The third -- and what some retailers say could be the biggest -- entry to the booming prescription to over-the-counter H2 antagonist segment is expected to hit supermarket shelves early this year.
Zantac 75, from Warner Wellcome Consumer Healthcare, London, received OTC clearance from the Food and Drug Administration late last month. The company, which said the drug will be available early this year, has yet to announce pricing or an exact ship date.
Indicated for the relief of heartburn, acid indigestion and sour stomach in adults and children 12 years and older, it initially will be sold in 4-, 10-, and 20-tablet packs. One tablet contains 75-mg of the active ingredient ranitidine hydrochloride. Some retailers predict it will be a heavy hitter in the antacid H2 antagonist segment, gaining more sales than its predecessors: Pepcid AC, from Johnson & Johnson/Merck, Fort Washington, Pa. and Tagamet HB, from SmithKline Beecham, Pittsburgh, both of which received OTC approval last year.
"I expect Zantac 75 to be the biggest because more people are familiar with the name," said Rebecca Litchet, a staff pharmacist for Dillon Cos., Hutchinson, Kan., a subsidiary of Kroger Co., Cincinnati. "Tagamet is a big name too, but for the last several years more people have been using Zantac, at least in our area."
Zantac 75 will be a low-dose version of the prescription drug Zantac, which received approval as a prescription drug in
1983 and went OTC in the United Kingdom in January, 1995. Its recommended dose for adults and children 12 years of age and older is one tablet swallowed whole with water, not to exceed two tablets in 24 hours. When used as directed, Zantac can be taken at the maximum daily dose for up to two weeks. Though pharmacists polled by SN think Zantac 75 will be the most popular of the H2 antagonists, they don't fear it will significantly erode sales of its prescription counterpart. Despite the popularity of Pepcid AC and Tagamet HB, sales of their prescription forms have remained stable at Fred Meyer Inc., Portland, Ore., said Marc Watt, pharmaceutical buyer for the chain. "So far, we haven't seen a drop in the prescription H2 blockers," said Watt.
One of the main reasons for this is that between 60% to 70% of Fred Meyer's pharmacy customers are on third party plans, which typically don't cover OTC products, Watt said. Most retailers polled by SN feel that Zantac 75 will gain sales from customers who currently aren't using anything to treat heartburn. More than 200 million Zantac prescriptions have been written in the U.S. since its approval, according to Warner Wellcome.
"There's a pretty good chance Zantac 75 will be No. 1," said Marvin Moen, director of pharmacy operations, Coborn's, St. Cloud, Minn. Along with its name recognition, Zantac 75 could become the market leader because it will not have any significant drug interactions when co-administered with 29 commonly used drugs. Tagamet's package directions, on the other hand, include a statement that patients taking theophylline, warfarin or phenytoin should consult their physician before taking the medication. "I had more concerns about Tagamet going OTC than Pepcid or Zantac, because of the drug interactions that are more likely to happen," Litchet of Dillon said.
Zantac 75 will be backed by the largest marketing campaign in the history of Warner Wellcome Consumer Healthcare, a joint venture by Warner-Lambert and Glaxo Wellcome, according to Warner-Lambert. Bob Casale, vice president, gastrointestinal marketing at Warner Wellcome, declined to say how much will spent, but said it will be competitive with Johnson & Johnson/Merck and SmithKline Beecham, both of which reportedly spent $100 million to promote the introduction of their H2 antagonists. The program will include radio, print and television advertising.
One concern with the growing H2 antagonist market is shrink. Because of their higher price points, the H2 antagonists are prime targets for shoplifters. Pepcid and Tagamet range in price from about $2.50 to $9, depending on the count.
Coborn's has been finding empty packages of Pepcid and Tagamet on its shelves, said Moen. Because of this, it may consider merchandising the H2s in a security cabinet in the lobby of the pharmacy. This would be a last resort because, since the pharmacy has different hours than the supermarket, the products would not be available as readily as they are now.