Despite elective surgery deferrals, meeting cancellations and the overall chaos of a pandemic, one company reported a sales INCREASE in large part because of the pandemic and the attendant surgery delays. That company was Flexion Therapeutics Inc. which reported $15.4 million in ZILRETTA net sales for the quarter ended this past June 30.
Used for the management of osteoarthritis knee pain, ZILRETTA is an intra-articular injection. Approved by the FDA on October 6, 2017, ZILRETTA provides extended pain relief.
Initially, demand for ZILRETTA fell when the pandemic hit. However, in the second quarter Flexion experienced month-over-month growth for ZILRETTA and the addition of new accounts. All this occurred as Flexion temporarily paused manufacturing and its sales team temporarily worked from home.
OTW spoke with Michael Clayman, M.D., president and chief executive officer of Flexion, about the unexpected surge in demand for ZILRETTA. Dr. Clayman identified three reasons for the increased demand.
Initially, the pandemic cancelled all elective surgeries, including those procedures for individuals with advanced knee pain. This created a demand from patients who would have otherwise had surgery. However, once hospitals began to reopen, some patients continued to opt out of surgery. Elderly patients were hesitant to go to the hospital for surgery because of the increased health risks. Younger patients were prioritizing work over surgery amid economic uncertainties.
Dr. Clayman told OTW, “You put all three of those elements together: delayed because elective surgeries are limited, delayed because a patient says, ‘I’m concerned about my health and being in the hospital,’ delayed because somebody has said, ‘I’m going to prioritize income generation over getting my knee replaced’—you have built now a repository of patients who have very advanced pain and can benefit from ZILRETTA.”
Since March 31, 2020, ZILRETTA’s growth has included 186 new accounts. The sales reps, called musculoskeletal business managers, worked diligently during the second quarter. Albeit from home most of the time. Instead of doing in-person visits, the sales reps called on existing accounts, as well as new healthcare practitioners.
Dr. Clayman commented to OTW, “In the second quarter, there was an increase of 25,000 calls made compared to the previous quarter.” While safety remains a priority, the sales reps are now back in the field.
Positive news for businesses is reassuring in these uncertain times. Dr. Clayman remarked, “While the future impacts of the pandemic remain impossible to predict, our confidence in both the near and long-term prospects for ZILRETTA remains undiminished.”

