To make a winner out of Invega, a follow-up to its Risperdal blockbuster, J&J will have to overcome several hurdles. In an investor note today, Bob Hopkins of Lehman Brothers offers insights gleaned after dining with two unnamed psychiatrists.

Both drugs come from the same molecule, which means they’re similar. Docs are loathe to switch patients who are doing alright with some other med or may see little use in switching patients for whom Risperdal isn’t working. Generic Risperdal is due next year, so a more expensive Invega is a hard sell. And the black box warning about heart rates doesn’t help.

The cure? Promotion. “The docs…suggested pyschiatrists are much more willing than most other specialties to buy into a strongly delivered marketing message, given the current dynamic of their market (lots of work and ‘much’ less pay than other medical specialties).”

Off-label prescribing should help: “Only 25 percent of Risperdal sales are in the anit-psychotic indication and Invega will only carry an anti-psychotic label, but doctors’ high comfort in prescribing these drugs off-label should not make this a significant hurdle to adoption.”

In the end, Hopkins is somewhat bearish. Success, he believes, “will come down to marketing and JNJ’s ability to get this drug on formularies across the country.” Given the controversy over the push to prescribe anti-psychotics - the flap over Zyprexa and Eli Lilly’s documents is a recent example - the Invega marketing effort could make for quite a show.

[tags]Eli Lilly, Invega, Johnson & Johnson, Risperdal, Zyprexa[/tags]