1. A clinical trial found that 65% of men with lower urinary tract symptoms (LUTS) did not report significant symptom improvement after 3 months of treatment with an alpha-blocker drug.
2. Improvement was defined as a decrease of more than 3 points on the International Prostate Symptom Score (IPSS). Only 35% of patients met this threshold of improvement.
3. The results suggest that over half of men with LUTS may not experience meaningful relief of their symptoms from short-term alpha-blocker therapy alone.
3. 65% of Men with LUTS Did Not Improve
While Taking an Alpha-blocker
In controlled prospective clinical trial,
After 3 months of alpha-blocker
treatment, men with LUTS did not
report symptom improvement
Not
Improvement was defined as Improved Improved
> 3-point decrease in IPSS 65% 35%
(n=44) (n=24)
Adapted from Lee et al. Illustrative Data
4. Over 50% of Men with LUTS Did Not Significantly
Improve after 3 Months of Alpha-blocker Therapy
Patients report that urgency, frequency and nocturia are the most bothersome symptoms
Percent of LUTS Patients Bothered after
3 Months Treatment with Alpha-blocker vs. UK-369
(% Mean Estimates)
0.60%
0.55%
0.50%
% of Male LUTS Patients
0.45%
0.40%
0.35%
0.30%
0.25%
0.20%
0.15%
0.10%
0.05% Flo o r
pt ete
ria
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y
e
y
g
nc
nc
c
nc
n
w
g
Po
an
ini
yin
tu
Em mpl
ue
ge
ine
sit
c
ra
No
Ur
eq
nt
co
St
He
Fr
co
In
VOIDING
In
STORAGE SYMPTOMS
SYMPTOMS
Illustrative Data
5. Cost of Capital Setting
Performance Standards
Cost of Capital Performance Standards
Other 2.00% 2%
2%
13% Budgeting 2%
2%
Process
2%
33% 1.55% 2% 2% 2%
1%
1.10%
1% 1%
1% 1%
1%
0.65% 1%
1% 1% 1%
Cost of 0%
0%
Capital 0%
54% 0.20%
A B C D E F G
Better Good Best
Performance-based Option is Clear Winner!
6. Aligning Performance Measures
and Incentives
Three Key Questions
Return on invested capital?
Cost of capital?
Management Compensation?
– Variable: 25–30%
– Stock ownership required
Senior Management Other Management
<1% of employees >99% of employees
Corporate performance measure Non-corporate operational and individual measures
Capital + Compensation =
10. Defendant’s O2OPTIX Net Sales
December 10, 2001:
Injunction granted
$400,000
January 7, 2002:
$255,000 CIBA Vision sends out
corrective letters to Eye
Care Professionals
$200,000 $200,000
September 20, 2001:
Vistakon seeks
court order for
injunctive relief
August 2001:
CIBA Vision begins
disseminating
false claims in $75,000
sell-sheets
and journal ads
$8,000
August September October November December January
2001 2002
11. CIBA Vision Corporation
Michael Kehoe
Chief Executive Officer
Henna Inam
President
MARKETING RESEARCH & FINANCE MANUFACTURING HUMAN INFORMATION LEGAL
DEVELOPMENT RESOURCES TECHNOLOGY
John McKenna MK Raheja Ray Greer Johanna Hough Christine Tsichlis Ray Greer R. Scott Meece
Chief Marketing Officer Vice President Chief Financial Officer Vice President Manager General Counsel
Mary Smith Timothy Walter Kathleen Casey Cliff Haskel Generalists (3) Specialists (9) Associate GCs (13)
Vice President Director Vice President Manager
Jeannie McBain Kimba Van Camp George Duck Tom Foristel
Director Manager Director Manager
Kathy Long Ian Everett Sean Higgins Alan O’Neil
Manager Manager Manager Director
Sales Reps (100) Product Teams (10) Analysts (15) Harriet Tolvey
Quality Assurance
Line Specialists (40)
12. (4) Vistakon Challenges CIBA Vision’s Claims
• 2005
– Introduced CIBASOFT Progressive Toric – a
specialty toric multifocal lens that provides
presbyopic, astigmatic patients with excellent
intermediate and near vision without
Vistakon questions the
compromising distance acuity. veracity of this claim . . .
– Opened a multi-million dollar manufacturing
facility in Singapore to expand production of
Focus DAILIES lenses.
• 2004
– Introduced O2OPTIXTM - a high-oxygen,
breathable daily wear contact lens that provides
whiter, healthy-looking eyes.
– Introduced AQuify® 5-Minute Multi-Purpose
Solution that cleans, disinfects, moisturizes and
stores all kinds of soft contact lenses including
silicone hydrogels.
• 2003
– CIBA Vision improves customer focus by
expanding our North America sales force.
– AOSEPT® Clear CareTM becomes the first
one-bottle peroxide lens care solution cleared Vistakon questions the
for use with rigid gas permeable lenses in the veracity of this claim . . .
United States.
13. Undue Experimentation
A chemist has two options to get an enantiomer:
1 Separate the racemate into left and right enantiomers
2 Use chemical substitution to create the enantiomer “from scratch”
H
H
O
H