The success of AstraZeneca’s Nexium in 2003 has as much to do with an internal corporate transformation as it does with the brand’s substantial professional and consumer promotion. That’s how the co-leaders of the Nexium team - Linda Palczuk and Doug Levine, MD - see this year’s achievements for Nexium (esomeprazole magnesium), which is on track for roughly $3.5 billion in worldwide sales this year. That compares with roughly $2 billion in the year-ago period. Third-quarter sales in the U.S. were up 114 percent.
As importantly, AstraZeneca reports that prescriptions for Nexium - which built its promotional strategy on a firm foundation of differentiating clinical data - in 2003 have risen 52 percent through September in the U.S. market, compared with category growth for proton pump inhibitors of 13.5 percent.

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Behind the numbers, according to Palczuk, executive director of commercial operations for Nexium, is the business transformation that AstraZeneca rolled out in March to put more focus on individual brands. A key point of this new structure was the naming of co-brand leaders to represent both the commercial and development perspectives of each brand. Palczuk brings commercial expertise to Nexium marketing, and Levine, executive director and development brand leader, adds the clinical and science proficiency as a research gastroenterologist. “A more traditional organization is usually built around disease areas, but this one is built around specific brand focuses,” Levine says. “Essentially, this is a two heads are better than one strategy.”
This means that as Levine and his staff put together clinical development plans, such as additional indications or line extensions, they get commercial input at every stage. And the reverse is true for any commercial planning that takes place. “In the past, we had almost a silo approach where development kind of tossed the ball over the wall to the commercial folks after a brand was launched, and we ran with it,” Palczuk says. “That is not the case now. The beauty of this model is that there is integration throughout the lifecycle.”
While such integration seems logical, and other companies may make the same claims, Palczuk says she believes competitors’ models are “more of a handoff” between clinical and commercial than true integration. “We believe this is a competitive advantage for our model,” she adds. “And it’s not one that comes easily. You have to work at it and recognize the value of each other’s input, and balance it.”
Professional promotion
The Nexium team also worked strategically in its promotion. It stepped up professional advertising in the first half by almost 60 percent, according to PERQ/HCI’s Journal Ad Review, moving up from 22nd to 7th among most advertised products. Journal ads, using the tagline “Stop the heartburn - Start the healing,” play up the fact that Nexium is the most widely prescribed PPI by gastroenterologists. The strategy was to focus on the clinical differentiation of Nexium. “That’s where we believe we have been successful in the past,” she says.
DTC advertising (with a budget estimated at between $165 million and $200 million annually by market researchers) was judged to be more effective by market research firm Ipsos Pharm Trends. Ipsos, in an October report, cited Nexium as the No. 4 brand in a ranking of ads by consumer recall. This compared with a No. 15 rank for Nexium in a previous survey. With consumers, the goal was “to educate patients suffering from gastroesophageal reflux disease (GERD) so they are better informed to speak to their healthcare providers” and to understand if Nexium is the right option, she says.
Palczuk says the marketing strategy will remain much the same in 2004, with small tweaks. “Although the market has become noisier both among the professional and consumer worlds - we will continue to differentiate Nexium and try to get our message across in that nosier world. It means we will have to shout a little louder, that’s all.”
In addition to the professional and consumer channels, the Nexium team worked hard at building relationships with managed care organizations. “We wanted to ensure that we did everything strategically aligned with the best interests of the brand to make Nexium available to as many appropriate patients as we could,” she explains. The strategy of focusing on managed care apparently has paid off. Following AstraZeneca’s annual business review in October, Merrill Lynch securities analyst James Culverwell wrote in a report: “Nexium has been positioned for efficacy rather than price. AstraZeneca has not experienced any change in attitude from managed care since the introduction of multiple generic Prilosec (which was anticipated) and Prilosec OTC.”
To build Nexium’s success, AstraZeneca filed for a new indication of Nexium for patients who also take non-steroidal anti-inflammatory drugs and an intravenous formulation. “The only way to [grow Nexium as a mega-brand] is to deliver new scientific data through our development programs,” Levine says. “To that end, 2003 was a remarkably successful year with regard to our regulatory submissions.”

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