During second half of 1977, it was internally announced that a new product will be launched early next year. The details of product were not revealed. Some time in October, the first training session was conducted. It was focused on nervous system; the anatomy, physiology and functions. In November, the second training session was conducted which focused on neurotic and psychotic disorders. Third and last session was held in late December. A guy named McEwan came from UK to conduct the session.
McEwan was young, energetic and active person. He did something very bold. First day, he asked us to take a crushed, white tablet in the morning, which we did. Before close of the session, he asked us to record how did we feel during the day. The process was repeated on second and third day. He revealed on the last day that first day he gave us Valium (diazepam), second day Ativan (lorazepam) and third day Frisium (clobazam). We recorded various degrees of lethargy and drowsiness. That he would keep us awake all day and manage to teach us, might have been a big gamble, but he pulled it off decently.
Majority feedback was that Frisium did not make them drowsy and helped them to focus better on learning.
Frisium was a mega launch for Hoechst. It had two main claims. It was the first 1-5 benzodiazepine, all others being 1-4. And it caused much less sedation, comparative to market giants Valium and Ativan thereby qualifying as a ‘day-time anti-anxiety’.
We went to the market with a lot of excitement, determination and commitment. We believed in the product and were eager to make it big. The customers listened to our claims with interest and we were able to generate a lot of prescriptions in the initial launch phase. My area was one of the best-selling as I had developed very good relations with key customers.
As the product was used in a larger number of patients, negative feedback started coming in. ‘It is too mild’ – ‘It does not work’ – ‘I want to sleep, and I need the product to put me to sleep, not keep me awake’ – ‘Not sure if it is doing anything’ – and so on.
Anxiety and depression were not buzz words in those days. In fact, depression came into fashion later thanks to Prozac (fluoxetine – Eli Lilly). Many GPs and physicians prescribed anti-anxiety products for a short time to calm down the patients if they felt the need. The standard question to patients used to be ‘Do you sleep well?’ Those who said they had problem sleeping were considered to be anxious and were given anti-anxiety prescription. It worked two ways; it helped patients to sleep smoothly, and it relieved anxiety in a few days. Almost all such patients got prescription for night use, not day use.
Frisium challenged the standard thinking, and lost. Lexotanil (bromazepam) was launched around the same time and became a huge success, partly because Roche was big in psychotropic drugs already, and partly because Lexotanil went along the standard track.
Frisium kept selling but never became a Mega Drug. We were too junior to understand it, but we did feel that the seniors were disappointed, and agitated. Renowned psychiatrist, late Professor Rasheed Chaudhry (KEMC/ Fountain House), was part of international trials before Frisium was launched. Later, he did trials in epilepsy and found it quite useful. He was a huge prescriber of Frisium in epilepsy.
Frisium is not the only product in Pharma market which did not come up to hyped expectations; several other products from other companies met the same fate. With the benefit of hind sight, I can say the following.
- The story of 1-5 benzodiazepine was relevant as it was translated into clinical benefit of maintaining alertness and activity due to less sedation and less muscle relaxation. It was clearly communicated and generally accepted.
- The patients (and treating physicians therefore) preferred to sedate the patients. Their prescription was for the night use and it helped the patients to sleep early and better. And they were expected to wake up fresh, which some did, and some didn’t. Hangover was quite common, and it kept the patients lethargic and unfocused during the day. If Frisium had pitched on the theme of ‘no hangover – wake up fresh’ the expectation would be different. Frisium was good in this area and would become more popular as ‘day-fresh’ rather than a ‘day-time’ anti-anxiety. It would not challenge the entrenched thinking (the current) and might have been a win-win for all.
The relative non-success of Frisium did impact Hoechst. We already had Lasix (frusemide) and Daonil (Glibenclamide) which were mega brands and gold standard. And we expected the same for Frisium. Both mega brands were challenged later fiercely.
In the marketplace, the marketers try to come up with what they think would be the best strategy. It clicks and wins accolades; or it flops. This is marketing life.
Hoechst used the same kind of marketing strategy (going against the current) in couple of other products later, and they met the same fate……