Xatral XL, an alpha-blocker licensed in the treatment of Benign Prostatic Hyperplasia (BPH) for 12 years, became the first drug to receive a licence extension to include the treatment of Acute Urinary Retention (AUR) for men aged 65 years and over. UK clinicians routinely treated AUR with alpha blockers at the time of emergency admission. However, research showed that they didn’t differentiate between the alpha-blockers when treating AUR. A major new study, ALFAUR, provided the evidence base for Xatral XL’s new licence and proved for the first time that not all alpha blockers worked in the same way in AUR. With this platform of evidence, we were charged with using Sanofi-Synthelabo’s annual urology meeting to dispel the ‘class effect’ myth in AUR and gain competitive advantage for Xatral XL.

WHAT WE DID:

We convened a multidisciplinary group, including urologists, a medico-legal expert and clinicians experienced in implementing successful protocols, to advise on the meeting format. The field force attended a two-day training conference on medico-legal issues and the production of treatment protocols and then identified who had the greatest influence to change formularies in their regions. Those identified were then invited to the meeting. We devised a novel agenda, using well-respected, influential speakers, and including an element of ‘theatre’. The meeting was branded with an innovative ‘Bond’ theme of ‘Licensed to Rx?’ to reinforce the message that AUR efficacy was not a class effect. Strong clinical content allowed the Royal College of Physicians (RCP) to allocate three Continuing Professional Development (CPD) accreditation points to the meeting. We also produced a meeting-in-a-box toolkit to ensure that the messages from the meeting were cascaded down to the wider clinical community. The toolkit included an electronic protocol, which was flexibly designed to enable units to develop their own evidence-based AUR protocols. This worked as an access item for the sales force to ensure effective follow-up and secure local speaker meetings, facilitated by the attendees at the national meeting.

THE RESULTS:

• 94 KOLs with formulary influence attended the meeting, 94% of whom rated it as ‘excellent’
• Three qurters of urologists increased their prescribing of Xatral XL because of the licence and evidence – more than three times the European average
• 95% of those not already using the brand said that following the meeting they would change their treatment of choice to Xatral XL
• In AUR management Xatral XL’s market share increased by 16%
• Xatral XL was listed on 57 shared care protocols and added to 11 new formularies
• A total of 80 regional meetings were held using the meeting-in-a-box material between Feb-April 2004