Provenge and the DTC Dilemma
“Small market drugs can use DTC given high revenue per patient.”
Provenge from Dendreon treats advanced prostate cancer and can prolong life. It is an expensive drug, costing around $90,000 for the three infusions. The clinical studies showed a significant survival increase versus men not treated. The results are good but not miraculous, in that 32% are alive after three years versus 23% not treated. This is not indicated on all men with prostate cancer, just those whose cancer has metastasized.
Provenge decided to try DTC. I saw their television ad today. Needless to say at $90,000 a user, the number to achieve payback is modest. I have read they will spend about $20 million on DTC. That means about 225 men need to take Provenge made aware of it by seeing the ad to payback the investment. Given that the target group is so small, the question needs to be asked about using mass television. That target is about 100,000 men who currently have metastatic cancer.
Usually diseases with such a small population would use consumer advertising through point of care or targeted direct marketing. So, why did they decide to do television? Their media will reach tens of millions looking for that elusive 100,000. On the other hand, their plan will work quickly by using television and although inefficient, it will likely be highly effective. After all, doctors see the DTC as well, and some may be more willing to listen to patient requests knowing the ad is out there.
The commercial itself is what I call meat and potatoes. It has the 60 year old man fixing the grandchild’s bike as the visual. This is the standard, be there for your family story used by cholesterol, blood pressure, diabetes, blood thinners, and other life saving medications. The message is clearly delivered that Provenge can extend your life. If I had advanced prostate cancer and was insured it would get my attention. I would only need to see it once and I would run to my doctor. You can see it on their web site if you wish.(www.provenge.com)
The reality is that of 100 men with advanced prostate cancer, Provenge would keep 9 more alive after three years versus not treating. The odds of success are not great but better than not treating. The 60 second ad does not give these data but the web site does. Provenge shows that small market drugs can use DTC given high revenue per patient. It is not a given they will get their 225 new users but I would be optimistic that they will exceed that number. The ad is clear, hopeful, and uses what every guy responds to. That is, your family needs you to be around as long as possible.
I would also expect Provenge to have a platinum level system of consumer support. I would hope they have live operators available 24/7 to answer questions. I would expect them to Fedex information out if requested. For $90,000 they can afford to coddle interested consumers. As a male in the prostate cancer age group I hope to never need it but I am glad it is out there.
Bob Ehrlich, Chairman
DTC Perspectives, Inc.