Eli Lilly

Pursue the first option of proving effectiveness to deal with depression related pain or the second one of proving effectiveness and safety under a single pill a day regime?

In order to select one of the two options, it is important to understand the consumers’ needs and tendencies, and the success rate of each option.

Jim Lancaster’s preferred option was to invest in the Phase 2 and Phase 3 of the clinical trials to test depression efficiency of a single (QD) 60 mg dose of Cymbalta instead of the existing 20-40 mg twice a day (BID). His main argument was that the competitors in the SSRI and SNRI classes offered drugs of type QD. But, according to the conjoint study held to measure relative importance of antidepressant attributes to physicians, it was clearly established that the dosing attribute accounts for only 8%, in term of importance, of the total attributes taken into consideration. Tolerability and efficacy, on the other hand, are considered much more important to physicians (Exhibit 9). For example, efficacy in pain attribute accounts for 8.5% of the total attributes weight taken into consideration. Therefore, the option of investing in clinical trials to meet a QD dosage is justified by a very little fraction of the important attributes that required an antidepressant, which can be considered as a tie.

In our opinion, the effectiveness of Cymbalta should be proved by emphasizing its efficiency in treating depression and related pain.

First and foremost, such a medication will potentially represent a huge point of differentiation between Cymbalta and the existing antidepressants. In an extremely competitive market such as the depression medication market, Eli Lilly needs to differentiate itself like it did in the past with Prozac. In the situation described in the case, many physicians viewed the efficacy of current antidepressants as similar, with not one drug ‘standing out’. Eli Lilly should concentrate both its R&D and marketing forces...