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To: Montana Wildhack who wrote (4243)	4/26/2000 9:48:00 PM
From: Tom Johnson	Read Replies (1) \| Respond to of 14101

Wolf: A chain like Shopper's Drug Mart usually makes their purchases directly from the manufacturer using a 1-800 number. When a new drug comes out (and it's made by one of the well-known companies) their is usually a standing agreement that each store will take a minimum order(pre-ordained).The manufacturers usually send out a notice describing the medication, it's indications, dosages and side-effects etc. If a pharmacy gets a prescription for a drug they do not have they can usually get it from a local wholesaler or alternately if time is not a major problem they will order from the manufacturer.Failing this they would contact the prescribing physician and ask if a substitution can be made,providing a generic substitution is unavailable. The Reps usually just call for PR reasons and to take returns, although in the case of a new product they will elaborate and answer whatever questions the pharmacist may have. Of course, different companies have different systems but generally it's done along these lines. (35 years in sales & marketing with 3 major companies gives me a little insight) Hope that helps, and I'm sure Jeff can add to this!

To: Montana Wildhack who wrote (4243)	4/26/2000 10:34:00 PM
From: Jeff Chan	Read Replies (4) \| Respond to of 14101

Hi Wolf...re: your questions (LONG POST!!) We've been talking about JNJ and a Euro distribution partner and I've been asking myself - what does that really mean logistically? Unless DMX (or any other company for that matter) has a distribution or sales force, they will be forced to sell the product or a portion of it to a company such as J&J to market and distribute it. Who does a chain like Shopper Drug Mart buy from? Do they see a JNJ (for example) sales rep periodically and make an order? When a new drug comes out, how does the Pharmacy anticipate this? Secondly, if a pharmacy gets a prescription to fill for a drug they do not have, how do they respond? Wolf, the pharmacy (or rather should I say the pharmacist) is NOT the primary driver for prescription sales. This belongs to the physician. That's why almost all marketing efforts go towards trying to persuade the physician to use the product. This occurs through one to one visits (otherwise known as detailing), medical education events by "specialists or recognized authorities" in a specific area of treatment, and through the distribution of samples at the doctor's offices. It is hoped that the doctor will write the prescription and, unless third party drug plans such as the government or Blue Cross will not pay for it, or unless there's a contraindication for using the product eg. drug interaction or whatever, the pharmacist in the community will fill it. Most drug stores, since they are motivated by profit will not jump to add yet another product to their inventory. Remember, although inventory is an asset, inventory still ties up a drugstore's money. If the product is not available upon a prescription, the drugstore will call up the manufacturer or, more commonly a drug wholesaler. There are a couple of them in Canada and, unless, the drugstore is in a rural or isolated setting, they will normally get the product within 48 hrs. Selling to the drugstore is just that...selling. In order to use the product, the company must persuade the physician to actually order it...that's why in most cases, it is the physician who is the gatekeeper. In hospitals, it is a little different. The Pharmacy has a little more say in which product(s) are used within the confines of the institution, however, I won't go into this since, Pennsaid will be mostly a retail or community product. A patient will be placed on the product by their family physician and we, in hospital practice, will bring it in because the patient is on it at home. One more thing...because osteoarthritis is primarily a disease of the elderly, the marketing agent for Pennsaid will also submit an application to the third party payors or government drug programs. In Ontario, this is the Ontario Drug Benefit Program, in order for listing on the Ontario Drug Benefit Formulary. If the company intends to do this, this alone will suppress the price of the drug as anything priced way out of line will not be covered by the provincial program...or at least will be covered only in a limited fashion, what is called "limited use criteria". This will have a large impact on whether it is prescribed. Obviously, if the government or plan will not pay for it, then the patient must pay for it on his/her own...something that may or may not occur. One could also consider applying for the product to become non-prescription status. This has the effect of bringing the product to a larger audience, so to speak. At this point, one could perform much greater marketing efforts as compared to prescription products...although having seen some of the garbage coming from the US direct-to-consumer ads for prescription products, there might not be much of a difference. Hope this helps, Jeff C