Lilly battling rivals for breast-cancer patients

John Russell, Indianapolis Business Journal, June 9, 2023

Eli Lilly and Co. is pushing hard to gain a sales edge against two other drugmakers in the war against metastatic breast cancer. It is spending hundreds of millions of dollars to win over patients with an extensive advertising campaign.

The Indianapolis-based company, maker of cancer drug Verzenio, is blanketing airwaves with commercials that tout its drug’s track record in helping afflicted women live a little longer.

Metastatic breast cancer—also known as MBC or stage 4 breast cancer—is a tough, crippling disease without a cure that claims about 40,000 lives a year. The disease is the most severe form of breast cancer. Nearly three-quarters of all women diagnosed with the disease die within five years.

Last year alone, Lilly spent $111.8 million advertising Verzenio, according to ad-tracking specialist, as reported by Fierce Pharma Marketing, an industry newsletter. That made Verzenio the 10th-most advertised drug in the U.S. by spending, up 60% from $70.1 million in 2021.

No other cancer drugs broke the top 10 list for advertising spending. (Lilly has two other drugs on the top 10 list—diabetes drug Jardiance, fifth-highest; and diabetes drug Trulicity, seventh-highest.)

Lilly declined to say how much it is spending on its Verzenio campaign, or to confirm the outside estimates. But it defended the use of the direct-to-consumer marketing effort.


The drugmaker has produced about 10 TV spots for Verzenio since 2018, and two of them are currently running as part of a “Future Photos” campaign for women with metastatic breast cancer. It is also running two spots highlighting use of Verzenio for treatment of early breast cancer as part of its “Make Your Way” campaign.

Lilly shows no sign of slowing its advertising push for Verzenio as it competes against Pfizer’s Ibrance and Novartis’ Kisqali in the war against metastatic breast cancer.

All three medicines belong to a class of drugs called CDK inhibitors, which work by blocking overactive enzymes that would otherwise allow cancer cells to proliferate.


The drugs are not cheap. List price for Verzenio or Ibrance is about $14,500 a month. For Kisqali, the price ranges from $6,000 to $15,000 a month, depending on the dosage. The actual price for all three drugs varies, depending on health plans and pharmacies.

Three-way fight

Some experts say the three-way advertising war is likely to confuse patients, as they try to figure out, with their doctors, which medicines are likely to help and what to expect from the side effects.

Common side effects for Verzenio, for example, are diarrhea, low white-blood-cell counts, anemia, nausea, headaches and tiredness.

“Competition can be good if it keeps prices down, but otherwise it can be confusing, because they all have different risks,” said Diana Zuckerman, an epidemiologist and president of the National Center for Health Research, a nonpartisan health think tank in Washington, D.C. “It’s rather impossible for the average person to make sense of the list of risks even if they read them.”


Last month, Lilly launched its latest commercial for Verzenio, an upbeat, 60-second spot that encourages patients to look ahead, not just back. The commercial opens with a 60-something, gray-haired woman sitting on a couch, flipping through a photo album.

“Living with metastatic breast cancer means I cherish my memories,” she says in a voiceover. “But I don’t just look back on them. I look forward to the chance to make new ones every day with Verzenio.”

The camera zooms in to show a new section of the album, titled “Future Memories.” The pages scroll by, showing pictures of the woman at an alumni reunion, a backyard cookout, a New Year’s Eve party and other celebrations, with everyone wearing big smiles.

“Verzenio is proven to help you live significantly longer when taken with fulvestrant,” the announcer says. How much longer? According to small type at the bottom, women who take Verzenio and fulvestrant (an older drug for breast cancer) lived for a median of 46.7 months, versus 37.3 months on fulvestrant alone.

Some experts raised an eyebrow when asked about the “significantly longer” claim, given that the additional survival benefit of Verzenio is about nine months, compared to taking an older drug alone.

“When people hear ‘significant,’ they probably think an extra year or two of life, at least,” Zuckerman said. “For cancer drugs, living nine months longer is considered a meaningful benefit, unless the side effects—nausea, vomiting, diarrhea, exhaustion, etc.—make a person’s life miserable. Wouldn’t you rather have 37 enjoyable months instead of 46 miserable months?”

Indeed, the announcer spends nearly half of the 60-second Verzenio spot listing common side effects and warning patients to see their doctors immediately. (“Blood clots that can lead to death have occurred.”)

Lilly said its direct-to consumer marketing campaign has been successful “at raising awareness and helping patients feel more prepared for discussions about Verzenio with their physicians.”

Two national patient-advocacy groups, Breast Cancer Action and the National Breast Cancer Coalition, declined to comment about the competition among the three drugmakers or the effectiveness of the drugs. Nor did they comment about whether direct-to-consumer marketing was helpful.

Some breast cancer patients who are taking Verzenio acknowledge that the drug has powerful side effects, including diarrhea, but they take it on the advice of their oncologist.


The ads run only in the United States, one of the few countries to allow direct-to-consumer drug advertising. IBJ asked a few patients who live overseas to look at the ads on the website for their reaction.

Debbie Donnison, 61, of Worcester, England, who was diagnosed in 2022 with stage 4 breast cancer, said she has read the package insert sheets carefully but was alarmed when listening to the announcer rattling through them in the TV spot.

“They sound terrifying without context,” she said. “…They say them as fast as possible whilst your brain is saying, ‘Hey, hang on a minute.’ I realize they don’t want to focus on them, though, and time is short.”

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