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Period 3 /5 – May/June
Pharmaceutical
Marketing Strategy
Professor: Reinhard Angelmar Assistant: Georgette Duprat
reinhard.angelmar@insead.edu georgette.duprat@insead.edu
PMLS 1.19 PMLS OSP A 1.07
Ext 2641 Ext 4267
Course Objectives and Target Audience
The aim of this course is to provide students with an understanding of the prescription
pharmaceutical industry, the context in which it is operating, and concepts for marketing
decision making in different phases of the category and product life cycle, to enhance their
ability for effective marketing decision making in the industry.
The course is designed with three groups of students in mind:
1. Students interested in working for pharmaceutical companies in all segments of the
industry (pharmaceuticals, biotechnology, generics).
2. Students interested in working for suppliers of products and services to the
pharmaceutical industry. The pharmaceutical industry purchases products and services
from a broad range of suppliers, including:
· Consultants and information service providers: the pharmaceutical industry is a major
customer for consulting companies and data/market research providers.
· Suppliers of R&D and manufacturing services, e.g., companies specializing in
medicine discovery technologies, medicine development, or medicine manufacturing.
· Communication, advertising, and P.R. companies: traditionally of interest only to
specialized healthcare communication boutiques, the rise of directtoconsumer
communication is turning pharmaceuticals into a major client industry for all
advertising/communication agencies.
3. Finally, the course is also potentially relevant for students interested in working for some
other player in the healthcare industry such as public or private insurers, hospitals, or
governmental organizations involved in the healthcare system.
INSEAD MBA Programme – Prof. Angelmar – Pharmaceutical Marketing Strategy –
May/June 2007
Course Overview : Pharmaceutical Marketing Strategy
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INSEAD MBA Programme – Prof. Angelmar – Pharmaceutical Marketing Strategy –
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Evaluation
Your grade will be based on three elements:
· Class participation 20%
· Individual case writeup 20%
· Project 60%
Individual case writeup
You can choose any of the following cases / case questions for a writeup:
· NICE : Multiple Sclerosis UK
· Cialis
· Amgen Europe in the Renal Anaemia Treatment Market
· Syntex (A)
· Celebrex: Question 2
· Celebrex : Question 3
· Lipitor (A): Question 2
· Lipitor (B): Question 1
· Lipitor (B): Question 2
· Eli Lilly and Company: Innovation in diabetes care
The writeup should not exceed five pages of text (12 point font, double spaced), plus
exhibits, and must be turned in by the beginning of the class for which the case is scheduled.
You should also be prepared to make a powerpoint slide presentation on your writeup.
By Thursday May 10 please send an email to Georgette Duprat stating your 1 st , 2 nd , and 3 rd
preference for the writeup. I will then make the assignments, taking your preferences into
account, while ensuring that there is a similar number of students for each writeup.
Project
The project may be carried out individually or in a group (maximum five students per group).
Reports may not be longer than 30 pages (12 point font, double spaced), plus exhibits.
Two types of projects are possible:
· The analysis of a real pharmaceutical marketing situation or issue. The report can be
based on your own experience, published information, and/or on information you
gather through interviews.
· The analysis of a more general pharmaceutical marketing issue.
You should submit a short description of your project by Monday, May 21. The deadline for
submitting the completed project is Wednesday, June 27.
Here is a list of general pharmaceutical marketing issues to stimulate your thinking. You are
by no means limited to these topics:
Dealing with regulators (governments, senior civil servants, etc.), marketing authorization
authorities (e.g., EMEA, FDA), and payers (e.g., insurance companies) as customers
The impact of regionalization of health care authorities (e.g., Italy, Spain) on pharmaceutical
marketing
Key pharmaceutical marketing challenges in China, India, etc…
Marketing to managed care organizations
The role and management of the pharmaceutical industry’s image
Obtaining desired prices and reimbursement conditions for “life style” drugs
Innovative pricing schemes: e.g., outcome guarantees; risksharing
How to increase consumers’ willingness to pay a price premium for a brand?
Suppose gross margins were only 50%. How would pharmaceutical marketing change?
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Successful marketing strategies for a small company in the GP market
Key success factors in comarketing and copromotion
Pharmaceutical branding policies: when is which branding policy recommended?
The role of the corporate brand in pharmaceutical marketing
When to do global, regional, or local marketing (branding, positioning, etc...)?
Pharmaceutical marketing in Europe: are country marketing organizations necessary?
Managing opinion leaders
How to deal with unfavorable results from a major clinical study?
Creating a market for a poorly known and understood disease
Creating a market for a new drug class (category)
Managing “mirrored” sales forces
When and how to implement key account management?
Suppose each physician could be visited only once a year by a pharmaceutical company,
with the visit lasting a maximum 30 minutes. How would this change pharmaceutical
marketing?
Suppose all physicians were to use electronic prescribing (they key in diagnostic
information, and get a small list of recommended drugs). How would this change
pharmaceutical marketing?
What are the implications for pharmaceutical marketing of having a broad range of
information (prescriptions, promotional actions by all competitors, etc.) on individual
physicians?
What is the role of samples throughout the product life cycle, and what are optimal
sampling policies?
Differentiating through nonproduct means (e.g., services)
Communicating with patients when directtoconsumer communication is not allowed
Onetoone marketing in the pharmaceutical industry
Integrated communication programs: managing all communications toward physicians in an
integrated way; managing communications toward different stakeholders in an integrated
way
Disease franchise management: managing a line of products/services in the same disease
area
Incumbent strategies for dealing with a new competing product with superior performance
on key attributes
Successful entry strategies for a metoo product
Designing and implementing product switching strategies to counter patent expiry (e.g.,
Losec Nexium)
Successful strategies for branded products when patents expire
Should researchbased pharmaceutical manufacturers also offer generics? If so, how?
Successful marketing strategies for generics manufacturers
Enhancing customer focus in pharmaceutical companies
What is the potential contribution of increasing coordination across healthcare markets:
prescription medicines, OTC products, diagnostics, and medical devices?
PART I : THE ENVIRONMENT FOR PHARMACEUTICAL MARKETING
Class 1: The Healthcare Environment
Pharmaceutical marketing is strongly shaped by the characteristics of the healthcare
systems in which pharmaceutical companies operate.
The main topics discussed during this class will be:
· Key characteristics of the healthcare environment
· Trends in the demand for healthcare products and services
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· What is different about pharmaceutical marketing?
Required reading:
· “The Healthcare Environment,” Chapter 1 in D. Dogramatzis, Pharmaceutical
Marketing, Denver: Interpharm Press, 2002, pp. 321.
Optional reading:
· Chapter 4, “Health care spending: the quest for affordable costs and sustainable
financing,” pp. 7793, in Towards HighPerforming Health Systems, OECD, 2004,
ISBN 9264015558.
Class 2: Pricing & Reimbursement I
Who pays how much for prescription pharmaceuticals varies significantly across countries. In
many countries, thirdparty payers such as public or private insurance organizations pay for
the bulk of the medicine expenditures. Growing concern with the rising cost of medicines is
making the pricing and reimbursement discussions between pharmaceutical firms and third
party insurers increasingly complex. The pricing function, therefore, is of vital importance for
pharmaceutical companies.
Guest speaker:
· Dr. Jens Grüger, Global Head, Pricing & Market Access, Novartis
Required reading:
· Deutsche Bank AG/London, “Funding and pricing of pharmaceuticals,” in Global
Pharmaceuticals, 5 August 2005, pp. 7184.
Class 3: Pricing & Reimbursement II
Following the lead of NICE (National Institute for Health and Clinical Excellence) in the UK,
payers in a growing number of countries use costeffectiveness (pharmacoeconomic)
analyses when making market access decisions.
Case Study: NICE or Nasty?
Access and Reimbursement of Multiple Sclerosis Medicines in the UK
Discussion Questions:
· What are the pros and cons of the NICE technology appraisal process for patients,
physicians, the NHS and pharmaceutical companies?
· What are the pros and cons of the risksharing scheme for patients, physicians, the
NHS and pharmaceutical companies?
· How should companies adapt their product development and launch strategies to the
NICE technology appraisal process?
· Should every country set up a similar process?
·
· Guest speaker:
· Dr Jacqueline C. Napier, Medical Director, Specialised Therapeutics, Schering UK
Optional reading:
· Office of Fair Trading, Annexe L: Evaluation of options for reform to the PPRS,
February 2007 (OFT8851).
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Class 4: The Pharmaceutical Market
Pharmaceutical sales are quite concentrated: a small number of countries, categories, and
products account for a high share of the industry’s sales. On the supply side, despite the
large number of recent mergers, the industry is still quite fragmented overall, although
concentration in specific product classes tends to be high. The industry is generally
considered to be highly profitable, although this may reflect flawed accounting practices
instead of true economic profitability. The forces shaping industry profitability are changing,
posing threats to future profitability. New technologies may change the bases for competition,
lead to market fragmentation, and provide alternatives to the current “blockbuster” model.
Topics that will be discussed during this class include:
· The structure of demand for pharmaceuticals
· The structure of the pharmaceutical industry
· Industry profitability, and the forces shaping it
· New technologies and their potential impact on the pharmaceutical market
Required reading:
· Deutsche Bank AG/London, “Overview,” in Global Pharmaceuticals, 5 August 2005,
pp. 635.
PART II : DEVELOPING PHARMACEUTICAL MARKETING STRATEGY
Class 5: Market segmentation
Market segmentation can be done for physicians, patients, payers, and other stakeholder
groups. Physician segmentation is particularly important for two reasons: 1. Physicians vary
widely in their prescription volume, the major determinant of a physician’s value to a
pharmaceutical company. This makes the precise targeting of marketing effort essential. 2.
Different physicians have different needs, expectations, attitudes, and other characteristics
which influence their response to marketing stimuli. Segmentation, therefore, is vital for an
appropriate tailoring/customization of the marketing mix.
Required readings:
· F.J. Mulhern, “Customer profitability analysis: Measurement, concentration, and
research directions,” Journal of Interactive Marketing, 13, 1, Winter 1999, pp. 2540.
· R. Brand & P. Kumar, “Detailing gets personal,” Pharmaceutical Executive, 23, 8,
August 2003, pp. 6694.
Optional readings:
· “Patients and customers: The inner circles,” from M.C. Smith et al., Pharmaceutical
Marketing, New York: The Haworth Press, 2002, pp.1842.
· “Secondary Data from Commercial Suppliers,” from M.C. Smith et al., Pharmaceutical
Marketing, New York: The Haworth Press, 2002, pp.7787.
Note: you should submit, by Monday, May 21 latest,
a short (halfpage) description of your project
Class 6: Segmentation and Positioning: Primary Care
Having defined the target customers, the main challenge consists in influencing their
behavior. Effective positioning is one of the key tools for achieving this.
Case: Product Team Cialis: Getting Ready to Market (HBS 9505038, Rev. March 27, 2006)
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INSEAD MBA Programme – Prof. Angelmar – Pharmaceutical Marketing Strategy –
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Discussion Questions:
· What should be the target market for Cialis?
· What are the main positioning options for Cialis, their pros and cons, and what
positioning would you recommend?
Guest Speaker:
· Laurence RubyBernier, Marketing Manager, Lilly France
Optional reading:
· “Positioning, Targeting, Profiling,” Chapter 8 in D. Dogramatzis, Pharmaceutical
Marketing, Denver: Interpharm Press, 2002, pp. 125135.
Class 7: Marketing Resource Allocation
In this class, we will discuss the key concepts for allocating resources across marketing
instruments, customers, and products. The “Syntex (A)” case will serve as a concrete
example of how these concepts can be applied to allocate sales force resources across
customer segments and products.
Case: Syntex Laboratories (A) (HBS 9584033, Rev. October 18, 1984)
Discussion Questions (Case Syntex Laboratories):
How many sales representatives should Syntex Labs have during 1983, 1984, and 1985?
Why?
· How would you allocate the sales representatives to the products, and to the
physician specialties?
· What issues do you foresee in the implementation of your recommendations? How
would you deal with these issues?
· What issues do you see in the SMM modeling approach? What would you do
differently?
Optional readings:
· P. Sinha and A.A. Zoltners, “SalesForce Decision Models: Insights from 25 Years of
Implementation,” Interfaces, 31,3, MayJune 2001, pp. S8S44.
· M.E. Elling et al., “Making more of pharma’s sales force,” McKinsey Quarterly,
Number 3, 2002, pp. 8695.
Class 8: Social Network Analysis: Pharmaceutical Applications
The various players (e.g., patients, physicians, payers) in the environment of pharmaceutical
companies are not acting in isolation, but are elements of social networks. An understanding
of the functioning of these social networks and of the position which the company occupies
can inform marketing decisions and provide novel performance indicators. The lecture will
discuss the use of social network analysis in the pharmaceutical industry.
Guest speaker:
· Dr. Andreas Penk, Country Manager Germany, Pfizer
Required readings:
· “Networking and Lobbying”, by Harald Katzmair, FAS.research
· “Business Case: Optimizing Investments into Stake Holder Relations by Means of
Social Network Analysis (SNA)”, by D.Spielthenner, H.Katzmair, FAS.research
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INSEAD MBA Programme – Prof. Angelmar – Pharmaceutical Marketing Strategy –
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· “Mapping the Scientific Infrastructure of Scholary Fields by Means of Social Network
Analysis (SNA)”, by D.Spielthenner, H.Katzmair, FAS.research
· “Business Case: Optimizing Key Account Management by Means of Social Network
Analysis (SNA)”, by D.Spielthenner, H.Katzmair, FAS.research
Class 9: Segmentation and Positioning: Hospital Care
Case: Amgen Europe in the Renal Anaemia Treatment Market
(INSEAD Case 03/2007 5410)
Discussion Questions:
· What market segments should Amgen Europe target?
· How should Aranesp be positioned?
· What changes, if any, in the marketing mix should be made?
· How should Amgen Europe deal with the PRCA issue?
Guest speaker:
· Erik Skullerud, Director of Competitive Intelligence, Amgen International Commercial
Operations
Class 10: The pharmaceutical promotion mix
The historical expansion of the sales forces of pharmaceutical companies has led to
declining returns to sales force spending. Companies are therefore exploring other ways of
reaching physicians, including edetailing, and other Webbased channels. Direct
communication with consumers is another communication channel of growing importance,
especially in the U.S., where prescription pharmaceuticals are among the top advertising
spenders.
Required readings:
· S. Narayanan et al., Return on Investment Implications for Pharmaceutical
Promotional Expenditures: The Role of MarketingMix Interactions, Journal of
Marketing, 68, 4, October 2004, pp. 90105.
· M.Y. Trucco and S. Amirkhanova, Transforming Pharmaceutical Marketing Through
edetailing: Case Studies and Recommendations, 3rd IEEE International Conference
on Enterprise Computing, ECommerce, and EServices, June 2006.
· American Medical Association, Report 9 on DTC to the Board of Trustees, June
2006.
PART III : PHARMACEUTICAL MARKETING STRATEGY OVER THE CATEGORY LIFE
CYCLE, THE PRODUCT LIFE CYCLE, AND IN A
THERAPEUTIC AREA
Class 11: Category creation
When a pharmaceutical company launches a pioneering new drug in a new drug category, it
has to build knowledge about this new drug category, and demonstrate its value in
comparison to existing, wellknown categories. At the same time, the pioneer has to prepare
for the entry of follower drugs in the new category.
The “Celebrex” case describes how Pfizer/Searle, who copromoted Celebrex, and Merck &
Co (Vioxx) created the Cox2 inhibitor category against the wellestablished NSAIDs (non
steroidal antiinflammatory drugs), many of which were offpatent and, therefore, available at
significantly lower prices than the new Cox2 inhibitors. The case also highlights pioneer
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INSEAD MBA Programme – Prof. Angelmar – Pharmaceutical Marketing Strategy –
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follower competitive dynamics, since Celebrex had only a few months lead time in the U.S.
market before Vioxx entered as the second Cox2 inhibitor.
Case: Celebrex (INSEAD, 11/20065403)
Discussion Questions (Case Celebrex):
1. What explains Celebrex’s launch success?
2. From Pfizer/Searle’s point of view, what are the main issues for Celebrex in April
1999? What are the options, their pros/cons, and what would you recommend?
3. From Merck’s point of view, what are the main issues for Vioxx in April 1999? What
are the options, their pros/cons, and what would you recommend?
Suggested reading:
· V. Shankar, “Pioneers’ Marketing Mix Reactions to Entry in Different Competitive
Game Structures: Theoretical Analysis and Empirical Illustration,” Marketing Science,
1997, 16,3, pp. 271293.
Class 12: Corporate Social Responsibility (CSR) Issues in the Pharmaceutical
Industry
The launch of the Cox2 class, discussed during the preceding class, was highly successful.
However, subsequent events, especially the withdrawal of Vioxx by Merck, resulted in a
decline of category sales and contributed to the image problem of the pharmaceutical
industry.
In this session, we will discuss key corporate social responsibility issues for pharmaceutical
marketing.
Required readings:
· J. Buckley, “The Need to Develop Responsible Marketing Practice in the
Pharmaceutical Sector,” Problems and Perspectives in Management, 4/2004.
· International Federation of Pharmaceutical Manufacturers & Associations (IFPMA),
IFPMA Code of Pharmaceutical Marketing Practices, 2006 Revision.
Optional readings:
· J.H. Barton & E.J. Emanuel, “The PatentsBased Pharmaceutical Development
Process. Rationale, Problems, and Potential Reforms,” JAMA, 294, 16, October 26,
2005, pp. 20752082.
· S. Vachani and N.C. Smith, “Socially Responsible Pricing: Lessons from the pricing of
AIDS drugs in developing countries,” California Management Review, 47, 1, Fall
2004, pp. 117144.
Class 13: Entering a category as a follower
Unlike Celebrex, which created a new drug category, Lipitor was the fifth drug to enter the
wellestablished statin category, ten years after the pioneer. The category was dominated by
powerful competitors (Merck and BristolMyers Squibb), who drew a significant share of their
sales and profits from the category. The “Lipitor (A)” case describes Lipitor’s entry and the
subsequent market dynamics, which vaulted Lipitor within two years to the number two
position in the category with $2.2 billion sales. The Lipitor (B) case, which sees the now $5
billion Lipitor closing in on Merck’s Zocor, describes the threat to the entire category resulting
from the highly publicized deaths associated with Bayer’s Lipobay/Baycol statin drug, and the
threat to Lipitor represented by a forthcoming new entrant, AstraZeneca’s Crestor.
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INSEAD MBA Programme – Prof. Angelmar – Pharmaceutical Marketing Strategy –
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Cases: Lipitor (A),
Lipitor (B) (INSEAD cases 10/20065404)
Discussion Questions for Lipitor (A):
1. What explains Lipitor’s successful launch?
2. From Pfizer’s point of view, what are the main issues for Lipitor visàvis Zocor in mid
1999? What are the options, their pros/cons, and what do you recommend?
Discussion Questions for Lipitor (B)
1. From Pfizer’s point of view, what are the main issues for Lipitor in mid2001? What
are the options, their pros/cons, and what do you recommend?
2. From AstraZeneca’s point of view, what are the main issues for Crestor in mid2001?
What are the options, their pros/cons, and what do you recommend?
Class 14: Generics
Generics represent an important segment of the pharmaceutical market, the size and growth
of which is driven mainly by patent expirations and governmental/payer policies toward
generics.
Required readings:
· Deutsche Bank AG/London, “Patents & market exclusivity,” AND “Generic drugs,” in
Global Pharmaceuticals, 5 August 2005, pp 6070.
· R. Nehru, Generics market analysis by country and region, Chapter 2 in Future
Growth Opportunities in Generics, Business Insights, 2006.
Guest speaker:
· MarieJosèphe Baud, President, Sandoz France
Class 15: Managing a therapeutic franchise
In addition to focusing attention on specific products, pharmaceutical companies may also
concentrate on one or several therapeutic areas, with a view to assembling a range of
products and services for managing these diseases. The “Eli Lilly and Company: Innovation
in Diabetes Care” case describes how Eli Lilly’s offering in the diabetes market has evolved
over time. It also compares Lilly’s strategy with that of Novo Nordisk, another major player in
the diabetes market.
Case: Eli Lilly and Company: Innovation in Diabetes Care
(HBS 9696077, Rev. Arpril 15, 2004)
Discussion Questions:
· How has Lilly’s offering in the diabetes market evolved over time?
· What do you think of the choices Lilly made?
· What are the main issues Lilly faced in the diabetes market in 1995, the main options,
their pros/cons, and what would you recommend?
Optional reading:
· R.Z. Goetzel et al., “Return on Investment in Disease Management: A review,” Health
Care Financing Review, 26, 4, Summer 2005.
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INSEAD MBA Programme – Prof. Angelmar – Pharmaceutical Marketing Strategy –
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PART IV : PHARMACEUTICAL MARKETING ORGANIZATION
Class 16: Panregional marketing
Most pharmaceutical companies have countrybased marketing and sales organizations.
Pharmaceutical companies also have a reputation of being rather productfocused.
In this class, we will be discussing a business unit of Eli Lilly, which is operating at a regional
level and aims to be highly customerfocused.
Case: Lilly Critical Care Europe (CCE). The case will be distributed prior to the class.
Discussion Questions:
· What are drivers and obstacles to panEuropean marketing in the ACS and sepsis
markets, and how has Lilly CCE overcome the obstacles?
· How well has Lilly CCE been responding to the needs of its customers in the ACS
and sepsis markets? What accounts for Lilly CCE’s customer focus?
· What, if anything, should Lilly CCE change to improve its performance with ReoPro
and Xigris?
· What growth strategy do you recommend for Lilly CCE?
· How easy is it for GSK to copy Lilly CCE?
· Which aspects of Lilly CCE should be generalized throughout Lilly?
Guest speakers:
· Dr. Jürgen Raths, Head Lilly Critical Care Europe
· Dr. Jürgen Günther, Customer Operations Manager, Lilly Critical Care Europe
Optional reading:
· S. Chacour & D. Amar, Taking the panEuropean approach pays dividends, SCRIP
Magazine, November 2001.
Deadline for submitting your project:
Wednesday, June 27
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INSEAD MBA Programme – Prof. Angelmar – Pharmaceutical Marketing Strategy –
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About the instructor
Reinhard Angelmar is The Salmon and Rameau Fellow in Healthcare
Management and Professor of Marketing at INSEAD. Other institutions
at which he has held appointments include the Sloan School (MIT),
Stockholm School of Economics, and the University Paris Dauphine.
At INSEAD, Professor Angelmar has taught in the MBA program, the PhD
program, and in many executive development programs. He has directed
INSEAD’s openenrolment International Marketing Programme, and
tailormade programs for companies including Eli Lilly, HewlettPackard, JanssenCilag, and
Pfizer. Other companies with which he has been involved include Almirall, BristolMyers
Squibb, Ipsen, Novartis, and Novo Nordisk.
Professor Angelmar received his undergraduate education in economics and business
administration at the Vienna University of Economics and Business Adminstration in Vienna,
Austria, and then went to Northwestern University, Evanston, under a Fulbright scholarship,
obtaining an MBA and a PhD degree at the Kellogg School of Management. His dissertation
won an award from the American Marketing Association.
Professor Angelmar is the coauthor of three books and has written numerous papers
published in journals including the Journal of Marketing, Journal of Marketing Research,
Journal of Medical Marketing, Journal of Industrial Economics, European Journal of
Operational Research, and Organization Science. He has also written many case studies,
which are used in business schools around the world. Case studies on the pharmaceutical
industry which he has written or is currently writing include “Advanced Drug Delivery
Systems: The Partnership between CibaGeigy Pharmaceuticals and Alza Corporation” (with
Y. Doz); Amgen Europe in the Renal Anaemia Treatment Market; Prescription for Trial:
Baycol/Lipobay; Celebrex; Lilly Critical Care Europe; NICE or Nasty? Access and
Reimbursement of Multiple Sclerosis Medicines in the UK; Johnson & Johnson; Organon
France; and “Zantac” (with C. Pinson) (winning case in the Marketing category, 1994, and
Overall Winner, 1998, European Case Clearing House Awards). Professor Angelmar is also
a court expert for pharmaceutical litigation.
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