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We leave Tarivid for a while and look at the other success story; Claforan® (Cefotaxime sodium), the third-generation cephalosporin antibiotic available as injection only.
Among Cephalosporins, range of bacterial coverage, bacterial sensitivity to antibiotic, and tissue penetration improved from first to third generation of cephalosporin family of antibiotics. Safety profile was generally good with some variations among molecules.
Eli Lilly had launched cephalosporins in mid/late 70s. These included Cefazolin and Cephalothin; both injections. Glaxo launched Ceporex® (cephalexin – first generation) in 1980. We were trained on the product during training at the end of 1979. It was a dedicated session and we were made to understand that Ceporex was a big breakthrough and was much superior to existing antibiotics. Ceporex was only Oral which made it popular in the outpatient treatment. Shortly after, the second generation Cephalosporins were introduced; Ceclor® (cefaclor – Eli Lilly), Velosef® (Cephradine – Squibb), Zinacef® (cefuroxime – Glaxo). Velosef had the advantage that it was available in oral (capsule, dry suspension) and parenteral dosage forms. It also had various strengths to treat children and adults as well as mild to severe infections. All three companies worked very hard on their product and got good response from the doctors in all specialties. Velosef became bigger brand over tim. The competition was intense and so were the promotional activities.
This was the environment in which Hoechst launched Claforan sometime in early/mid 1980s. I understand that the company was not geared to make a mark in the face of such stiff competition. Claforan therefore did not make any waves. When Hoechst reorganized its sales/marketing functions under Tariq Umer and Dr. Asad Sadiq, these products were reviewed. Starting from 1985, Claforan and Haemaccel were under intense focus and promotion. We shall discuss Claforan here and take up Haemaccel later, separately.
For Claforan, following major actions were taken.
Positioning. Claforan was positioned for moderate to severe/ life threatening infections caused by sensitive pathogens in all age groups, including special populations; neonates, elderly, patients with decreased renal or hepatic function. Claforan was not an alternative for existing antibiotics; nor was it a reserve drug for cases where other drugs failed. Claforan was positioned to be used from the beginning in cases where it was rational choice.
Customer Selection. Claforan was injection only and therefore had to be used mainly in hospitals. Enough clinical studies were available for its use in medical and surgical settings as well as a range of indications and age groups, from neonates to elderly. Customers were selected across Pediatrics, Internal Medicine, General Surgery, Gynecology, Orthopedic, Neurosurgery and Intensive Care. Selected customers were largely from the top tier. They were respected by peers and juniors alike.
Rationale to Use. Claforan had broad spectrum of activity. For each indication its use was discussed vis-à-vis most prevalent causative pathogens. It was argued that even the empirical therapy did not have to be blind. Bacterial coverage was further supported by adequate tissue penetration as shown in studies. Together, these two factors resulted in high/very high clinical success as demonstrated by study after study. Extensive clinical data helped to establish the rationale for use of Claforan in various indications and conditions.
Promotional Suite. There was a full suite for promotion of Claforan. There were indication wise folders and there were reprints of original articles from renowned medical journals. More indications were added as more evidence came in. There were focus groups and discussion forums. There were leading foreign consultants who attended local events and delivered keynote addresses. All of this lent a great deal of credibility to Claforan promotion.
Claforan became and stayed as the drug of choice in Pediatrics, Surgery, Neurosurgery and Gynecology. It persevered in the face of Rocephin (ceftriaxone – Roche) launch. Rocephin had become popular in many countries soon after launch. In Pakistan, Claforan was so well entrenched that Rocephin struggled to get a foothold. Claforan also stood its ground firmly against generic cefotaxime preparation initially from Taiwan and later from Pakistan.
Claforan brand building has several lessons to learn:
- How to identify the true potential of a product
- How to position correctly
- How to organize brand strategy and promotion
- How to build customers
- How to manage sales
Claforan is a huge success story worthy of a case study……