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Thought leadership

Double Trouble? Marketing Fixed-Dose Combinations

Jeff Greene, Evoke VP, StrategyBy Jeff Greene, VP, Strategy

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It seems like no matter what field of medicine you examine—from endocrinology to pulmonology—you’ll find HCPs prescribing fixed-dose combinations (FDCs). These combination treatments have become more common since 2010. In fact, one recent study concluded that FDCs comprised 10% of all US approved drugs. While they offer unique benefits, they also present a nuanced challenge to marketers. How do you position an FDC without “cannibalizing” its component molecules? What messages might differentiate one FDC from countless others?

The Evoke Franchise Marketing Center of Excellence assessed a dozen FDC products currently being marketed in the United States. These products span across a variety of disease states, included both orals and inhalers, and excluded combination treatments that only included generic components.

What did we find? The products we assessed fit into 1 of 3 strategic categories:

    1. Convenience Strategy: For patients already taking multiple generics, pairing a strong branded molecule with a common generic reduces medication burden. In diabetes and heart disease, for example, all 5 FDCs we looked at followed this strategy.

    2. Innovation Strategy: Combining an older branded molecule with a newer branded molecule can pack more clinical punch. This is a common approach in categories like HIV, where innovation and polypharmacy have significantly improved the outlook for patients.

    3. Synergy Strategy: In some cases, a new molecule is approved only in combination with a generic for safety reasons. These unique FDCs, in categories such as asthma, pursue a hybrid strategy of both Convenience Strategy and Innovation Strategy.

The right positioning and messaging for an FDC depends on which strategic approach its leadership team pursues.

The Right Component Is Everything

Looking at patient and HCP websites and digital ads, more than half of the FDCs we assessed had no relationship with their component brands, only mentioning scientific names where required for legal purposes. Of the FDCs that mentioned their component brands, we found a wide variety of approaches. Several brands offered combination websites, particularly for HCPs. Logos and links made it easy to navigate between FDC and non-FDC brands within a franchise. In one case, we found a logo on a patient website that explicitly called out one of the FDC’s components—pharma’s version of Intel Inside.

Most importantly for marketers, we found that 4 of the 5 FDCs that mentioned their branded components were in the type 2 diabetes or cardiovascular categories, where the Convenience Strategy rules. The finding is clear: When component brands are commercially successful on their own, FDC marketers don’t want to give up the equity in the component. When there’s no longer equity in a component brand—or, in the case of Synergy Strategy products, when it didn’t exist in the first place—marketers want to tell a fresh story.

Getting Past the Numbers Game

It’s not easy to talk about an FDC beyond the obvious—it has more than one medicine. Not surprisingly, we found numbers to be the focus when FDC marketers sought to differentiate the benefit of a combination product versus its separate components.

  • "3 powerful medicines in 1 pill."

  • "Contains 2 medicines, working together."

  • "Works in 3 different way to achieve results."

Brands willing to think creatively can use insights to get past the numbers. For example, one FDC with a Synergy Strategy encouraged patients to ask if Drug X could be the “missing piece” in their treatment. Rather than focusing on the number, the brand created tension between the patient’s current and potential regimen, only mentioning scientific names where required for legal purposes. That could be a lot more motivating than “2 medicines working together.”

For FDCs with a Convenience Strategy, the greater opportunity to stand out is with HCP messaging because physicians are both aware of FDCs and tinkering with treatment regimens daily. However, across all 3 strategic approaches, we saw more unique messaging targeting HCPs. Marketers should challenge the assumption that the number of components is the most compelling attribute of the FDC.

  • "Should you start with more than monotherapy?"

  • "Give them the simplicity of a single-dose pill."

  • "The foundation of X with a novel drug from class Y."

Strategies for FDC Success

Combination drugs are a valuable addition to the treatment landscape, whether offering patients convenience, a more powerful treatment, or both. To launch FDCs successfully with a clear path forward, marketers should first determine which strategic approach they will pursue.

Our key recommendations:

  • Innovation and Synergy marketers should generally focus on what’s new. Marketing efforts should feel like new drug launches. Differentiate the FDC as a unique product, with its own benefits separate from its components.

  • Convenience marketers should generally focus on winning HCP targets. Physicians have the clinical context to weigh FDC products versus multiple pills. Create an integrated brand experience that makes it easy for them to learn about the component brand and its FDC cousins.

  • Patient marketers should get past the numbers. Start by diving into insights, uncovering the impact that a single-pill (or single-puff) product will have on consumers’ lives. That emotional benefit should become the framework for a unique and differentiating campaign.

How can marketers of fixed-dose combinations (FDCs) find success? The Evoke Franchise Marketing Center of Excellence looked at a dozen FDCs currently on the market and created guidelines for brand and franchise marketers to follow.

Marketing Fixed-Dose Combinations

The Evoke Franchise Marketing Center of Excellence helps pharmaceutical marketers effectively launch and grow successful franchises. Our cross-disciplinary experience includes category branding, customer experience strategy for multi-indication treatments, and FDC launches. To request case studies or more information, contact

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Kwon KC, Lee C. Analysis of fixed-dose combination products approved by the US Food and Drug Administration, 2010-2015: implications for designing a regulatory shortcut to new drug application. Therapeutic Innovation & Regulatory Science. 2017;51(1):111-117.