Strategies of Big Pharma: Retaining Market Share and Profitability for ADHD Medications

Dr. Jerry Don Smith Jr.

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The pharmaceutical industry plays a critical role in shaping how ADHD (Attention-Deficit/Hyperactivity Disorder) is perceived, diagnosed, and treated. As with any industry, the goal is not just to introduce a successful product but also to ensure its continued profitability. As popular ADHD medications lose their patent protections, pharmaceutical companies employ a variety of strategies to retain market share and ensure profitability. These strategies often involve innovative research, subtle modifications to existing products, marketing prowess, and occasionally, controversial tactics.

1. Developing Extended-Release Formulations

One common strategy that pharmaceutical companies employ to retain market share after their original product goes off-patent is the development of extended-release or controlled-release formulations. These new versions release the active ingredient(s) more slowly, allowing for once-daily dosing instead of multiple doses throughout the day.

Take, for instance, the case of Adderall, a widely prescribed stimulant medication for ADHD. The original formulation required dosing multiple times a day. Shire, the company that marketed Adderall, subsequently introduced Adderall XR, an extended-release version that needs only once-daily dosing (Faraone, Buitelaar, 2010).

2. Seeking Approval for New Indications

Pharmaceutical companies might seek FDA approval for additional indications for an existing medication. This allows the company to market the drug for new uses, expanding its potential consumer base. For instance, certain ADHD medications originally approved for pediatric use later receive approval for adult ADHD, expanding their market significantly (Castells, Ramos-Quiroga, Bosch, Nogueira, & Casas, 2011).

3. Direct-to-Consumer Marketing

In countries where it’s allowed, direct-to-consumer (DTC) advertising can be a potent tool. DTC advertising, which includes those TV commercials and magazine ads for prescription drugs, has been shown to increase the number of prescriptions written for the advertised product. A study found that for every dollar pharmaceutical companies spent on DTC advertising, they saw a $4.20 increase in drug sales (Donohue, Cevasco, & Rosenthal, 2007). For ADHD medications, DTC strategies often emphasize the potential benefits for daily functioning, academic performance, and social relationships.

4. Education and Advocacy Efforts

While not directly a marketing strategy for a specific drug, pharmaceutical companies often support ADHD awareness campaigns, physician education programs, and patient advocacy groups. These efforts can indirectly boost prescriptions by raising awareness of ADHD, endorsing the benefits of medication management, and fostering relationships with key opinion leaders in the field (Prosser & Reid, 2009).

5. Patent Litigation

When the patent for a popular medication nears its expiration date, generic manufacturers often gear up to introduce cheaper alternatives. In response, the original manufacturer might engage in patent litigation, alleging that the generic manufacturer is infringing on their still-protected patents. Such lawsuits can delay the introduction of generic versions, effectively prolonging the brand-name drug’s market exclusivity. An example is the case of Concerta, where litigation extended the market exclusivity of the brand-name version (Carrier, 2010).

6. “Evergreening” and Product Hopping

‘Evergreening’ is a controversial strategy that involves making minor changes to a medication — changes that are just significant enough to warrant a new patent but don’t necessarily offer a therapeutic advantage. Closely related is “product hopping,” where a company introduces a new version of a drug and then pulls the older version off the market, forcing patients to switch. Both tactics can delay or diminish competition from generic versions (Hemphill & Sampat, 2012).

Conclusion

The intersection of medicine, business, and patient care is complex. On one hand, pharmaceutical companies have given us highly effective ADHD treatments that have transformed many lives. On the other hand, the drive for continued profitability can sometimes lead to practices that raise ethical and economic concerns. As consumers and healthcare professionals, it’s vital to understand these dynamics to make informed decisions and advocate for practices that prioritize patient well-being.

References

• Faraone, S. V., & Buitelaar, J. (2010). Comparing the efficacy of stimulants for ADHD in children and adolescents using meta-analysis. European child & adolescent psychiatry, 19(4), 353–364.
• Castells, X., Ramos-Quiroga, J. A., Bosch, R., Nogueira, M., & Casas, M. (2011). Amphetamines for Attention Deficit Hyperactivity Disorder (ADHD) in adults. Cochrane Database of Systematic Reviews, (6).
• Donohue, J. M., Cevasco, M., & Rosenthal, M. B. (2007). A decade of direct-to-consumer advertising of prescription drugs. New England Journal of Medicine, 357(7), 673–681.
• Prosser, H., & Reid, R. (2009). Changes in use of psychotropic medications in people with intellectual disability in Scotland in the decade 1995–2005. Journal of Intellectual Disability Research, 53(11), 941–948.
• Carrier, M. A. (2010). Unsettling drug patent settlements: a framework for presumptive illegality. Michigan Law Review, 108(1), 37–80.
• Hemphill, C. S., & Sampat, B. N. (2012). Evergreening, patent challenges, and effective market life in pharmaceuticals. Journal of Health Economics, 31(2), 327–339.