Contrave: The Problem of Scale in Obesity Treatment

At the JPMorgan Healthcare Conference, Orexigen presented a good overview of the problem of scale in obesity treatment — the scale of the disease and the scale of the challenge to overcome inertia in treating it. Oh, and they provided helpful perspective on how they plan, with their partners at Takeda, to overcome that inertia.

It’s not the first time we’ve heard that obesity is a big problem. The presentation offers a pretty clear, well-researched, and up-to-date assessment of the obesity problem and the opportunity. And more interestingly, it provides a pretty good analysis of what it will take to overcome the problem of bringing obesity treatment advances into the mainstream of medicine. Selected findings from market research illustrate the problem of physicians who know they need to treat significantly more patients for obesity, but are waiting “for most of my colleagues” to start doing it first.

Not surprisingly, they make the case that they will bring the resources necessary to overcome that inertia when they launch Contrave this year. Approval could come as early as June 10, when FDA has promised to provide a decision on their application. Brandy Betz, an analyst for the Motley Fool, says:

The benefit of Takeda’s big pharma backing will kick in if the drug hits the market. Takeda has more than 2,000 people in its sales force who can potentially market the drug on-the-ground to health care providers. That compares to the roughly 200 person team Eisai put behind Belviq’s launch.And Takeda has experience in marketing diabetes-related drugs with Actos.

They might be right. It’s happened before, for example in the market for treating depression. Tremendous marketing and medical education scale was necessary to bring medical treatment of depression into the mainstream of medical practice.

But it’s also been the case — for example in cancer treatment — that progress was more incremental. A new specialty (oncology) had to emerge over years and years and clinicians had to come to terms with the fact that cancer is more than a single disease that a silver bullet can cure.

In the case of obesity, we might find some truth in both of these examples.

Click here to access the Orexigen presentation and here for perspective from the Motley Fool.

Scale, photograph © Giacomo Bartalesi / flickr

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