Pharma Xenical is melting pounds, but not enough to make the cash register ring. Now Zogg Kettiger Gasser wants to reposition the drug for Roche. The legendary actress and author Mae West is said to have once said that everything beautiful in life has a catch: "It's immoral, illegal, or it makes you fat." Especially fat. Despite the ever-growing number of light products, nutritionists and fitness centers, the proportion of overweight and obese people in the population of Western countries continues to rise.
A study by the Center for Disease Control and Prevention in the USA shows that around a third of all Americans are obese and another third are overweight. These almost 130 million obese people often suffer from dissatisfaction, chronic illnesses such as diabetes or heart disease, as well as certain forms of cancer. And they cost the American healthcare system over 75 billion dollars in 2003 - according to a market research study by RTI International.
The widespread disease of obesity also has legal implications in the home of the body cult: A few weeks ago, the US House of Representatives put a stop to claims for damages against fast food chains - with a law that invokes the freedom and personal responsibility of consumers. On the other hand, one food company after another is removing its maxi portions from its range and replacing them with smaller, but higher-margin pack sizes. And McDonald's recently even launched a salad offensive.
However, obesity is not just a problem in the USA, but in practically all affluent nations. According to a recent study by the Laboratory of Human Nutrition at ETH Zurich, one in five children in Switzerland between the ages of six and twelve is overweight, and four percent of children are massively overweight. A study by the Federal Office of Public Health (FOPH) and Nestlé states that 31 percent of the Swiss population is overweight, which means an increase of 25 percent in eight years. The FOPH attributes 13 billion Swiss francs, or around a third of all healthcare costs, to diet-related illnesses.
Anti-obesity medication has been available for several years. One of the best-known anti-obesity drugs is Xenical. With sales of 618 million Swiss francs, it was Roche's sixth best-selling product in 2003. But anyone who believes that sales of the power brand developed in line with the obesity boom is mistaken. Although sales of the drug group in Switzerland have risen by a whopping 36 percent since 1995 to 26 million Swiss francs (2002), the trend was anything but linear. In 2003, for example, Xenical's international sales fell by a full 13 percent; in some cases, the drop was even greater for the competition. The reason: apparently patients often have too high expectations of the drug, perceive it as a lifestyle pill or do not follow the dosage instructions correctly, resulting in unpleasant side effects. This often leads to them discontinuing the medication prematurely.
Acceptance problem with doctors
Not only are obese patients increasingly refusing to swallow such anti-obesity preparations. In its consumer and problem analyses, the commissioned agency Zogg Kettiger Gasser (ZKG) found that there is also a large discrepancy in perception among doctors, which is also responsible for the modest success of Xenical. Many doctors do not recognize obesity as a disease and therefore do not treat it with medication. "Many consider these patients to be lazy when it comes to diet and exercise," explains Max Winiger from ZKG. As a result, doctors like to assume that obese patients who ask for medication want to lose their unnecessary pounds in the easiest possible way. This is where Christoph Lögler, Group Product Manager at Roche Pharma Switzerland, found a need for correction: "With the repositioning of Xenical, we wanted to move away from the lifestyle image towards medically supervised therapy on the one hand and redynamize the brand on the other."
Change of strategy in Switzerland
As Xenical - unlike Reductil - is a drug that is covered by health insurance, the options are limited to specialist advertising, i.e. addressing doctors. The new communication concept therefore had to respond to the aforementioned prejudices among this target group and at the same time encourage patients. With the clear advertising message "I want", the campaign conveys the conviction that overweight people need to tackle their illness. Patients who opt for Xenical therapy are also accompanied by a support center that aims to change behavioral patterns with entertaining elements and a collegial tone.
With the same claim and differentiated content, doctors are to be confirmed and encouraged in their support and medical treatment. To motivate doctors, in addition to the patient brochures, Roche and ZKG are introducing the mailing magazine Volo (Latin for "I want") for doctors, in which a coach gives doctors tips on how to deal with obesity patients. In the advertisements, the two disease terms - obesity and type 2 diabetes - are clearly emphasized and the diet accompanying the treatment is clearly pointed out. The aim is to "medicalize" the syndrome.
However, the pharmaceutical company is gaining a more credible position for Xenical with the medical profession primarily through the realization that weight loss cannot be achieved with medication alone: In England, Roche carried out a project together with the Sainsbury retail chain in which it successfully motivated overweight and obese people to adopt a healthier diet.
ZKG's Xenical campaign shows obesity patients at an intimate distance in order to create trust and understanding.
Careful information guides patients towards Xenical therapy and motivating support helps them to persevere with the therapy.
How Xenical affects the metabolismThe Roche drug Xenical with the fat blocker orlistat has been on the market for
It was launched on the Swiss market on September 1, 1998 and is prescribed for the treatment of obesity. The mechanism of action is unique, but it is only really effective if strict dietary restrictions are adhered to. Unlike the competitor product Reductil, which is not covered by health insurance and which induces a feeling of fullness in the blood and prevents the absorption of serotonin and noradrenaline, Xenical works exclusively in the gastrointestinal tract. There it reduces fat absorption and causes around a third of dietary fat to be excreted undigested via the intestines. In Switzerland, health insurance companies cover the treatment costs of Xenical both for type 2 diabetics (adult-onset diabetes) with a body mass index (BMI) of 28 or more and for overweight people with a BMI of 35 or more. Last week, the European Commission
for Xenical has expanded the area of application. (la)
Luca Aloisi