Campbell Alliance says in a new study that 2004 will be a “pivotal” year in determining winners and losers in the $6 billion angiogenesis II receptor blockers (ARB) hypertension market.

The multi-client study on the managed care environment for antihypertensives was conducted with regional managed care organizations and physicians. It reveals increasing use of ARBs at 86 percent of managed care organizations (MCOs).

Campbell Alliance says the study also shows a growing tendency among physicians to prescribe ARBs as first-line treatment for hypertension, despite the availability of lower-cost alternatives such as diuretics and generic angiotensin converting enzyme (ACE) inhibitors, which improve cardiac output.

“We are about to see the world change pretty dramatically for companies promoting antihypertensives, and many will be caught off guard,” said Brian Levy, a Campbell Alliance consultant who co-authored the report. “To date, managed care has not aggressively managed ARB utilization, but with the huge spend in the category and new evidence to work with, managed care is primed and ready to drive utilization to preferred brands. The trajectories of many products will be set or reset during 2004–.”

Pricing also will become a defining issue for ARBs in 2004, says Levy, citing Sankyo’s contracting efforts to support the launch of Forest Labs’ Benicar, which he says have put price back on the table in this hyper-competitive class.

“Extremely favorable product perceptions among both physicians and managed care…as well as an aggressive pricing strategy…have placed Benicar in a very favorable position,” noted Levy. “It is the fastest growing ARB on the market, often gaining market share at the expense of Merck’s Cozaar, which managed care decision makers view as particularly vulnerable due to the drug’s propensity for dose creep.”

Other products vulnerable to greater MCO restriction, according to the Campbell Alliance study, include Boehringer Ingelheim’s Micardis, AstraZeneca’s Atacand and Biovail’s Teveten.

The consulting report also provides assessments of Pfizer’s Norvasc, Bristol-Myers Squibb’s Avapro, Wyeth’s Altace, Novartis’ Diovan, and Abbott Labs’ Mavik.

Campbell Alliance is a management consulting firm specializing in the pharmaceutical and biotech industries. It currently has offices in Raleigh and Parsippany, NJ.

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