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Companies raise drug-sales efforts

Rivals compete for top share of diabetes market

– Drugmakers led by Novo Nordisk and Merck are increasing sales efforts for their top- selling diabetes drugs to grab as much of the market as possible ahead of a wave of new therapies.

At the start of this year, Novo, the world’s biggest maker of insulin, directed its sales force to boost promotion of the company’s drug Victoza. Soon after, revenue slowed for competing treatments from Merck and Bristol-Myers Squibb, forcing those companies to put more resources behind their medicines and overhaul their strategies.

With a half-dozen new products lined up for approval within two years, the fight to win the growing $22 billion U.S. diabetes market will only intensify, said Michael Leuchten, a Barclays analyst.

By expanding sales forces and spending more on educating doctors, the top companies in diabetes are working to more strongly establish brand loyalty.

“It’s going to be a push for market share and somebody’s going to get squeezed,” said Leuchten, who is based in London. While drugs used in the pre-insulin stages of diabetes may work differently, “they’re all competing for the same patients.”

There were 26 million Americans with diabetes in 2011, an increase of 2 million from 2007, according to the Centers for Disease Control and Prevention.

People with diabetes fail to produce insulin or their body doesn’t use the hormone properly to convert blood sugar into energy, leaving blood sugar levels too high without treatment.

Merck’s Januvia, Bristol-Myers’ Onglyza and Eli Lilly & Co.’s Tradjenta are DPP-4 inhibitors. The drugs cause the pancreas to make more insulin and cut sugar produced by the liver.

Victoza and Bristol-Myers’ Bydureon and Byetta are in a class called GLP-1 receptor agonists. The drugs spur the body to make more insulin when blood sugar rises, and can also cause weight loss.

Newer drugs, called SGLT2 inhibitors, cause the kidneys to cut excess blood sugar. New Brunswick, N.J.-based Johnson & Johnson’s Invokana, approved by the Food and Drug Administration in March, and Bristol-Myers’ Forxiga belong to this class.

Lilly and Boehringer Ingelheim, AstraZeneca and Bristol-Myers, and Merck and Pfizer are developing related medicines, now in the final stages of testing.

Last year, Novo increased its U.S. sales force 25 percent to introduce a diabetes product called Tresiba.

When that drug was rejected by the FDA in February, the Bagsvaerd, Denmark, company refocused the sales workers on Victoza, raising its revenue by more than a third to $474 million and cutting into sales of Merck’s Januvia, first-quarter revenue of which fell 4 percent to $884 million from a year earlier.

Merck responded by having more of its sales representatives focus solely on pushing Januvia, the first in a new class of medicines when it entered the market in 2006.

The company also boosted spending on doctor education efforts, and last month Whitehouse Station, New Jersey-based Merck signed a co-promotion deal with Avanir Pharmaceuticals Inc. to reach patients in nursing and long-term care homes.

“This is the No. 1 priority for Merck in the U.S. and around the world,” said Frank Clyburn, Merck’s president of primary care and women’s health.

Januvia is the top drug for the company, the second-biggest U.S. drugmaker, and dominates the class with 73 percent of the market for DPP-4 inhibitors.

Bristol-Myers, which co-promotes its diabetes drugs with London-based AstraZeneca, replaced the head of its U.S. diabetes business, Mark Pavao, a decade-long company veteran, nine months after he had been given control of the unit, according to an online resume.

In his place, it hired Richard Daly, a former executive at Takeda Pharmaceutical Co., said Ken Dominski, a spokesman. Dominski declined to comment on the company’s strategy.

Onglyza and a related drug, Kombiglyze, generated $202 million in sales for New York-based Bristol-Myers in the first quarter.

In the future, a key product will be pills that combine two or more of the different types of drugs. “Polypharmacy is the way to go,” said Marshall Gordon, a New York-based analyst with Legg Mason’s ClearBridge Investments affiliate.