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How can pharmaceutical companies best tap into the travel health market?

Posted on: 07 Jun 04
How can pharmaceutical companies best tap into the travel health market?

Summary

Recent events, such as the approval of Salix Pharmaceutical's oral antibiotic Xifaxan, suggest renewed interest in the travel health market. However, with growing concerns regarding global travel and historically poor compliance to recommended travel vaccine programs, Datamonitor's Amber Gibson suggests that companies must still consider how they can most effectively reach their target audience...

According to the World Tourism Organization, the number of travelers from industrialized nations to developing regions is around 50 million a year and growing by around 5-6% per annum. This growth in the number of travelers is driven by decreasing costs and journey times, increased accessibility to travel and a social trend to go further afield.

However, with such travel comes increased exposure to diseases such as malaria, typhoid and yellow fever, which pose considerable problems for Western health authorities attempting to treat sick travelers once they return. In addition, travel increases exposure to a number of less severe types of infection that lead to significant discomfort, inconvenience and often delayed journeys.

For example, traveler's diarrhea or 'Delhi belly' afflicts 20-50% of all international travelers, an estimated 10 million people each year, creating a significant requirement for effective medication. The potential demand for such products is perhaps reflected by recent developments on this front. Chiron has recently released an oral vaccine, Dukoral, which targets ETEC and cholera, Microscience has a vaccine in advanced development and Salix Pharmaceuticals has recently gained approval for Xifaxan for the treatment of non-invasive E. coli.

Resistance fears may limit antibiotic prescriptions

Recent developments in the management of traveler's diarrhea follow two key approaches, namely vaccine prevention and antibiotic therapy. Both present significant barriers to companies involved in marketing such products. For antibiotic therapies, the key challenge is ensuring that patients can obtain therapy when they need it. This has particular relevance for those visiting rural regions where medical facilities are infrequent and Western medicines may not be available. As a result, targeting such patients will require prescriptions to be written prior to travel and prior to contraction of the disease. This has significant consequences for overuse of medication and the potential for the development of resistance, which will limit future drug efficacy.

Salix Pharmaceutical's Xifaxan could offer a solution to this problem. The drug is a non-systemic, gastrointestinal-selective (less than 0.4% is absorbed into the bloodstream), oral antibiotic. This means that the use of this antibiotic is less likely to precipitate the development of bacterial resistance outside the gastrointestinal tract. As a result, physicians may be more willing to prescribe this product for patients planning long periods of travel, prior to illness. Salix will need to promote this benefit effectively if it is to fully capitalize on this potentially lucrative market. In addition, the company will need to overcome the significant threat from vaccine products, such as Chiron's Dukoral.

While antibiotic therapy is effective in managing the symptoms of diarrhea, it does not prevent the inconvenience and potential delays to travel. With holiday time becoming increasingly precious as Western society places greater demands on its workforce, holidaymakers and travelers will benefit more from prophylactic treatments that prevent illness. In addition, physicians are likely to prefer such approaches as they remove the risk of resistance development and limit the need for self-diagnosis. In addition, the oral administration of Dukoral provides a more convenient and less painful approach to immunization.

Awareness needs to be improved

Despite the clear benefits of vaccination against traveler's diarrhea, Chiron and Microscience will face significant challenges in raising awareness and driving uptake in travelers. Historically, compliance to recommended immunization programs that prevent life-threatening diseases has been sub-optimal, in part due to the costs associated with vaccination and in part due to a lack of awareness.

Individuals traveling to endemic regions often have a poor perception of the risk of tropical diseases, built, in part, by the spread of Western style hotels and facilities. This false sense of security limits uptake of travel vaccines and will need to be overcome if market growth is to be stimulated. In addition, access to vaccination programs should be improved and made more convenient to encourage patients to comply with recommendations.

For the majority of travel vaccines, patients are required to make an appointment with a physician or travel clinic, which obviously requires considerable time investment. If travelers could gain access to immunization over-the-counter (OTC), compliance could potentially improve. However, this would require non-parenteral delivery routes, allowing patients to self-administer.

Chiron's Dukoral already has this advantage but is not yet available OTC, although patients are permitted to fill prescriptions for the product and self-administer at home. Gaining OTC status would not only allow easier access to Dukoral but would also increase Chiron's ability to promote its product and drive awareness through direct-to-consumer channels.

Related Research:

  • Tropical Infections: A Status Update

  • Commercial Perspectives: Vaccines - Nosocomial Pathogens

  • Stakeholder Opinions: Community Acquired Respiratory Tract Infections - Room for Ketek?
  • Datamonitor

    Last updated on: 27/08/2010 11:40:18

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