 PhysicianForum --
October 2003
 In This Issue...
Despite the fact that the
antibiotic drug market has many efficacious and interchangeable agents, GlaxoSmithKline’s
Augmentin and Bayer’s Cipro have achieved $1 billion+ sales status in the United
States based on their improved tolerability, convenience, and efficacy compared
with many other antibiotics. The patent expiry of these two blockbuster
antibiotics will escalate the level of generic competition in this market and increase
the barrier to entry of new agents. Both companies have launched extended release
versions of these dominant branded antibiotics, but under the scrutiny of
managed care and formulary switches to generic agents Augmentin XR and Cipro XR
face difficult challenges in securing patient share.
Growing antibiotic resistance
among respiratory pathogens is fueling the transition from the use of low-cost
agents, such as amoxicillin and the cephalosporins, to broader-spectrum, more
expensive agents, such as the novel fluoroquinolones. New drugs positioned to
treat patients with antibiotic resistance are needed, as are agents that are
highly safe and broadly efficacious in difficult-to-treat patients; however,
the commercial opportunities in the antibiotic market are waning for these
specific niches and patient populations. Aventis’s Ketek (telithromycin) has
the advantage of treating antibiotic-resistant pathogens and
thereby satisfies an unmet need in medical management.
Decision Resources’ PhysicianForum
survey Antibiotics: Impact of Major Patent Expiries and New Drug Entrants
explores the current outpatient treatment practices for respiratory tract
infections (e.g., community-acquired pneumonia, chronic bronchitis, acute
sinusitis, otitis media). This survey examines how the landscape is changing
following the patent expiry of Augmentin and Cipro, and evaluates the potential
impact of novel fluoroquinolones and an important member of a new class of
antibiotic, Aventis’s Ketek. We surveyed 70 primary care physicians (PCPs) and
20 HMO pharmacy directors and compared their responses to assess similarities
and differences.
This study describes the
following attitudes and trends in the current antibiotic treatment market:
- Current prescribing patterns for beta-lactams, macrolides, fluoroquinolones,
cephalosporins, and tetracyclines for treating respiratory tract infections.
- Choice of antibiotic prescribed by type of respiratory tract
infection: physician preference vs. formulary preference.
- Significant factors influencing physician selection of antibiotics
to treat respiratory tract infections.
- Antibiotic resistance concerns and their impact on physician prescribing
of newer fluoroquinolones and other antibiotic drug classes.
- Physician and pharmacy director positions regarding the new ketolide,
telithromycin (Aventis’s Ketek): what types of patients will be targeted to
receive Ketek, what drugs will be replaced by Ketek, expected managed care
formulary decisions on Ketek.
- Attitudes toward switching current Augmentin and Cipro users to generic
agents vs. Augmentin XR and Cipro XR.
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