DRUG makers trying coupons, guarantees to keep customers

<br>TRENTON, N.J. (AP) _ Pharmaceutical companies promoting their top-selling prescription drugs are luring customers with the same tactics as mass merchandisers: coupons and, in some cases, money-back

Friday, June 1st 2001, 12:00 am

By: News On 6

TRENTON, N.J. (AP) _ Pharmaceutical companies promoting their top-selling prescription drugs are luring customers with the same tactics as mass merchandisers: coupons and, in some cases, money-back guarantees.

Several major drug companies, including Bristol-Myers Squibb Co., Eli Lilly & Co., Novartis Pharmaceuticals Corp. and Schering-Plough Corp., currently are offering a month's free supply of key medications through coupons redeemable at most pharmacies.

The coupons are available through ads running in many major newspapers, company Web sites, patient education brochures posted in pharmacies _ even through some physicians who prefer the coupons to storing and handing out packaged drug samples.

``This really started about five years ago when the (Food and Drug Administration) started to loosen the rules about direct-to-consumer advertising,'' Hemant Shah, an independent pharmaceutical analyst in Warren, N.J., said Thursday.

The twist, he said, is that a large number of blockbuster drugs are starting to lose patent protection, including billion-dollar sellers such as the ulcer drugs Prilosec and Zestril. Companies know generic competition can quickly wipe out much of a prescription drug's sales, so some develop ``improved'' versions and get new patents for them.

``They have to shift sales to patent-protected products,'' Shah said, ``otherwise they're going to lose a fortune.''

The newer versions sometimes are more effective, but generally are just more convenient, although drug makers note that helps patients follow doctors' orders better.

Many of the newer versions are taken less frequently, such as Indianapolis-based Lilly's new Prozac Weekly. On sale since March, it replaces the once-a-day antidepressant pill, which had worldwide sales of $2.6 billion last year but loses patent protection this year.

Most companies offer a one-month free trial for one or two products, and some still have a few years of patent protection. Novartis offers coupons for nine different products, including three cardiac drugs and its Alzheimer's treatment, Exelon, but it only distributes them through physicians.

A handful of companies, including Bristol-Myers Squibb, offers cholesterol- or blood pressure-lowering drugs with a guaranteed refund if a patient's cholesterol level or blood pressure fails to respond to the drug. Bristol-Myers Squibb currently offers coupons for its diabetes treatments, Glucovance and the extended-release Glucophage XR.

Schering-Plough offers coupons for its nonsedating antihistamine pill, Claritin, a $2.6 billion drug that loses patent protection next year, as well as for its nasal spray, Nasonex.

Merck & Co. has a more modest program, offering $5-off coupons for its $5.3 billion cholesterol drug, Zocor, and its arthritis and pain drug, Vioxx, as well as $20 off a customer's second 90-day supply of the baldness treatment Propecia. The discounts have been available on and off for several years, according to company spokeswoman Jan Weiner.

With all the offers, patients must first see a doctor to be examined and get a prescription.

The offers may be smart business strategy, although because of patient confidentiality rules companies don't know which patients getting free samples end up using a product long-term. But some experts question whether the tactic is bad for the public.

``It's the worst kind of exploitation of patients,'' said Dr. Sidney Wolfe, co-founder of Public Citizen's Health Research Group. ``The purpose of it is to get patients hooked on these more-expensive drugs by providing them free for a short period of time'' so patients are used to the ``more convenient, but more expensive drug.''

``Anything you can think of to forestall the loss of money through generic competition is being done,'' Wolfe said.

Most such efforts are legal, but some pharmaceutical companies now are being sued by consumer groups or investigated by government regulators for allegedly bribing generic drug makers to keep competing products off the market.