lipitor marketing case study

It Took A Brilliant Marketing Campaign To Create The Best-Selling Drug Of All Time

When it was in development, the cholesterol-lowering medicine was viewed as such an also-ran it almost didn't make it into patient testing.

By the time Lipitor went on sale in early 1997, it was the fifth drug in a class called statins that lower LDL or bad cholesterol. The class already included three blockbusters, drugs with sales of $1 billion a year or more. Normally, that would make it very tough for a latecomer to sway many doctors and patients to switch.

But a 1996 study showed Lipitor reduced bad cholesterol dramatically more than the other statins, from the very start of treatment and even more so over time. A striking graph of those results helped Lipitor sales representatives turn it into the world's best-selling drug ever, with more than $125 billion in sales over 14 1/2 years.

Nicknamed "turbostatin," Lipitor became the top-selling statin barely three years after it was launched. It's provided 20 percent to 25 percent of Pfizer Inc.'s annual revenue for years.

But after nearly a decade as the top-selling drug, Lipitor is set to be toppled in 2012 after getting its first generic rivals four weeks ago.

It's a run not likely to be repeated.

Back in the early 1980s, the public was just starting to learn what cholesterol was. There was little evidence that controlling it with medication could be so crucial in preventing disability and early death, and the coming epidemic of obesity and diabetes in an aging population wasn't foreseen.

At the time, heart attack prevention basically amounted to telling patients to eat more oatmeal and skip the steak.

Lipitor creator Warner-Lambert, a mid-sized drugmaker best known for consumer health products including Listerine, Benadryl allergy pills and Halls cough drops, got a late start in what turned into a surprisingly fast-growing market.

Merck & Co. had a decade lead with Mevacor, launched in 1987. By 1994, its successor drug, Zocor, along with Bristol-Myers Squibb Co.'s Pravachol and Novartis AG's Lescol, had crowded the market.

"Those other companies didn't even take us seriously. They didn't think we could be a viable contender," said Adele Gulfo, then head of cardiovascular marketing at Warner-Lambert Co. who now heads Pfizer's primary care drugs business.

Doctors said they were "quite satisfied with the medicines we have," she recalled recently.

Given that, marketing executives at Warner-Lambert were projecting Lipitor sales of $300 million a year at best, recalls the drugs's inventor, chemist Bruce D. Roth.

"I wish someday you guys could make us a drug we could sell," the marketers told his team, recalls Roth, a research vice president for Genentech, a biotech pioneer now owned by Swiss drugmaker Roche.

They had, but didn't see it.

"There was a lot of controversy at Warner-Lambert as to whether we should even take our molecule into the clinic" for human testing, Roth says. "It was kind of a big risk ... It's millions of dollars."

But senior management was persuaded in 1990 to at least fund the initial round of testing on a couple dozen employee volunteers.

The results were far better than what had been seen in the animal tests.

"It tremendously, incredibly outperformed the other statins," Roth says. "It was as good at its lowest dose as the other statins were at their highest dose."

So Warner-Lambert partnered with much-larger Pfizer, considered the industry's top marketer, first to help fund the expensive late-stage testing of the drug in people and then to promote Lipitor after it was launched. Pfizer bought out Warner-Lambert in 2000 to block two other companies trying to acquire it and get control of Lipitor.

Pfizer benefited from some lucky timing: Lipitor went on sale in 1997, the year the Food and Drug Administration first allowed drug ads targeting consumers.

So Pfizer spent tens of millions on ads, including on the popular drama "ER," first urging patients to "Know Your Numbers" and then showing patients discuss how Lipitor helped them get their cholesterol numbers below guideline goals.

Meanwhile, health groups kept lowering the cholesterol targets in national guidelines, making millions more patients good candidates for statin treatment, as new research showed the link between cholesterol levels and consequences such as heart attacks. All those new patients boosted sales for the whole statin class, particularly Lipitor.

The Lipitor promotion team set new standards for a marketing campaign. They repeatedly visited family doctors as well as cardiologists, and blanketed patients with data showing that Lipitor was best at lowering cholesterol. They stressed to doctors nervous about safety that Lipitor's lowest dose worked as well as rivals' highest doses. They gave free samples of the white pills and sometimes bought lunch for the office staff.

In another savvy move, Lipitor was priced below rival drugs.

The company continued research on Lipitor, through this year conducting more than 400 studies, costing roughly $1 billion and including more than 80,000 patients. The studies have shown how Lipitor helped patients with heart problems, diabetes, stroke risk and other conditions, by preventing heart attacks and strokes and reducing plaque buildup in arteries.

Even with Zocor, Pravachol and Mevacor all going generic several years ago, and AstraZeneca PLC's Crestor joining the market in 2003, Lipitor sales have remained strong. It's the only brand-name drug among the 20 most-dispensed drugs in the U.S., according to data firm IMS Health.

But Pfizer, the world's largest drugmaker by revenue, has struggled to develop another runaway blockbuster. Its bid to create a next-generation statin flamed out in 2007 when it had to abandon heavily touted compound torcetrapib, after roughly $800 million in testing, because it raised heart attack and stroke risk.

In recent years, Pfizer has focused on creating other types of drugs and on another unprecedented strategy — this one for hanging onto Lipitor revenue until June, when multiple new generic Lipitor versions will join one sold by Ranbaxy Laboratories and the authorized generic from Watson Pharmaceuticals Inc. Pfizer is offering patients and insurance plans big discounts and rebates, including cards giving patients a $4 monthly copayment, if they stay on Lipitor until then.

But branded Lipitor is by no means history.

Its patent is still in force in many major foreign countries and Pfizer is promoting it heavily in emerging markets such as China.

Pfizer's strategy to keep U.S. patients on Lipitor appears to be working a little better than some analysts expected: The number of Lipitor prescriptions filled in the first full week after generics arrived only fell by half.

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Sanford Bernstein analyst Dr. Tim Anderson forecasts Lipitor sales will decline from about $11 billion in 2009 and 2010 to $3.9 billion next year and just above $3 billion in 2015.

That would make it Pfizer's No. 3 drug that year — and possibly still among the world's 20 top-selling drugs by revenue, as half those on the current list also will have generic competition by then.

Lipitor, the best-selling drug in the history of pharmaceuticals, is the blockbuster that almost wasn't.

Nicknamed "turbostatin," Lipitor became the top-selling statin barely three years after it was launched. It's provided 20 percent to 25 percent of the company's annual revenue for years.

So Warner-Lambert partnered with much-larger Pfizer Inc., considered the industry's top marketer, first to help fund the expensive late-stage testing of the drug in people and then to promote Lipitor after it was launched. Pfizer bought out Warner-Lambert in 2000 to block two other companies trying to acquire it and get control of Lipitor.

In recent years, Pfizer has focused on creating other types of drugs and on another unprecedented strategy — this one for hanging onto Lipitor revenue until June, when multiple new generic Lipitor versions will join one sold by Ranbaxy Laboratories and the authorized generic from Watson Pharmaceuticals Inc. Pfizer is offering patients and insurance plans big discounts and rebates if they stay on Lipitor until then.

Its patent is still in force in many other countries and Pfizer is promoting it heavily in emerging markets such as China.

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Lipitor: positioning the world's first $12 billion drug

This case study focuses on the marketing strategy that led to the success of lipitor, with 2005 sales of $12.2 billion making it the world's best-selling drug by a wide margin..

Case A describes its market entry and rise to market leadership. Positioned as a more effective product, Lipitor was the fifth entrant into a well-established category with strongly entrenched competitors. Case B analyzes the challenges to Lipitor posed by competitor repositioning, a product safety crisis potentially affecting the entire pharmaceutical category, and the planned entry of a new competitor intent on beating Lipitor at its own game.

Author Reinhard Angelmar, the Salmon and Rameau fellow of healthcare management and professor of marketing, describes the strategy employed by executives at Pfizer to ensure the product's phenomenal growth.

The marketing of prescription medicine is a complex business. All new pharmaceutical products first require approval from health authorities such as the US Food and Drug Administration (FDA) and the European Medicines Evaluation Agency (EMEA) prior to market introduction. Products may only be promoted for the approved indications, dosage and administration, and safety and risk information must be disclosed.

In most countries, prescription medicines can only be promoted to healthcare professionals. Consumer-targeted ads which raise awareness of symptoms without naming specific brands are generally tolerated, but brand advertising is authorized only in the US.

Case A looks at the rationale behind the partnership between Pfizer and Warner-Lambert and the conditions and circumstances surrounding the launch of Lipitor in February 1997 in the US, UK and Germany. The success of the product had come at the expense of Merck & Co, which had pioneered the statin product category and whose Zocor brand was fighting to remain competitive.

Pfizer executives had to decide what changes they should make to Lipitor's marketing strategy to counter Merck's latest efforts to enhance Zocor's effectiveness and range of indications, underlining its determination to defend its position.

The need to ramp up Lipitor's marketing strategy in response to its competitors' recent moves threw up a number of challenges for management: What should be done to counter Zocor's new HDL-C indication? Should Lipitor, hitherto promoted only to healthcare professionals, also be promoted to consumers? What other initiatives should be taken to ensure Lipitor's continued growth?

Case B takes up the story in August 2001, when executives at Pfizer were grappling with how to defend Lipitor's market leadership, then worth $5 billion. How should they prepare for the arrival of Crestor, a new statin drug from AstraZeneca? Hyped as a "superstatin", would Crestor do to Lipitor what Lipitor had done to Zocor? And how should they react to the sudden market withdrawal, due to safety risks, of Bayer's statin drug, Baycol/Lipobay?

INSEAD 2006

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Major Waste Management/Utilities project - Category Manager

Leading Saudi Arabian Utilities company - Major construction project Role: Buyer Salary: 25-35,000 SAR Location: Saudi Arabia This Leading Procuremen

Procurement Senior Manager - Global Blue-Chip

World renowned professional services firmRole: Senior Consultant - Indirect GeneralistLocation: London - WFH / Occasional travelSalary: £60-70k + Pack

Safeguarding Trustee

Flexible location

Save the Children

Are you motivated by our vision of creating a world where every child doesn't just survive, but thrives, and can go on to change the world?

Grade 10 - £63,673 to £69,561 (appointment is normally made at lowest point on scale)

The Alliance for Sustainability Leadership in Education - EAUC - has a unique opportunity to be our CEO. Are you that person?

Deputy Young Transport Workers Officer (London)

Starting at £54,879 – £64,730 (plus a bonus of 1/12th of annual salary)

International Transport Workers Federation (ITF)

The Deputy Young Transport Workers Officer, based in our London office will develop strategies for organising young transport workers, ensuring tha...

Innovative Procurement Manager - Media Production

GBP55000 - GBP65000 per annum + + Package

HRIS Specialist

£50000.00 - £65000.00 per annum + Bonus, negotiable, work abroad

This is a fully autonomous role, where you will have full ownership to design, implement, and bring to life an established but underutilised HRIS system.

Head of Human Resources - Part Time

SW3 6JJ, London (Greater)

£60,000 - £70,000 FTE + Benefits

Job description Job Purpose The Royal Marsden Cancer Charity (RMCC) raises money solely to support The Royal Marsden, a world-leading cancer centre...

Head of People

Wallington, London (Greater)

Cognus Band 6 £39,872.04 (0.6 FTE of £66,454.84)

Cognus Limited

We are looking for a highly motivated and experienced Head of People to lead our HR department, develop our teams and provide strategic direction.

Construction Category Manager

£570 per day (inside IR35)

Langley Search & Interim

The Opportunity:-   Our client is currently recruiting for an interim Construction Category Manager to deliver commercial strategy and tendering / ...

Senior Indirect Procurement Consultant / FTSE 250

Hr business partner - hybrid working.

Salisbury, England

£47000 - £53000 per hour

Are you an experienced HR Business Partner with Public Sector experience who can commute to Salisbury 2-3 days a week? Are you available to start a new interim role at relative short notice? If so please apply today.

Global Mobility Senior Manager

£70000.00 - £95000.00 per annum + Bonus, cash allowance, negotiable

We are looking for a Senior Manager to join our Financial Services Global Mobility Services (GMS) Technology team in London. Our Global Mobility Service (GMS) practice is a diverse and fast-growing area of our Tax business.

Junior Business Partner

Your new company This company is one of the world's leading technology communication companies. They have a large international presence, leveraging 12,000 employees in the UK alone.

Head of External Affairs: Fair By Design

£47,013-£56,415 pa + up to 10% contributory pension

Barrow Cadbury Trust

Seeking a talented individual with an outstanding track record of successfully delivering impactful communications and public affairs strategies.

Associate Director – B2B technology PR

£65000 - £80000 per annum

Are you an Associate Director ready to change agencies? Looking to work with industry defining clients? Are you an individual with the ambition to become...

Tewkesbury, England

£45000.00 - £55000.00 per annum + full range of benefits

HR Manager, to £55k pa + bens, hybrid working, Tewkesbury based organisation, HR generalist post, perm. Proud to be the exclusive recruitment partner for a superb leading,well established and growing retail organisation.

GBP50000 - GBP65000 per annum +

Direct Procurement Specialist- Leading Automotive Firm- £40-50K+ Package- London Based Procurement Consultant Role- Leading Top 100- Forbes Procurement and Supply Chain Consultancy Specialist- £65K+ Exciting Benefits Prestigious Central Lo

MD for an ambitious PR agency

£120,000 - £150,000

f1 Recruitment

An incredible opportunity for an MD to join this award winning integrated agency. Reporting into the CEO, this is an exciting opportunity to lead t...

HR & OD Business Partner

£54223 - £60316 per annum

Are you an experienced HR Business Partner looking for a new challenge? With a refreshed HR & OD Strategy and senior leadership team this is a great time to join.

Head of Development

Clerkenwell, London

£45-50k per annum

Art Angel Trust

The role has a strong understanding of the funding landscape in the UK and has successfully fundraised from trusts and foundations and private patrons

Oxfordshire, England

£50000 - £60000 per annum

A newly created Head of HR role within a post-transformation setting.

Procurement Manager - Travel and Events

USD120000 - USD130000 per annum +

Procurement Manager - Travel and Events Procurement - $120,000 - $130,000 - Global Leader in Food and Beverage - RemoteIf you want to hear more about

HRIS Project Manager (iTrent)

£400 - £500 per day

1 My London based healthcare client is looking for an experience HRIS Project Manager (iTrent) to join the team on an interim basis. (Hybrid working)

Director of Communications

Avon & Somerset Police

We support the lives of millions of people across our diverse communities, and have a workforce of over 6,000 inspiring and dedicated staff,

Head of Digital

City of London, London / London

£100000 - £120000 per annum

Head of Digital (B2B Marketing)**NEW ROLE** The CompanyAn international law firm with an exceptionally strong brand platform and a reputation for exce

Interim Head of HR

£70000 - £75000 per annum

We are looking for a Head of HR to join a unique organisation in central London for 12 months.

FM / Construction Procurement Manager - Global FTSE 250

Dublin City Centre

EUR75000 - EUR85000 per annum + bonus + flexi working

FM & Construction Procurement Manager - Global FTSE 250 FMCG - 85,000 EURO + package Location: Berkshire (flexible working available)

Procurement Manager - Production and Special Projects

GBP55000 - GBP60000 per annum + + Package

Procurement Officer - Global Mega City

GBP50000 - GBP60000 per annum +

Procurement Officer - Flagship Mega Project in Saudi Arabia - Raw Materials and Direct Procurement - Riyadh - 15-20,000 SAR per month + benefits - ARA

FM Procurement Manager - Global FTSE 250 FMCG

GBP75000 - GBP80000 per annum + bonus + flexi working

FM Procurement Manager - Global FTSE 250 FMCG - £80,000 + package Location: Berkshire (flexible working available)

Recruitment Partner - Technology / Digital

£45000 - £55000 per annum + bonus, benefits package & hybrid working

We are looking for you to be a great team-player who enjoys working with others to achieve exceptional team results.

Procurement & Supply Chain - Management Consultants

GBP70000 - GBP90000 per annum + bonus + excellent package

Procurement & Supply Chain - Management Consultants - Multiple Opportunities Rapidly Growing Management Consultancy London + Flexibility + Some Travel £70,000 - 90,000 (depending on experience)

Director of Finance and Operations

£77,500 - £85,000

We are looking for a strategic inspiring leader with substantial experience in delivering financial and operational leadership.

Global Hard FM Procurement Manager

GBP70000 - GBP80000 per annum + bonus + excellent package

Global Hard FM Procurement Manager - Global FMCG - London - £70,000 - £80,000 + Package

Senior Facilities (FM) Procurement Manager

GBP75000 - GBP85000 per annum + Package, Rapid Progression

Senior Facilities (FM) Procurement Manager - Global Property Giant - London - £75,000 - £85,000 + Package

Generating over $600 million in annual revenue, this dynamic food and beverage organization are undergoing progressive internal transformation - buil

Head of Innovation and Partnerships (Health)

£50520 - £51468 Per Annum

Head of Innovation and Partnerships (Health) We have an exciting opportunity for a Head of Innovation and Partnerships to drive innovation to support the work in integrated health and care delivery, and progress opportunities to build new partners

Taxation Accountant

Sandy, Bedfordshire (Hybrid)

£42,768.00 - £52,124.00 per annum

This role will become the charity's internal tax expert, providing advice on all taxes that affect the organisation and its entities.

Head of Business Development

£49584 - £50520 Per Annum

We have an exciting opportunity for a Head of Business Development to deliver the charity’s ambitious business development goals.

Finance Manager (maternity cover, 15 months)

E2 9DA, London (Greater)

£50 - £60k depending on experience

ISEAL Alliance

ISEAL is looking for an experienced and motivated 15-month maternity cover for the position of Finance Manager. The role encompasses all responsibi...

Director of Talent & Learning

Essex (Hybrid)

C£90,000 basic salary plus Excellent Benefits

Essex (Hybrid: 2/3 days per week Essex with travel/WFH) Our client is a multi-site, fast paced service organisation with strong values. The busines...

Global Indirect Procurement Specialist

GBP50000 - GBP60000 per annum + Excellent Bonus, Rapid Progression

Global Indirect Procurement Specialist - World-Leading Professional Services Organisation - London + Flex. - £50,000 - £60,000 + Excellent Package

Head of People and Organisational Development

Location: Bridgwater College Academy

Salary: £65,000 - £75,000 per annum

Bridgwater & Taunton College

Bridgwater and Taunton College Trust is seeking to recruit an outstanding colleague to the position of Head of People and Organisational Development.

Head Of Procurement

St Helena Island, South Atlantic

£75k pa (Salary of £60k pa, plus International Supplement)

St Helena Government

Enjoying unique lifestyle opportunities, St Helena Island is a self-governing overseas territory of the United Kingdom.

Contract Manager

£60k pa (Salary of £45k pa, plus International Supplement)

ASSOCIATE DIRECTOR | Corporate Reputation, Brands

£75,000 - £80,000

This global communications agency is seeking a proven corporate and business media strategist, with solid editorial relationships and deep expertis...

Associate Director / Senior Associate Director – Energy & Sustainability

London (Central)

Depending on experience

Premier Resourcing UK

Associate Director / Senior Associate Director – Energy & Sustainability GV5409 Exciting London agency looking to recruit someone with publ...

Director (Financial PR - Tech, Natural Resources, Financial Services )

Up to £150'000 + benefits

Brook Street

Director (Financial PR - Tech, Natural Resources, Financial Services ). Leading Corporate & Financial PR Agency. Competitive Salary.

Procurement Manager - Strategic TV Production

GBP60000 - GBP65000 per annum + + Package

Head of People, Organisational Development and the Workplace

Hybrid Working with Head Office at Euston, London NW1 1BS

Circa £80,000 pa plus excellent benefits

Origin Housing

Origin Housing are now seeking an exceptional individual to join them as their new Head of People, Organisational Development and the Workplace.

Senior Procurement Manager - Indirects - Global Law Firm - Leeds & Hybrid working - £70-75k + package This globally recognised law firm, renowned for

Strategic Sourcing Manager - International TV Production

Senior media relations manager.

Senior Media Relations Manager Seeking a new in-house challenge leading a team to create and deliver media relations strategies for a global profes

Interim Resourcing Advisor

Your new role You will be joining this multinational market leading brand as they prepare to launch an exciting new project across the UK.

Senior Manager - Pay & Reward

Hybrid flexible working with office locations nationally

£55000 - £65000 per annum + generous benefits

My highly respected national Charity client has an exciting opportunity for an experienced Pay and Reward specialist to join their organisation.

Senior HR Advisor

Bournemouth, England

£20.58 - £28.64 per hour

Seeking an experienced HR Advisor / Senior ER Advisor to join a large organisation managing a complex case load of ER 3-6 months +

Programme Manager

£55k per year

Implement key organisational change initiatives which are critical to the achievement of the Charity's strategic aims and objectives.

Director of People & Operations

Hybrid working. Largely home-based, some in-person expected. Some flexibility for hot-desk locations

Are you an ambitious, innovative, and values-led leader who could form a key part of this charity's Senior Leadership Team?

Account Director

£400 - £450 per day

Head of Finance

£52,404 - £62,573

We are looking for a Head of Finance to lead on the development and implementation of financial strategy, financial planning and budgeting

Head of P2P Outsourcing (BPO)

EUR100000.00 - EUR120000.00 per annum +

This international FinTech organization provides technology and consulting services to its clients around the world including the implementation of customized Procure-to-Pay (P2P) and Source-to-Contract (S2C) solutions that digitize and simplify purchasin

Indirect Marketing Procurement Manager / Best-in-Class

Indirect Marketing Procurement Manager / FMCG / Nationally Loved Brand / London / £60,000 - £70,000 + Benefits inc. Bonus

Resourcing and Data Analytics Manager

£65000.00 - £80000.00 per annum

Resourcing and Data Analytics Manager, Leading FTSE 250 Firm, London, Hybrid, Permanent, 65K - 80K

Head of HR/HR Director

Abingdon, England

£75000.00 - £100000.00 per annum

We are looking for a Head of HR/HRD with M&A experience to join our life science client in Oxfordshire.

Category Manager

Senior Procurement Category Manager- Global FMCG London Based- £60-70K + Package

Flagship project - Procurement Buyer - Tech

GBP60000 - GBP80000 per annum +

Procurement Buyer- (IT, Hardware, Software) (Multiple Roles) - Working with a leading Global Procurement Consultancy on a Flagship Project in Saudi

Leading Saudi Arabian Utilities company - Major construction project Role: Buyer Salary: 25-30,000 SAR Location: Riyadh This Leading Procurement & S

Interim Benefits Manager EMEA

£300.00 - £600.00 per day

Interim Benefits Manager EMEA - Financial services - London Hybrid Competitive day rate - inside scope of IR35 Interim Benefits job Interim Benefits Specialist Interim Benefits Consultant

Interim HR Talent Partner / HR Business Partner

Procurement category manager - indirects.

Global Procurement CPS Lead - £multibillion FMCG Major - LONDON / WFH - £70-77k + Car and other package details Global FMCG brand is seeking a bright

Global Procurement Category Manager - Professional Services

Title: Procurement Category Manager - Professional Services and Business IntelligenceCompany: Global FTSE 100 Financial Services FirmLocation: WFH - L

Interim HP BP - Technology

£427.00 - £518.00 per day

Interim HR BP to support a Tech population - 9-12 months + - London Hybrid up to £518 per day inside scope Interim HR Business Partner job Immediate start

Regional HR BP - 12 M FTC

£65000.00 - £70000.00 per annum

Interim Regional HR BP - 12 month FTC - Facilities Management - London - c£65,000 - £70,000 plus car allowance Interim HR BP - 12 month FTC - Facilities Management - London - c£65,000 - £70,000 plus car allowance Interim Human Resources Business Partn

Interim Reward Manager

£400.00 - £500.00 per day

Interim Reward Manager - Global Law Firm - London/Remote - up to £500 per day inside scope Interim Reward Manager - Global Law Firm - London/Remote - up to £500 per day inside scope

Procurement Consultant

GBP60000 - GBP65000 per annum +

Procurement Consultant - Forbes Top 100 Procurement and Supply Chain Consultancy Specialist-£65K+ Exciting Benefits- Prestigious Central London Office Location Procurement Consultant Forbes Top 100 Procurement and Supply Chain Consultancy Speciali

Talent Acquisition Partner - Technology

An international Investment Management Firm

Procurement - Managing Consultant

GBP40000 - GBP60000 per annum + package

Procurement - Managing Consultant - Global FTSE 100 Professional Services Firm - London - £40 - 60k + Excellent Benefits Package

Global Procurement Consultant (multiple roles)

GBP30000 - GBP60000 per annum + package

Global Procurement Consultant (multiple roles) - Management Consultancy - London - £30,000 - £60,000 + Excellent Package + Personalised Career Plan + State of the Art Offices

Global Junior Procurement Consultant

Global Junior Procurement Consultant - GNFR- International FMCG Firm - London - £40,000 - £60,000 - Excellent Package - Fast Track Career Progression

Strategic Sourcing Manager, IT & Technology

EUR60000 - EUR90000 per annum + bonus + benefits

Strategic Sourcing Manager, IT & Technology - Global FTSE 100 FMCG Player - Dublin- £50,000 - €90,000 + Bonus & Benefits

Procurement Category Manager, HR & Professional Services

Procurement Category Manager, HR & Professional Services - Iconic Brand - Dublin with Flexible Working - €90,000 + Benefits

IT Procurement Team Lead

EUR60000 - EUR80000 per annum + package

IT Procurement Team Lead - Global FTSE 100 Conglomerate - Amsterdam - €80,000 + Package

Software Technology Procurement Manager

EUR55000 - EUR90000 per annum + bonus + benefits

Software Technology Procurement Manager - Strategic Growth Initiative - £25bn+ Professional Services Giant - DUBLIN

Reward Manager - Analytics

Bonus, car cash allowance, hybrid

The Reward Manager (Analytics) role requires a professional with a broad and detailed working knowledge of compensation processes with the expertise to implement change using complex reward analytics.

Reward Analyst

Bonus, hybrid, negotiable

The scope of this role is to support the Reward Director in the delivery of group wide annual pay and performance review, share plans across the organisation, the provisions for pension arrangements and the employee benefits offering across the Group.

Procurement Consultant - Forbes Top 100 Procurement and Supply Chain Consultancy Specialist-£65K+ Exciting Benefits- Prestigious Central London Office Location Senior Procurement Consultant Forbes Top 100 Procurement and Supply Chain Consultancy S

Part home/part office (London) based

£90,000 per annum

The UK Committee for UNICEF

This is a great opportunity to join the UK Committee for UNICEF (UNICEF UK) as the Director of Communications.

Non-Executive Directors

£4,800 p.a.

Raven Housing Trust

We’re looking for two people to join our Board...

In House Media Relations Manager Role at Top Law Firm

Exceptional In House Media Relations Manager wanted for top tier global Law Firm!   Salary: £70k DOE - our client will flex for the right candidate

Head of Foundation Partnerships

£60,000 per annum

This is a great time to join the UK Committee for UNICEF (UNICEF UK) as we have ambitious plans over the next five years.

Bradford, West Yorkshire

Bradford Council

City of Bradford Metropolitan District Council – Head of Procurement Bradford is an extraordinary city. Vibrant and diverse, it’s a place of opport...

£50000.00 - £60000.00 per annum + full range of benefits

Trainer, to £60k pa, permanent, hybrid with Bristol/Birmingham/Bracknell or Guildford office. Finance sector, leading, long standing and award winning company.

HR Consultant - TMO Change Project

Cheltenham, England

£350.00 - £400.00 per day + WFH/remote working

HR Consultant - Target Operating Model change project, up to £400 per day, remote working, interim asap. FTSE 100 multi-national engineering organisation which has its headquarters in Cheltenham.

Principal Commercial Manager

Canary Wharf, London (Greater)

£51,810 - £59,405 pa

Exciting opportunity for a proven senior commercial professional, with extensive experience of delivering end to end procurement activity.

Senior Procurement Manager - Professional Services

GBP60000 - GBP75000 per annum +

Senior Procurement Manager - Professional Services - Multinational Communications Firm - £80-90K + Bonus - London based (hybrid model working) One of

Procurement Category Manager - Professional Services & HR

GBP60000 - GBP75000 per annum + Benefits

Blue chip FMCG firm seeks a strong Professional Services sourcing expert to join its world-class procurement function.

Procurement Category Manager

GBP55000 - GBP65000 per annum + + Car & Benefits

Iconic FMCG brand seeks a high-achieving procurement expert to join the ranks and drive a crucial spend category towards best-in-class.

Belper, England

A Permanent HR Manager Job in Belper, Derby Paying up to £60,000 + 10% Bonus Depending on Experience

Deputy Development Director

Cambridge, Cambridgeshire

£45,000, - £50,000, depending on experience.

This is a great opportunity for an enthusiastic & motivated professional to develop their fundraising skills in one of the most friendliest Cambridge.

Senior Procurement Consultant

Senior Procurement Consultant - Forbes Top 100 Procurement and Supply Chain Consultancy Specialist-£65K+ Exciting Benefits- Prestigious Central London Office Location Senior Procurement Consultant Forbes Top 100 Procurement and Supply Chain Consult

Head of Communications and Engagement

Gatwick, West Sussex

Circa £70,000 per annum + excellent benefits, including flexible working and 33 days annual leave +

KENT SURREY SUSSEX AHSN LTD

KSS AHSN is seeking to appoint a dynamic Head of Communications and Engagement to join their team!

Head of People Support Services

West Midlands Region

£70,086 - £73,333

West Midlands Fire Service

Head of People Support Services West Midlands Fire Service £70,086 - £73,333 Who we are West Midlands Fire Service is an ambitious and progressive ...

Strategic Partnerships Director - Remote

Up to £80,000 per annum + benefits

Micro:bit Educational Foundation

Partnership is a key value of the Micro:bit Educational Foundation and has been central to our success from the very start of the organisation, hel...

Procurement Administrator / Riyadh

GBP15000 - GBP22000 per month + living allowances

Procurement Officer Arabic Speaking - supporting a Flagship Mega Project in Saudi Arabia - Renewable Energy & Sustainable Technologies - Riyadh - 15,0

Procurement Consultant opportunity, Saudi Arabia

Expat Procurement Consultant opportunity - Flagship Mega Project in Saudi Arabia - Renewable Energy & Sustainable Technologies - Saudi Arabia - £60-75

Mid/Senior Backend Developer

£50000 - £110000 per annum

I am working with a UK mobile app, website and branding agency looking for an engineer to join their team.Skillset:Expertise in NodeJS and Javascript,

Deputy Head of Knowledge and Evidence

Cardiff (Caerdydd)

£58,611 - £63,522

Natural Resources Wales

Role Purpose   As a member of the core Leadership Team of Natural Resources Wales (NRW), you will fulfil a key strategic role, alongside your funct...

Buyer CAPEX OPEX - GAB

GBP5000 - GBP6000 per month + Benefits

Buyer - Capex / Opex Procurement Consultant - Global Consulting firm working on site with a Waste Management organisation - Riyadh, Saudi Arabia - 25-

Senior PR Manager (UK and Australia)

£65000 - £72000 per annum + Bonus

Senior PR Manager (UK & Australia)Up to £72,000 + annual bonus We are proud to be a partner for one of the world's leading dating brands in their sear

Head of Finance & Operations

£50k - 58k per year

Harris Hill is recruiting for a Head of Finance & Operations for this Children's Charity based in London (Hybrid)

Head of Programme - Diversity & FIR

£60,000 - £70,000

Recruitment Revolution

We are seeking an experienced leader to help us drive change in the construction and engineering industry.

Senior Outsourcing Consultant - Global Consultancy

GBP65000 - GBP75000 per annum + Package

Role: Senior Technology Outsourcing Consultant Firm: Global Consultancy Salary: £65,000 - £75,000 Location: London / Hybrid Working Contact: Tabitha -

Senior Indirect Procurement Manager / Best-in-Class

Senior Indirect Procurement Manager / Best-in-Class Professional Services Organisation / Rapid Career Progression / London / Flexible Working / £57,000 - £67,000 + Benefits inc. Bonus

Global Procurement Consultant - Manager Grade

GBP80000.00 - GBP100000.00 per annum + Car Allowance, Bonus

Global Procurement Consultant - Manager Grade - Industry-Leading Procurement Consultancy - London + Hybrid Working - £80,000 - £100,000 + Excellent Bonus Scheme + Car Allowance If you are a Senior Procurement Consultant at either a 'Big 4' or a Bo

Procurement Consulting Opportunities / Leading UK firm

Business director.

£75000 - £90000 per annum

Job Title - Business Director The Role / Company A fashion and entertainment agency are looking for a Business Director to work on a US fashion brand!

Director of Fundraising

£80k - 85k per year

Harris Hill are thrilled to be partnering with a much-loved British veterans charity to recruit their new Director of Fundraising.

Supply Chain Coordinator

GBP200.00 - GBP400.00 per day +

Supply Chain Co-Ordinator - Global FMCG - London + Flexible Working - £400/day (flexible dependent on experience) - Initial 6-month contract Market-leading consumer goods company, responsible for some of the most recognizable brands on supermarket

Head of HR Part Time

£80000.00 - £100000.00 per annum

Head of HR in Wealth Management & Financial Planning, based in Mayfair Part Time - 3 Days a week

Interim Reward Manager - Global Law Firm - London/Remote - up to £500 per day inside scope

Interim HR Project Manager - Remote UK

£500.00 - £600.00 per day

Interim HR Project Manager job- 6 month duration - Remote working in the UK - £400-£600 per day outside of scope HR Program Manager job / HR BP job

Global Procurement Lead - Supply Chain

GBP75000 - GBP80000 per annum + Benefits

Iconic brand seeks a high-achieving procurement expert to join the ranks and drive a crucial spend category towards best-in-class.

Indirect Procurement Director - Procurement Consultancy

GBP100000.00 - GBP110000.00 per annum + Excellent Bonus

One of the largest specialist procurement consultancies in the UK is looking to bring on a Director level procurement professional with a strong track record across both delivery and sales within a management consultancy environment.

Interim Regional HR BP- 12 month FTC - Facilities Management - London - c£65,000 - £70,000 plus car allowance

Associate Director of Resourcing

Gloucestershire, England

£257.00 - £292.00 per day

In this strategic post you will be a key member of the senior People & OD leadership team and you'll be implementing effective resourcing strategies that support the workforce transformation plans for the organisation and enable the recruitment, supply an

Senior Recruitment Manager

£75000.00 - £85000.00 per annum

Partnering with NASDAQ listed business to deliver expert support to their global talent acquisition function.

Head of Operations

London, E1, with scope for flexible working

£45,000 - £50,000 per annum

SPAB (The Society for the Protection of Ancient Buildings)

Could you bring senior level support for financial management and operational resilience, enabling us to fulfil our charitable purpose effectively?

Head of TA - Europe

£75000.00 - £90000.00 per annum

Head of TA - Europe, International Recruitment Agency, 75K - 90K, Hybrid, Permanent.

Head of HR in Wealth Management & Financial Planning, based in Mayfair

Communications Lead

NEW Communications Lead position with the TNFD.

Director of Development

Murray Edwards College, Cambridge

Murray Edwards now seeks to appoint a new Director of Development

MG2-3 £52,225 - £68,532 per annum depending on location

Avanti Schools Trust

This is an exciting opportunity to join Avanti in a forward-thinking, dynamic and strategic role to drive our ambitions about our people and culture.

Assistant Director - Education and Equalities

London Fields, London (They promote a flexible, hybrid way of working)

This is an exciting opportunity to join the charity as an Assistant Director to lead their highly skilled and passionate Education and Equalities team

Chief People Officer

London (Central), London (Greater) - Agile/Hybrid - Homeworking,

£97-£100k FTE plus 6% contributory pension. 27 days plus bank holidays

Anna Freud Centre

Within this role, you will have an opportunity to create and shape the new role of Chief People Officer within the Centre.

Managing Director - Leading Consumer Lifestyle PR Firm - London

Based in the heart of central London

Up to £130'000 + benefits, bonus and E MI Share Option Scheme

Are you an entrepreneurial M.D or highly experienced Director looking for more creative control at a top Consumer Lifestyle PR Firm? If so, read on!

Performance Marketing Manager

London, City of London

£50000 - £70000 per annum

Performance Marketing Manager - Financial Services - London£50,000 - £70,000I am excited to be working with a Global Financial Services business that

Talent Acquisition Manager

Talent Acquisition Manager - Central Oxford - Hybrid - Up to £55,000

Resourcing advisor

£24.09 - £26.83 per hour + Hybrid working

Full-time Resourcing Advisor - £24.09 - £26.83 This is a great opportunity to join a non-profit organisation within the education sector as a Resourcing Advisor. Hybrid working available.

Buckinghamshire

£50k per year

Harris Hill is recruiting for a Permanent Head of Finance for this well-established charity based in Buckinghamshire -Only 1 day a week in the office

£65000.00 - £75000 per annum

Head of Production

Up to £90k plus benefits

​This full-stack consultancy and communications company is looking for a Head of Production

HR Business Partner/Associate HR Business Partner

Portsmouth, Hampshire

See job advert

University of Portsmouth

The University of Portsmouth are looking for talented and ambitious people to join our HR Partnering Team.

Associate Director – B2B technology and sustainability

£75000 - £80000 per annum

Consider yourself a tech savvy individual? Are you looking to move into an industry defining agency? Are you fascinated by all thing’s sustainability, healthcare, and...

Director of Corporate Communications - FTSE 100 - 6 month FTC

Windsor, Berkshire

£80,000-£120,000

Fantastic 6 month FTC for a Corporate Communications Director to joing a FTSE 100 business in the Travel/Hospitality sector.

Senior Tech Recruitment Partner

£60000.00 - £65000.00 per annum

An international strategy consulting firm for more than 50 years

£80,000 - £85,000

The Great & The Good

London-based network agency seeks entrepreneurial Business Director to play a key role in their future growth.

Internal Communications Manager

Up to £60000.00 per annum

We are looking for an Interim Internal Communications Manager to join a scientific organisation with a clinical purpose, aiming to set the standard for the future of pathology.

Strategy Director - Consumer creative clients

£65k-£90k (London) or £60k-£80k (Scotland)

NEW Strategy Director position with hugely creative and established communications agency.

Resourcing Projects Lead

£45648.00 - £57056.00 per annum

Permanent Opportunity - Resourcing Projects Lead

£50000 - £53000 per annum

We have an urgent requirement for a passionate EDI lead to join a London based NHS Trust as their EDI Manager for the next 3 to 6 months.

Head of Government Relations and Public Affairs

£60000 - £61000 per annum + pension, flexible working, life assurance

The Commonwealth War Graves Commission

Head of Government Relations and Public Affairs Location: Maidenhead, with Hybrid Working Contract Type: Permanent, Full Time Benefits: Circa £60,000 with substantial benefits package

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Unleashing the power of marketing

Lipitor’s ‘Know Your Numbers’ Campaign: A Success Story in Pharmaceutical Marketing

This case study aims to examine the marketing strategies and tactics used by Pfizer during the launch of Lipitor , a cholesterol-lowering drug. The case study will analyze the target market, the campaign strategies employed, and the results achieved by the campaign. Lipitor, also known as atorvastatin , is a medication that is used to lower cholesterol levels.

Pfizer’s campaign “Know Your Numbers” was a major component of Pfizer’s marketing strategy for the drug. The campaign was designed to educate consumers about the importance of managing their cholesterol levels and the risks associated with high cholesterol.

Target Market:

The target market for Lipitor were individuals with high cholesterol levels, particularly those at risk for heart disease. Pfizer aimed to educate and raise awareness about the importance of managing cholesterol levels among this group, with the ultimate goal of driving sales of Lipitor.

Campaign Strategies:

Pfizer employed a multi-faceted approach for the “Know Your Numbers” campaign, which included:

• Direct-to-consumer advertising through television commercials, print ads, and other forms of media
• Partnerships with organizations such as the American Heart Association to increase awareness and educate people about cholesterol management.
• Use of opinion leaders in the medical community to promote Lipitor as an effective treatment option for high cholesterol.

The “Know Your Numbers” campaign was successful in increasing awareness of Lipitor and driving sales of the drug. By the time Lipitor’s patent expired in 2011, it had become the best-selling drug in the world, with annual sales reaching over $13 billion. The campaign also helped to establish Lipitor as a trusted brand and solidified Pfizer’s position as a leader in the cholesterol-lowering drug market.

Conclusion:

The Lipitor “Know Your Numbers” campaign is an excellent example of how a pharmaceutical company can use targeted marketing strategies to educate and raise awareness about a specific health condition and drive sales of their product.

The campaign’s use of a multi-faceted approach and partnerships with relevant organizations helped to establish Lipitor as a trusted brand and solidified Pfizer’s position as a leader in the cholesterol-lowering drug market.

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• v.10(2); 2021 Dec

Real-world Evidence for Adherence and Persistence with Atorvastatin Therapy

Konstantinos tsioufis.

1 First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece

José María Castellano Vázquez

2 Centro Integral de Enfermedades Cardiovasculares (CIEC), Hospital Universitario HM Montepríncipe, Grupo HM Hospitales, Madrid, Spain

3 Centro Nacional de Investigaciones Cardiovasculares (CNIC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain

Georgia Sykara

4 Medical Affairs, Viatris, Athens, Greece

Franco Mondello Malvestiti

5 Medical Affairs, Viatris, Rome, Italy

Joris van Vugt

6 Medical Affairs, Viatris, Cappelle a/d Ijssel, The Netherlands

Associated Data

Data sharing is not applicable to this article as no datasets were generated or analyzed during the current review.

Atorvastatin, which has been approved by regulatory agencies for primary- and secondary-prevention patients with dyslipidemia, has historically been the most commonly prescribed statin and is now widely available in generic formulations. Despite widespread statin usage, many patients fail to attain recommended (LDL-C) targets. While several factors impact the successful treatment of dyslipidemia, suboptimal patient adherence is a major limiting factor to medication effectiveness. In this narrative review we sought to investigate patient adherence and persistence with atorvastatin in a real-world setting and to identify barriers to LDL-C goal attainment and therapy outcomes beyond the realm of clinical trials. Moreover, in light of growing generic usage, we carried out targeted literature searches to investigate the impact of generic atorvastatin availability on patient adherence/persistence, and on lipid and efficacy outcomes, compared with branded formulations. Unsurprisingly, real-world data suggest that patient adherence/persistence to atorvastatin is suboptimal, but few studies have attempted to address factors impacting adherence. Data from studies comparing adherence/persistence in patients prescribed branded or generic atorvastatin are limited and show no clear evidence that initiation of a specific preparation of atorvastatin impacts adherence/persistence. Furthermore, results from studies comparing adherence/persistence of patients who switched from the branded to the generic drug are conflicting, although they do suggest that switching may negatively impact adherence over the long term. Additional real-world studies are clearly required to understand potential differences in adherence and persistence between patients initiating treatment with branded versus generic atorvastatin and, moreover, the factors that influence adherence. Targeted education initiatives and additional research are needed to understand and improve patient adherence in a real-world setting.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40119-021-00240-8.

Key Summary Points

Introduction.

Atorvastatin was first introduced to the market in 1996 and has been approved by regulatory agencies for use as a moderate-to-high intensity statin therapy (10–80 mg/day, respectively). The lipid-lowering efficacy of atorvastatin is well established, and patients receiving 10–80 mg/day generally experience dose-dependent reductions in low-density lipoprotein cholesterol (LDL-C) and total cholesterol, and small reductions in triglycerides [ 1 , 2 ]. In addition, the long-term benefit and safety of atorvastatin for lowering cardiovascular (CV) risk have been demonstrated in > 80,000 patients across 11 CV clinical outcomes trials for both primary- and secondary-prevention patients, with and without comorbidities [ 3 – 13 ]. The landmark Anglo-Scandinavian Cardiac Outcomes Trial–Lipid Lowering Arm (ASCOT-LLA) trial was terminated early after hypertensive patients with at least three additional CV risk factors demonstrated a 36% reduction in non-fatal myocardial infarction (MI) and fatal coronary heart disease (CHD) when atorvastatin (10 mg) was added to blood pressure-lowering regimens, versus patients receiving placebo [ 7 ]. Similarly, the Collaborative Atorvastatin Diabetes Study (CARDS) in patients with dyslipidemia and type 2 diabetes was terminated approximately 2 years early because patients treated with atorvastatin (10 mg) experienced a 37% reduction in the incidence of major CV events compared with those treated with placebo [ 11 ]. The benefits of more intensive atorvastatin therapy were later demonstrated in studies such as the Treatment to New Targets (TNT) study, where patients with clinical evidence of CHD receiving 80 mg atorvastatin experienced a 25% reduction in major CV events versus those receiving 10 mg atorvastatin [ 4 ]. Collectively, outcomes data have contributed to the development of clinical management guidelines for cardiovascular disease (CVD) [ 14 – 16 ] and resulted in > 400 subsequent clinical trials, accruing over 250 million patient-years of experience.

The patent for branded atorvastatin expired globally in November 2011, although the generic formulation was available as early as 2008 in South Korea [ 17 ]. Generic products are approved on the premise that they contain the same active compound as the branded product, their inactive ingredients are safe, they are pharmacokinetically bioequivalent (i.e. equivalent rate and extent of exposure) and they display no significant differences in efficacy or safety, when administered at the same dose under the same conditions as branded drugs [ 18 ]. Generic products are deemed bioequivalent if the mean (and 95% confidence intervals) of maximum serum concentration ( C max ) and/or area under the curve (AUC) are contained within 80 to 125% range of the proprietary values [ 18 ]. The most commonly prescribed statins, namely atorvastatin, rosuvastatin and simvastatin, are all now available as generic products. It has been shown that the availability of generic statins directly influences prescription trends [ 19 – 22 ]. For example, in the UK, branded atorvastatin was the most prescribed statin formulation but was outcompeted by generic simvastatin introduced to the market in 2003, in accordance with National Institute for Health and Care Excellence (NICE) guidelines recommending usage of the statins with the lowest cost and highest efficacy [ 21 ]. With expiration of the global patent for branded atorvastatin and marketing of its generic formulation with cheaper acquisition costs, atorvastatin once again became the most frequently prescribed statin by healthcare professionals [ 21 ]. Similarly, in the USA and Korea, the availability of generic atorvastatin led to widespread prescribing [ 19 , 22 ], and atorvastatin has remained the most frequently prescribed lipid-lowering drug worldwide.

The Problem of Adherence

‘Adherence’ is a crucial factor associated with gaining full therapeutic benefit from a medication regimen [ 23 ]. Patients are enrolled into randomized controlled trials (RCTs) under strict inclusion/exclusion criteria, and they remain closely monitored by medical staff responsible for ensuring protocol adherence. With a focus on outcomes, RCTs do not always report adherence (only 85% according to some reports [ 24 ]), and investigators often utilize different adherence assessments, which may preclude comparison between RCTs and/or with real-world observations [ 24 , 25 ]. The 2016 European guidelines on CVD prevention recommend an LDL-C target of < 70 mg/dL for very high-risk patients, < 100 mg/dL for high-risk patients and < 115 mg/dL for remaining patients [ 26 ]. However, the EUROASPIRE V (2016–2017) survey that used these guidelines found that most patients had LDL-C levels ≥ 1.8 mmol/L (≥ 70 mg/dL) and that more than one-third (37%) had LDL-C levels ≥ 2.5 mmol/L (≥ 100 mg/dL), despite being classified as very high risk, 1 year after acute MI and/or acute myocardial ischemia [ 27 ]. Decades of clinical evidence with statin therapy is now available in electronic databases, enabling researchers to link real-world adherence with efficacy and outcomes [ 28 , 29 ]. As such, there is now potential to determine the impact of non-adherence with atorvastatin therapy in the real-world setting by studying these reports.

The aim of this targeted review of the literature was to identify studies that report patient adherence to atorvastatin therapy in the real-world setting (i.e. non-clinical trial). Specifically, we sought to investigate reported barriers to LDL-C goal attainment and how adherence to atorvastatin therapy has been related to efficacy outcomes, in an attempt to better understand medication-taking behavior of patients prescribed atorvastatin. Specifically, in the advent of widespread prescribing of generic atorvastatin, we sought evidence reporting the impact that generic atorvastatin has had on adherence and (where available) other efficacy outcomes.

Targeted literature searches of the PubMed ( www.ncbi.nlm.nih.gov/pubmed ) database were performed, with a focus on the years following the introduction of generic atorvastatin (1 January 2009 to 1 January 2020). A search of available meeting abstracts was also conducted using the Web of Science ( http://apps.webofknowledge.com/ ) database. Meeting abstract data were only available from the Web of Science database from 2010 onwards; therefore searches were conducted between 1 January 2010 and 1 January 2020. The patent for atorvastatin expired globally in November 2011, although some countries did produce generic products prior to this date (as early as March 2008 in South Korea). These date ranges selected for our targeted searches aimed to cover the period just before and after global patent expiration.

Relevant publications and congress materials were identified using a combination of key search terms in different strings (atorvastatin; Lipitor; adherence; compliance; persistence; generic; brand; cardiovascular outcome or event; low-density lipoprotein cholesterol/LDL/lipid; mortality; treatment satisfaction). Relevant literature was supplemented by the inclusion of published evidence identified from screening of the reference lists of identified literature at the time of publication. Literature from these targeted searches was first assessed for relevance in order to provide context for the background of the narrative review. Targeted searches were also carried out to specifically identify literature discussing adherence with branded versus generic atorvastatin. Titles and abstracts of all literature were screened. These articles were then taken forward for full-text screening to confirm relevance. Literature that focused on prescription trends, switching to a different statin (non-atorvastatin) therapy, genetic conditions, atorvastatin use in children or health economic outcomes were not included.

This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.

Defining Medication Adherence

Medication adherence and compliance have historically been used synonymously to describe ‘the extent to which the patient follows medical instructions’ [ 30 ]; however, in 2003 the World Health Organization expanded this definition to incorporate dietary and lifestyle factors, and to further distinguish adherence from compliance by emphasizing that agreement to the recommendations is required by the patient [ 30 , 31 ]. Medication persistence refers to the duration of medication use, from initiation to discontinuation, for the prescribed duration [ 32 ]. These terms are used by medical professionals and other healthcare providers to give a comparative ‘guide’ to assess whether patients are taking their medication as prescribed. Although different methods for assessing adherence and persistence are still used in the medical literature [ 33 – 36 ] (see Electronic Supplementary Material [ESM] Table S1), taking medication in accordance with 100% of the prescribed regimen is rarely achieved in the real-world setting [ 30 , 37 ]. Consequently, patients will not receive the full therapeutic benefit from their medications, which in CVD means they remain at higher risk for major CV events than if they took their medications as prescribed [ 38 ].

Atorvastatin: Real-world Adherence, LDL-C Goal Attainment and Outcomes

While the efficacy of atorvastatin has been demonstrated in several RCTs and meta-analyses [ 3 – 13 , 39 , 40 ], LDL-C goal attainment remains inadequate in a real-world setting [ 41 – 54 ]. For example, a cross-sectional, observational study of 1849 outpatients from across Croatia who were receiving statins reported that although nearly half of patients were taking atorvastatin (43%), LDL-C goal attainment was low (39%), especially among those at high CV risk (37%) [ 51 ]. The authors also reported that adherence was suboptimal overall, with only 35% of patients compliant with > 70% of their prescribed dose and just half (51%) being fully compliant [ 51 ].

Observations from the IDEAL study demonstrate how poor adherence to atorvastatin may be linked to increased CV risk. Although conducted in the clinical trial arena, IDEAL was a non-blinded, open-label study of atorvastatin (80 mg/day) versus simvastatin (40 mg/day), the results of which demonstrated high patient adherence (total study medication exposure as a percentage of follow-up time) of 89%, and a low discontinuation rate (14%) [ 5 ]. However, a subanalysis of IDEAL that adjusted for categorical adherence (above and below 80%, within each treatment arm) and censoring of the first occurrence of a CV event demonstrated a significant lowering of CV risk by 6% in patients with > 80% adherence [ 52 ].

Primary- and secondary-prevention patients have been compared to determine if a previous history of CV events drives better adherence in a real-world setting [ 53 , 54 ]. For example, an analysis of 94,287 patients with dyslipidemia demonstrated that approximately 50% of patients were non-persistent with atorvastatin after the first year of treatment, with CV events occurring in approximately 2 and 9% of primary- and secondary-prevention patients, respectively [ 53 ]. Across both cohorts, patients who remained ‘adherent’ with their medication (taking a relatively conservative ≥ 60% proportion of days covered [PDC; ESM Table S1] in the year after initiation) were significantly less likely to experience CV events versus non-adherent patients, and the relative risk was 8% lower for secondry-prevention patients [ 53 ]. Similarly, a study of 500 patients newly prescribed atorvastatin found that those with a prior CV event or history of diabetes were significantly more adherent and persistent throughout the 6-month study period compared with patients without a history of comorbidities [ 54 ]. These results are consistent with observations from studies of other statins which demonstrate that secondary-prevention patients appear to appreciate the importance of managing CVD risk and are more likely to be adherent and persistent to these measures after experiencing CVD complications, as reviewed elsewhere [ 55 ]. There is a clear need to fully understand factors associated with poor adherence in order to help optimize adherence and CV risk factor management [ 56 ]. More recently, in an era where generic formulations have contributed to the increased utilization of statins [ 21 ], the influence of cheaper, generic statins on patients’ medication-taking behavior has become an additional consideration. Therefore, we specifically sought out literature that compared adherence and efficacy outcomes following use and/or switching to generic or non-generic atorvastatin therapy.

Comparing Adherence and Persistence with Branded Versus Generic Atorvastatin

Studies of adherence among patients prescribed atorvastatin have demonstrated that the switch from branded to generic atorvastatin had a mixed impact on adherence [ 57 – 61 ]. For example, a 6-month retrospective study analyzed adherence in 3417 patients on statin therapy (atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin) who switched from a branded to a generic formulation [ 57 ]. Patients with a medication possession ratio (MPR; ESM Table S1) ≥ 80% were considered to be ‘adherent.’ Of those who switched from a branded to generic formulation, the majority (52.3% [ n  = 1786/3417]) switched from branded to generic atorvastatin. While this study did not record adherence data for each specific type of statin, combined data showed that adherence was below optimal for one in four statin users who switched from branded to generic formulations (75.4% with MPR ≥ 80%) [ 57 ]. Many factors were identified that affected adherence, such as previous compliance with statin therapy [ 57 ].

Studies of patients who switched from branded to generic atorvastatin have also shown that switching may change patients’ adherence [ 57 – 61 ] (Table ​ (Table1). 1 ). For example, an 18-month non-interventional real-world study conducted in Greece by Tsioufis et al. compared the adherence of patients who continued taking branded atorvastatin with those who switched to generic atorvastatin [ 58 ]. In this study, patients remaining on branded atorvastatin therapy were more persistent than those switched to generic atorvastatin (76.4 vs. 90.1%; p  = 0.1627) and significantly more adherent using both PDC (73.0 vs. 79.1; p  < 0.001) and the Morisky Medication Adherence Scale-4 (MMAS-4; 73.7 vs. 26.3%; p  < 0.001), although adherence remained suboptimal (< 80% across both the PDC and MMAS-4) (Table  1 ; ESM Table S1) [ 58 ]. Conversely, a shorter observational study (180 days) by Mano et al. in Japanese patients showed higher adherence, albeit non-significant (92.2 vs. 89.4%; p  = 0.058) and persistence (75.6 vs. 67.3%; p  = 0.097) in patients who switched to generic atorvastatin [ 59 ] (Table ​ (Table1). 1 ). Mano et al. also reported a higher overall adherence in both cohorts than seen in the longer-term study by Tsioufis et al. It appears that the first 180 days of follow-up is the most critical period in determining whether patients become non-adherent or discontinue treatment [ 62 , 63 ], which reflects the observation that patient adherence decreases as time progresses [ 23 ]. Why switching to a generic medication could impact adherence and/or persistence may be a consequence of changes to medication appearance (tablet color, shape and packaging) throughout treatment, leading to patient confusion [ 64 ]. Therefore, it is important to consider how adherence is impacted in patients who were not switched, but rather initiated on either branded or generic atorvastatin [ 60 , 61 ] (Table ​ (Table1). 1 ). Results from a Korean study utilizing insurance claims data of 747 patients showed that those who were newly prescribed generic atorvastatin had a significantly lower coverage ratio than those prescribed branded atorvastatin (Table ​ (Table1) 1 ) [ 61 ]. These results are consistent with those from another study of Spanish patients who were prescribed either a branded or generic statin, and further highlighted the impact of poor adherence with a generic formulation on lipid and CV outcomes [ 65 ].

Studies reporting data on adherence, persistence or compliance in patients taking branded or generic atorvastatin

ATO Atorvastatin, MMAS-4 4-Item Morisky Medication Adherence Scale, MPR medication possession ratio, NA not available, PDC proportion of days covered

a Patients who switched from branded to generic formulations, or vice versa, were censored

b Includes other statins in addition to atorvastatin. Of those receiving branded atorvastatin, 57% were switched to generic atorvastatin

c No significant difference after Cox proportional-hazards regression model analysis (adjusted hazard ratio 0.97; 95% confidence interval 0.61–1.55)

d Parentheses indicate comparison of % change pre- to post-index

Comparing Efficacy and Safety Observations with Branded Versus Generic Atorvastatin

Our literature searches identified studies reporting patient adherence and persistence with branded or generic atorvastatin, but these rarely included data on changes in lipid levels [ 2 , 66 , 67 ] (Table ​ (Table2). 2 ). Two observational studies provided lipid data for patients who switched from branded to generic atorvastatin over a period of 1–3 months, with the authors reporting no significant difference in LDL-C or triglyceride levels after switching to generic atorvastatin (Table ​ (Table2) 2 ) [ 2 , 67 ].

Studies reporting lipid outcomes in patients taking branded or generic atorvastatin

Lipid levels reported as mmol/L were converted to mg/dL: HDL and LDL = mmol/L × 38.67; TG = mmol/L × 88.57

CK Creatine kinase, HDL-C high-density lipoprotein-cholesterol, LDL-C low-density lipoprotein-cholesterol, NS not significant, TG triglyceride

* p  < 0.01 (median change in HDL-C); ** p  < 0.01 (mean change in HDL-C)

a No significant intergroup differences found

b p values not reported

c Patients had to be taking generic atorvastatin for at least 3 months to be included (after switching); blood test taken at least 3 months after transition date

d Patients had to be taking generic atorvastatin for at least 1 month to be included (after switching)

e Period of time for taking of each type of treatment

While it is not clear why adverse events (AEs) may occur upon switching in some patients, differences in excipients may cause adverse reactions [ 68 ]. Four RCTs comparing branded versus generic atorvastatin reported myalgia as an AE, with a slightly higher prevalence in the generic cohort, although no formal analyses were conducted [ 69 – 72 ]. Historically, patients may report concerns around AEs as a factor impacting adherence [ 73 ], although we did not identify any studies that included patient perspectives of generic versus branded atorvastatin. The so-called ‘nocebo’ effect may negatively impact how patients or physicians perceive branded or generic treatment. In a non-blinded extension phase of the ASCOT-LLA trial, wherein patients knew they were receiving atorvastatin, trialists observed increased reporting of muscle-related AEs versus when patients were in the blinded phase and did not know if they were receiving a placebo or statin therapy [ 74 ]. The authors attributed this to the nocebo effect, as during the blinded phase of ASCOT-LLA, muscle symptoms, as well as other AEs such as sleep disturbance, cognitive impairment and erectile dysfunction, were reported at a similar rate in both the placebo and atorvastatin arm [ 74 ]. The nocebo effect has also been documented in patients who switch from other branded to generic medications, resulting in reduced effectiveness and increased reported AEs as a consequence of a negative bias toward generic products [ 75 , 76 ].

When looking at longer-term outcomes, a single study by Jackevicius et al. [ 60 ] that enrolled patients aged ≥ 65 years with acute coronary syndrome and prescribed either branded or generic atorvastatin upon discharge from hospital showed that both cohorts remained adherent with their medications, with an identical MPR of 88.4% [ 60 ] (Table ​ (Table1). 1 ). Patients taking branded or generic atorvastatin had an equivalent rate of MI/angina (17.7% for both), heart failure (6.3 vs. 6.6%), stroke (1.6 vs. 1.9%) or overall mortality (11.6%), which might be anticipated given the similar MPR [ 60 ]. No other articles were identified that monitored the long-term CV outcomes of branded versus generic atorvastatin. However, similar to the conclusions drawn by Jackevicius et al., a study by Corrao et al. [ 77 ] that followed 13,799 patients newly prescribed generic or branded simvastatin showed no difference in persistence or CV outcomes over a 3-year period. It has been shown that patients are more likely to adhere to their statin treatment regimen following a cardiac event [ 56 , 78 , 79 ] and that statin patients following an MI are approximately 10% more adherent than primary treatment patients [ 80 ].

What Evidence is Needed to Help Improve Adherence in the Real-World Setting: Gaps in the Literature

In this review we highlight that many barriers to adherence occur throughout the initiation, execution and persistence stages of treatment [ 30 , 81 , 82 ]. These factors have been reviewed extensively elsewhere and have been broadly characterized into five interacting factors [ 30 ]: patient-related (lifestyle, perceptions), socio-economic (demographics, costs, family, country, conflict), therapy-related (side effects, treatment regimen/concomitant medications, type of statin [formulation, branded, generic], dose), condition-related (disabilities, disease severity, comorbidities, access to treatment) and healthcare-related factors (patient interactions, physician perceptions of therapy effectiveness, clinical inertia) [ 23 , 30 , 55 , 83 , 84 ].

However, we also highlight a paucity of data directly comparing real-world adherence with atorvastatin to longer-term lipid and CV outcomes and, in addition, whether the introduction and use of generic formulations has impacted CV morbidity and mortality. The conclusions reported here are drawn from mixed sources depending on available studies, but we highlight a number of gaps in the literature that could be addressed by future studies in this area (Table  3 ).

Barriers to adherence with atorvastatin therapy: gaps in the current literature

SPC Single-pill combination

a Based on the 5-dimensions of adherence, as outlined by the World Health Organization [ 30 ]

The literature on outcomes in patients who initiated or switched between branded atorvastatin and its generic version was also sparse; instead, we frequently found studies focusing on therapeutic substitution (switching between different types of statin) [ 85 – 94 ]. Studies that saw improved adherence with switching therapies highlighted associations with increasing age, prior CVD and polypharmacy, with the authors suggesting that patients who are switched may receive more attention at the pharmacy [ 95 ]. In patients initiated on generic statins, lower out-of-pocket expenses have been associated with improved adherence and persistence [ 88 , 96 ]. Conversely, variability in excipients and co-payment effects are potential hurdles to compliance upon switching statin therapy [ 65 ]. Real-world observational studies are needed which monitor adherence and persistence alongside lipid outcomes and therapeutic goal attainment, but also factor in these barriers to adherence (Table  3 ).

How Can Healthcare Providers Work to Improve Adherence in the Real-World Setting? Practical Advice for Improving Statin Therapy Adherence

Although physicians are aware of the importance of treatment optimization, additional factors more specific to lipid-lowering therapies should be considered. For example, patients with dyslipidemia do not have immediate ‘feedback’ to recognize/feel improvements in their condition associated with lipid-lowering therapy. This lack of perceived benefit may negatively impact adherence [ 63 , 97 ]; therefore, a blood test and follow-up assessment are required to confirm if patients are taking medications as prescribed [ 16 ]. Subsequent appointments may be needed to further allow healthcare providers to consult patients about their medication adherence and to discuss reasons for non-adherence, all of which require active benefit on the part of both patient and prescriber. A patient–physician interaction provides the physician with an opportunity to consider changes to the treatment regimen (e.g. up-titration, concomitant therapy, monitoring of AEs) or, if needed, to provide further support (e.g. counseling, reminders, support group sessions, involving family) to ensure adherence to achieve recommended treatment targets [ 16 , 98 ]. The relationship between patient and physician should be based on both verbal and non-verbal communication (‘body language’) aimed at increasing patient understanding of their disease and the risks and benefits of the chosen treatment [ 99 ]. Mutual collaboration between patient and healthcare provider can not only reduce the risks of non-adherence, but also improve patient satisfaction with therapy and, ultimately, patients’ healthcare outcomes [ 99 ]. Healthcare providers should also consider the demographics of their patients. For instance, while statins are increasingly used in some children (aged > 10 years), particularly those with genetic lipid disorders [ 100 ], limited data are available on adherence in this patient population. Considerations of age-appropriate formulations, weight-appropriate dosing, acceptability, palatability and the role of their parents/carers are critical for improving adherence in the pediatric population, and further studies are required to understand their influence with real-world statin usage [ 101 , 102 ]. This trust is especially important for statin patients, as chronic medication regimens, fear of AEs and polypharmacy are all factors linked to poor adherence [ 103 ].

Patient perceptions also influence adherence to statins and are intrinsically tied to treatment-related factors [ 23 , 30 , 83 ]. Studies are needed that link patient’s perception and preference with their statin formulation to adherence. When focusing on generic versus branded atorvastatin therapy, we were unable to identify any studies that included a survey of patient preferences or perceptions of their atorvastatin medication (i.e. perceived benefit or need) (Table ​ (Table3). 3 ). In this review of the literature, only a single study by Tsioufis et al. was identified that reported both atorvastatin adherence and treatment satisfaction data [ 58 ]. In this study of 190 patients from Greece, the authors report that global patient satisfaction and perceived effectiveness, measured by the Treatment Satisfaction Questionnaire for Medication (TSQM), in those who did not switch to generic atorvastatin was significantly higher versus those who switched (mean score 68 vs. 58, respectively; p  < 0.001) [ 58 ]. These observations support the association between patient treatment satisfaction and greater treatment adherence/persistence, an association that has been noted in other non-atorvastatin studies [ 104 , 105 ]. While most physicians discuss statin treatment with their patients, those patients who discontinue have reported being less satisfied with these discussions [ 106 ]. Thus, poor adherence as a consequence of patient perceptions is also closely tied to interactions with their physician and may be compounded by a non-perceived benefit and/or medical distrust [ 83 ]. On balance, it remains unclear whether the prescription of generic or branded atorvastatin influences adherence in a real-world setting. Studies investigating patient perceptions would help physicians understand this patient-related barrier to adherence with atorvastatin therapy (Table ​ (Table3 3 ).

Conclusions

Adherence to atorvastatin remains suboptimal in the real-world setting, and the introduction of generic formulations adds further complexity to the multifaceted issues around poor adherence. There are clear gaps in the literature concerning the factors responsible for poor adherence and their impact on efficacy outcomes, including data on cost, long-term usage, patient perspectives and polypharmacy. Furthermore, we highlight a paucity of real-world data from comparisons between initiation with branded or generic atorvastatin and the impact on adherence/persistence and lipid/CV outcomes. However, healthcare providers should consider the potential impact on adherence of switching patients between branded and generic medications. Targeted education initiatives and additional research are still needed with the aim to improve adherence to atorvastatin in the clinical setting.

Below is the link to the electronic supplementary material.

Acknowledgements

This review and Rapid Service Fee was sponsored by Legacy Upjohn, a division of Pfizer, now part of Viatris Inc.

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Authorship Contributions

All authors were involved in discussing the concept of the review. All authors were involved in researching and reviewing the literature discussed in the review. All authors provided critical input during development of the manuscript and approved the final draft for submission.

Medical Writing, Editorial, and Other Assistance

Medical writing support was provided by Jake Evans, PhD and Karen Burrows, MPhil, of Engage Scientific Solutions (Horsham, UK) and was funded by Legacy Upjohn, a division of Pfizer, now part of Viatris Inc.

Disclosures

Costas Tsioufis has received research grants or honoraria for advisory boards and lectures from Medtronic, Servier, Bayer, Menarini, Novartis, AstraZeneca, Boehringer Ingelheim, Pfizer, Chiesi, Sanofi, Amgen, ELPEN, Recordati and Winmedica, and is a Member of Task Force of the 2018 ESC/ESH Hypertension Guidelines. Georgia Sykara, Franco Mondello-Malvestiti, and Joris van Vugt are full-time employees of Viatris. José María Castellano Vázquez has nothing to disclose.

Compliance with Ethics Guidelines

Data availability.

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Lipitor Marketing Case Study

“Strategic marketing focuses on choosing the right products for the right growth markets at the right time” (Jain & Haley, 2009, p.

26). When Lipitor hit the market in 1997 that is just what it achieved – the right product, the right growth market, and the right time. Lipitor quickly gained the No. 2 spot with 18% of the market share within the first year that led the way to gain the top spot as the market share leader. Warner-Lambert developed the drug initially but needed to catch up in the market so they teamed up with Pfizer , known for their marketing and sales competency.This partnership was just what the doctor ordered for the initial introduction of Lipitor to the market. In 2001, Pfizer took full control of Lipitor and changed the marketing game once again. The strategic marketing efforts created competitive advantage for the drug by “delivering a product in the most profitable way by achieving a sustainable competitive advantage based on superior performance relative to competition” (Jain & Haley, 2009, p. 11). There were several strengths and opportunities to Pfizer’s Lipitor strategic marketing that culminated as Lipitor becoming the market leader with 42% market share and $7.

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B sales by 2002. At the time of Lipitor’s market entry, the cholesterol lowering statin drugs were limited with little consumer awareness about the risks of high cholesterol. In 1987, the first cholesterol-reducing drug, Mevacor, hit the market as the market pioneers to educate public of the dangers of high cholesterol. They also had to convince doctors that statins would extend their patients lives. The connection between high cholesterol and heart attacks increased and heart patients knew their cholesterol numbers and the public began to know the difference between HDL and LDL.There was an estimated one-third out of 52 million people with high cholesterol in the U.

S. getting the medical attention they needed. This number would be growing as the baby boomers were hitting the target market. While the target market and public awareness was growing, Pfizer expanded on the initial market statins’ public awareness campaign to include direct-to-consumer marketing – “Know Your Numbers” and “You don’t have to be visibly unhealthy to have dangerously high cholesterol. ” In response to this, food markets began producing low fat and high fiber food – changing the way the public ate in a way to fight high cholesterol.

Pfizer’s marketing and sales campaign aimed was not just directed to the public. The sales crusade to doctor’s offices was aggressive. Pfizer extensively trained and tested its sales force on anatomy and physiology to be as knowledgeable as doctors about health-care trends. The sales force was top ranked. Additional triumphs for Pfizer’s marketing efforts included two FDA approvals: approval to include clinical trial curve data in packet insert of Lipitor packaging and a low starting dosage.The clinical trial curve data reflected a more effective starting dose and that it reduced cholesterol by proportions that the other drugs on the market could not.

Lipitor was approved for a 10-to- 80 mg dosage while the other statins were approved for 20-to 40 mg. This was a physiological advantage as doctors thought if FDA approved up to 80mg, 10 mg must be safe. The final strategy for Lipitor to gain competitive advantage was the pricing. They wanted to price the drug so it was affordable to all in need by undercutting the price by nearly half of the current market leader, Zocor.However, Lipitor still faced challenges with threats and weaknesses.

To this day, the long-term effects of statins in general are questioned. On January 12, 2012, ABC News reported that statins are linked to type 2 diabetes. Two legal challenges Pfizer faced was a claim by FDA of false advertising and a settlement of charges that they overcharged Medicaid for Lipitor. As the popularity for statins increase, so will the new market entrants. Fortunately, due to the patent pending, other drug companies cannot get their hands on Lipitor for drug comparison testing.

However, new drug entrants may develop the next best drug threatening Lipitor’s market share. When the patent expires, generic market entrants will also threaten market share. Pfizer’s strategic marketing implementation for Lipitor differed from Merck ‘s Mevacor, the first drug of its class. Mevacor was the market pioneer so focused on the “where” to compete and not enough on “how” to compete in the market.

Merck knew it needed to gain public awareness of the risks of high cholesterol and gain doctors confidence to prescribe their drug. Merck was still conducting research to prove that statins could save patients lives.Pfizer devoted attention to clinical studies prior to market introduction. Pfizer further expanded on Merck’s initial public awareness campaign. The focus on the sale force education was Pfizer’s “how” to reach the doctors approval to prescribe their cholesterol-fighting drug, as well as the low starting dosage psychological advantage.

The low starting dosage allowed Pfizer to focus on their uniqueness of Lipitor compared to Mevacor. While Mevacor was the first drug of its kind and was unique, Lipitor was able to focus on the effectiveness in proportions that Mevacor was not achieving.By including the clinical research studies in graphs in their marketing, this gained the confidence of doctors to prescribe Lipitor. Merck did not emphasize enough on “when” to compete. The timing of Mevacor’s market entrance was not optimally timed. The optimum time is one that reduces or removes competition.

While it was the market pioneer, it opened up the market for new entrants. Timing decisions must include market knowledge; competition; and company readiness (Jain & Haley, 2009, p. 31). The market knowledge was in its infancy and Merck should have taken some time to educate their market – both doctors and public initially.Merck rushed to get their drug into the market then began their education campaign.

While Merck’s decision to enter the market early to beat competition, it is often a common problem. Merck simply was not ready to enter the market with their research. They were still conducting research to prove statins could save the doctors’ patients lives with their Four-S study. All of Merck’s initial market groundwork paved the way for Pfizer to come into the market with all the right strategic marking implantation efforts of “how” and “when” while utilizing their uniqueness compared to all other drugs of its kind.Pfizer was able to perfect the “how” to enter the market by utilizing the initial public awareness and further educate the growing high cholesterol target audience. In addition, Pfizer trained their sales staff to gain the confidence of doctors.

Pfizer conducted focus groups with doctors and found selling points that other statins missed: they were scared of the dosages. Pfizer also knew that by entering the market late, their advantage was an advantage of clinical trials against statins currently in the market – while those on the market could not test against Lipitor.This research proved that Lipitor not only was more effective at lowering cholesterol but also achieved it with lower dosages. This was the foundation of marketing efforts in literature to doctors to gain their confidence by showing the uniqueness of Lipitor over the statins on the market. By emphasizing the “when” to enter the market with market knowledge, competition knowledge and company readiness, Pfizer was able to quickly gain the dominance in the market.

As Pfizer loses patent protection of their miracle holesterol-lowering drug, Lipitor, generic entrants to the market will threaten the drugs market share leadership. Pfizer is limited with options to combat the fight head-on. Pfizer can offer competitive pricing to match the generic drugs. Pfizer can offer discounts and incentives for patients and insurance companies to keep the drug the cost down and allowed within the insurance plans as well as affordable for the patients to pay the difference if not allowed non-generic drugs in the plan.Many pharmaceutical companies offer a co-pay card to pay the difference.

As a doctor writes a prescription script, they offer the patient this card to be enrolled online with the pharmaceutical company. Thus allowing a database of its consumers and a way to maintain a means of contact to reach out to the consumer for future offerings and ensure their loyalty to Lipitor. Pfizer may consider this strategy. Pfizer may also consider collaborating with specialty pharmacies to direct mail patients the Lipitor at a lower cost.The next steps that Pfizer takes at this time with the patent protection is out and generics enter the company will determine if Lipitor remains as the top market share leader.

Pfizer utilized their competency in marketing and sales to promote their cholesterol-lowering drug, Lipitor. It was the right product in the right growth market at the right time. They created a sustainable competitive advantage to last over 10 years based on superior performance relative to competition with a superior product, strong marketing and sales team, and knowing the how and when to enter the market.Pfizer marketing strategies had a clear market definition; a good match between corporate strengths and needs of the market; and superior performance relative to the competition (Jain ; Haley, 2009, p. 19) that made Lipitor the market leader since introduction.

The future steps Pfizer makes to protect Lipitor against the generic market entrants will determine the fate the drug has to sustain market leadership in the future.

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Please note you do not have access to teaching notes, managing the challenges of pharmaceutical patent expiry: a case study of lipitor.

Journal of Science and Technology Policy Management

ISSN : 2053-4620

Article publication date: 3 October 2016

The paper aims to study how global pharmaceutical companies such as Pfizer have managed the challenges of pharmaceutical patent expiry.

Design/methodology/approach

A case study method was applied. The best-selling brand drug over the past 10 years – Lipitor – was chosen as the case target.

For dealing with this, this paper describes all the details of the corresponding strategies of Pfizer before and after patent expiration of Lipitor. Before patent expiry, Pfizer undertook the activities of direct-to-consumer marketing, pricing strategy for competition, legal delay and me-too drug R&D. After patent expiry, Pfizer chose to carry out continuous marketing for brand, rebate strategy, authorized generics and change to over-the-counter. In addition, diversity and globalization strategy was applied before and after patent expiry.

Research limitations/implications

This research provides strong implication for managing pharmaceutical products before and after patent expiry.

Practical implications

It is strongly recommended for both brand and generic drug companies to design strategies to meet the challenges of pharmaceutical patent expiry.

Social implications

For the global pharmaceutical market, a conclusion can be drawn that, nowadays, the “patent cliff” is the most significant factor influencing decision-makers to consider futuristic policies. Further, it is also a considerably effective solution for reducing health-care costs for policymakers.

Originality/value

This paper contributes to the field of patent expiry management in high-tech industries such as pharmaceuticals.

• Pharmaceutical industry
• Health care cost
• Patent expiry

Acknowledgements

The authors would like to acknowledge their thanks to the funding support from the University of Macau (MYRG2016-00055-ICMS-QRCM).

Chao, C.K. , Hu, H. , Zhang, L. and Wu, J. (2016), "Managing the challenges of pharmaceutical patent expiry: a case study of Lipitor", Journal of Science and Technology Policy Management , Vol. 7 No. 3, pp. 258-272. https://doi.org/10.1108/JSTPM-12-2015-0040

Emerald Group Publishing Limited

Copyright © 2016, Emerald Group Publishing Limited

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