long as it is tempered with some reality. A positive attitude with no room for the consideration of realities is a recipe for a quick burnout when things start going sideways.
 






Anonymous said:
Not so...in the Pac NW alone Wyeth has several RNs and RPhs and even a couple of PharmDs all with hospital experience in their fields now selling various hospital drugs and they are all seen as simply drug reps. Though the credentials may impress a few initially they do no better than the rest of us accesswise or performancewise.
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Agree both ways, more credibility would be great but I have seen the same thing happen in our company with those who have those credentials. It would be nice if all the continuous training we do could actually lead to an RPh degree or something similar. Many of us have already completed all the pre-med and/or pre-pharm school prereqs anyway. Sometimes I wonder if I should just go back to med-school but then another one of my pre-med partners pops up in the community as a physician working longer hours, fewer vacation days, making less than I do, monsterous malpractice insurance and with a $200+K loan to top it off. So far they all seem disappointed in the realities of medicine and come across as relatively unhappy. Maybe I made the right choice.
 






Anonymous said:
---Most hospitals don't want ANYONE walking their halls and talking to Drs. and staff trying to influence them into using a product that is currently not on formulary, especially if it is higher priced.
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They would likely have even more of a problem with the thought of industry-paid MDs walking around the hospital promoting non-formulary products than they do with us.
 






It is not too hard to find good credentialed sales people, just push them up 10% -20% in salary...you get what you pay for and for this launch it will be well worth the investmant.
 






What are you concerned about with a 2 hour infusion? As a critical care pharmacist my advice to you is simple, you address the pharmacodynamic properties of Beta-lactam drugs---time dependent killing. The more time above the MIC the better (T>MIC) and the ONLY way to achieve that with time dependent drugs is to extend the infusion time. That is why extended infusions and continuous infusions are all the rave in literature now with the beta-lactams.... Make that your selling point, EXTENDED INFUSIONS provide more optimal T>MIC for beta-lactams!!!!
 






Anonymous said:
Well that's that, then. I guess I'll have to renege on my offer unless I want to be considered "not top caliber" by the keyboard generals on CP.
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JNJ here, you think I am going to let a Basilea rep in the hospital. They can call on all the PCPs they want. You think I need help selling this? MDs are clamoring for this drug
 






Anonymous said:
JNJ here, you think I am going to let a Basilea rep in the hospital. They can call on all the PCPs they want. You think I need help selling this? MDs are clamoring for this drug
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I'd be awful careful there. You're not in a position to "let" anybody do anything. If you'd just wait and see who you'll be working with and what they bring to the table, you might be pleasantly surprised. That is, if you can get past your ego.

Some of us who are coming on board have been eating your lunch for years with our old companies, hotshot, and Basilea was smart enough to recruit us. Let's not start off with this kind of bullshit -- it takes the focus off of moving drug, which is what we all get paid to do.
 






Md's are clamoring for this drug????

Where and Why?

Have you launched an IV antibiotic before becuase physicians don't clamor for IV antibiotics and I have "launched" several in a few different capacities.

Unless thier is "superiority" data in an area of vital need or a huge financial incentive to the physician....there will be no "clamor"
 






All the posters here kill me... Cefto may launch, maybe not. Certainly not in 2008. Lots of stuff coming in the anti MRSA category, including a once-a-weeker (look it up) that will help kill off any infusion center business if it launches. J&J has good hospital presence with levaquin and doripenem, and knows the players. Get over yourselves.
 






Anonymous said:
All the posters here kill me... Cefto may launch, maybe not. Certainly not in 2008. Lots of stuff coming in the anti MRSA category, including a once-a-weeker (look it up) that will help kill off any infusion center business if it launches. J&J has good hospital presence with levaquin and doripenem, and knows the players. Get over yourselves.
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I'm not sure why this thread "kills you". You aren't the most informed on this topic based on your short post. The once-a-weeker you speak of has had an "approvalable letter" for about 3 years and hasn't moved any closer to launch.

Your right, in that, there are other MRSA type drugs that are being studied but all seem to have been held up by the FDA, with "approvable letters". It would seem, that unless, any of these MRSA drugs show "superiority" data to Vancomycin then they will all be questioned. The FDA criteria for antibiotic approval seems to have become much more difficult and drugs like Zyvox, Cubicin and Tygacil have entered the market in the last 5 years.

As a J&J rep you should remember Floxin before the Levaquin days. I'm sure you guys have a good presence in the hospitals but the longer it takes to get on the market the more obstacles/objections you are going to have and the more solidified other products will be.

A delay is not good!
 






Hey, poster 39... read the "if" in my short but uninformed post. I agree - delays are not good, but ID's are keeping track of G+ pipeline because of the control issues they'll have to face. Doesn't take a J&J rep to understand that. The FDA and ID's have both been burned in the past; it's going to take some really good date to get any of us something new to sell.
 






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