More Challenges For Brand Launch Success In The New Normal

The drug manufacturers’ life blood to drive business growth has always been successful new product launch. However, this task has always remained a tough challenge to crack, since last so many years for various reasons. According to McKinsey & Company: “About two-thirds of drug launches don’t meet expectations. Improving that record requires pharmaceutical companies to recognize the world has changed and adjust their marketing accordingly.” Several research studies have been carried out by now to gain actionable insight on this issue.

Existing challenges for successful drug launch got further amplified, as Covid-19 pandemic added a novel dimension in this space. It involves disruptive changes in many facets of customers’ new product-value expectations. Similar changes are witnessed in the product value delivery process, doctor-patient engagement, content development and delivery platforms, among others. This article will explore this area from successful new product launch perspective, in the days ahead.

Dismal outcome of many new drug launches – more for primary care:

According to a recent study, published by L.E.K Consulting on December 18, 2020: ‘About half of all products launched over the past 15 years have underperformed pre-launch consensus forecasts by more than 20%.’ This is quite in line with what McKinsey & Company found in 2014, as quoted in the beginning of this article.

However, in a relative yardstick, the primary care market has been the most vulnerable, which continues even during the ongoing pandemic. For example, according to an April 2020 Evaluate Vantage analysis, ‘Covid-19 adds a new danger to drug launches.’ The study emphasized, new drug launches, especially those targeting the primary care market, are particularly vulnerable as the pandemic continues. The key reason being, besides widespread disruptions in the health care system, sales teams will be physically unable to reach frontline physicians, as much as, and also the way they could do the same in the old normal. The studies underscore that a strong launch is critical to achieving maximum commercial potential, despite odds.

Some pivotal factors demand a greater focus than ever before:

After in-depth analysis of various studies in this area, some pivotal marketing factors appeared critical to me, in order to reduce success uncertainty while launching new products.

Alongside, unbreachable and agile supply chain alternatives also assumed a never before-frontline-importance in the new normal, unlike pre-Covid days. Another recent study, titled ‘Competitiveness During Covid-19 Pandemic: New Product Development and Supply Chain Agility’, published by ResearchGate in October 2020, vindicated the point.

As the title indicates, the above study examined the effect of new product development and supply chain agility to gain competitiveness during the Covid-19 pandemic and probably beyond. Thus, while developing and launching new products in the new normal, some pivotal factors, such as the following, appeared critical to me, in order to reduce success-uncertainty while launching new products:

  • Early planning for launch with a robust market access strategy, better sales forecasting with stretch goals – supported by state-of-the art forecasting tools and relevant learnings from the past.
  • Gaining actionable insight on changing customer needs, market dynamics and competitive threats in the new normal – by generating credible and contemporary data and leveraging the power of analytics – to offer differentiated stakeholder value.
  • Driving home patient-centric coeval product values that will delight customers – through flawless execution of stakeholder engagement strategies.
  • Working out virtual, innovative, personalized and impactful alternatives to some critical launch related physical events, such as, conferences, seminars, webinars and the likes, for doctors and other customers.
  • Developing creative and contemporary content and other marketing assets for significant online or omnichannel presence of new brands – supported by video clips and other tools, aiming at the target audience.
  • Differentiating the launch product clearly from those of the nearest competitors, where a focus on price-value relationship of the brand – from the patients’ perspective, could play a game changing role. As McKinsey & Company also highlighted, launching an undifferentiated product in an unestablished disease area carries a greater risk of failure.
  • Creating a robust and agile supply chain to navigate through unexpected market changes – as all experienced recently.

Delivering ‘patient-centric’ real value of the brand together, is critical:

Interestingly, L.E.K Consulting has also emphasized in its recent study that to drive and effectively deliver ‘patient-centric’ real value of new products, it is imperative for drug companies to execute the launch process flawlessly.

To make it happen on the ground – at the moment of truth, careful selection of a team of self-motivated people is necessary. This needs to be followed by intense training in all aspects of the specific launch, including effective use of modern digital tools and platforms – and above all – by creating a ‘can do’ team spirit to deliver the deliverables.

This requirement has been epitomized in the recent article, titled ‘Beyond the Storm: Launch excellence in the new normal,’ published by McKinsey & Company. Therein, the authors articulated, ‘Intangible though it may sound, great launches have a different feel from normal launches. There is a real sense that – we’re all in this together.’

Pharma’s current way of using digital platforms doesn’t satisfy many doctors: 

Over the last one year, as the pandemic brought all human activities virtually to a grinding halt, there has been a significant shift towards digital tools and online platforms, including in the way medical practitioners interact with drug companies. As recent surveys indicate, pharma customers don’t seem to be quite satisfied with the way many pharma players are currently making use of this technology.

This is happening even with those doctors who are open to virtual engagement and in favor of remote patient consultations. The issue needs to be resolved soon, particularly for new product launch successfully – using digital platforms, as reported in recent surveys.

The survey reports retraining of ‘sales reps to become digital orchestrators’:

One such recent survey, conducted by Indegene, which was also reported by Fierce Pharma on February 01, 2021, digital dissatisfaction of doctors with pharma companies, has jumped during the pandemic. The rates of dissatisfaction with pharma digital interactions, across media channels, ranged from 23% to almost 50% of physicians. Some of the key findings of the study include:

  • 49% of physicians are not happy with pharma’s social media engagements – perceived as less sophisticated when compared to expectations set by consumer companies.
  • Pharma is far from providing a satisfactory digital experience, as compared to other industries. The current dissatisfaction level where a higher percentage of doctors were dissatisfied, include marketing emails – 46%, telephone sales calls with sales reps – 42% and both webinars and websites – each at 39%.
  • In-person meetings dropped from 78% to 15% during the pandemic, but even now only 48% of doctors surveyed expect in-person engagements to continue in the post-COVID world.
  • Attendance at medical conferences also dropped from 66% to only 16% during the shutdowns and travel restrictions, but only 50% of HCPs now expect to resume in-person congresses after it’s safe to hold them.
  • The number of physicians engaged in remote sales visits increased from 11% to 47% during the pandemic, probably because there weren’t other alternatives available. Interestingly, one-third of physicians still plan to continue with virtual sales meetings even after the pandemic.
  • Most stakeholders are realizing, this is going to be the new normal, with senior pharma leadership also saying, ‘it’s never going to be the same as before.’
  • About 5 of the top 15 global pharma players are retraining their sales reps to become “digital orchestrators” and working to help them create clear and comprehensive digital communications for doctors.

Speedy resolution of these issues is likely making a substantial difference in improving pharma-to-physician interactions, particularly during new drug launches, in the days ahead.

Conclusion:

Success uncertainties in new product launches have always been a cause of concern for the drug industry, especially after having invested a substantial resource towards innovation and clinical developments. Interestingly, pharma players were mostly following ‘stick to the knitting’ dogma, as it were, in their launch planning. Despite the availability of sophisticated digital tools and analytics over the last several years, particularly in generating and accurate analysis of contemporary and credible data to gain insights, not much had changed radically. Suddenly Covid pandemic disrupted most market traditions, business processes, and the general belief on decision makers’ ‘gut feelings’ on customer behavior, market dynamics. Besides, the mindset of ‘doing better that what you have been always doing’, prevailed in many cases. In India, market research for most companies remained within the ambit of syndicated retail and prescription audit, despite frequent grumbling of many marketers on some critical findings of these reports.

The last one year has created more challenges in this area, although with a silver lining. A large number of drug companies have now stepped into the area of digital marketing – in varying degree, scale and resource deployment. This shift is expected to help reduce launch success uncertainties of new drugs. It will again, depend on how effectively the technology is leveraged by the cerebral power of astute markers.

Another article on pharma product launch, published by McKinsey & Company on December 15, 2020, also vindicated this point. It underlined: ‘As pharmaceutical companies reshape their commercial model to prepare for the uncertainties ahead, personalization and digital enablement will be crucial to launch success in the new environment.’

Amid these, as some surveys highlight, many doctors are not satisfied with the way digital technology is being currently used by pharma companies – to interact with them and cater to their information needs. With these ‘teething troubles’ being properly and promptly addressed, many drug companies, I reckon, will be able to remarkably reduce success uncertainties of new drug launches in the new normal.

By: Tapan J. Ray     

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

 

Create Purpose-Driven-Brands To Win Marketing Warfare In The New Reality

As we navigate through the Covid days, the hope of somehow getting back to the pre-pandemic normal still lingers – notwithstanding a host of uncertainties in its way. The longing is driven by the hype of availability of scientifically proven, safe and effective drugs and vaccines – unrealistically soon, despite top experts still keeping their fingers crossed. Some are even more forthright in their expression, as reflected in a September 30, 2020 report. It flashed a headline - “There is no getting ‘back to normal. The sooner we accept that, the better.”

Alongside, COVID-19 crisis has also triggered some disruptive changes in the business processes around the world. Amid this global health crisis, interestingly, several global pharma CEOs are sensing a number of game-changing opportunities – having business implications, even much beyond the pandemic.

One such example, as Bloomberg reported on September 29, 2020, the CEO of GlaxoSmithKline Plc feels: The Covid Pandemic is ‘a Shot at Redemption in Pharma Industry.’ Elaborating the point, she said: ‘the sector’s push to find vaccines and drugs to end the crisis, if successful, could change the perception of pharmaceutical companies in the future.’ Coincidentally, the researchers from The Harris Poll found:

  • As of May, 40 percent of the American public said pharma’s reputation had improved since the beginning of the COVID-19 outbreak
  • And 81percent recalled seeing or hearing something about the industry during that time.
  • This is a continuation of the former trend that The Harris Poll first noted on March 2020.

There shouldn’t much doubt, either, that similar general impression on the pharma industry, with a varying degree, may now be felt in most countries, across the globe.

Curiously, flowing from this ‘redemption of pharma reputation’ angle – with new drugs and vaccines, the scope for leveraging another opportunity is also surfacing. This is from pharma ‘branding’ perspective and pertains to creating ‘purpose-driven brands’ for success in the new reality – during the pandemic and much beyond. In this article, I shall focus on the second area, and would start with its relevance to increasingly more informed health care consumers of date.

‘Purpose driven brands’ – attained greater relevance in Covid time:

The concept of creating ‘purpose driven brands,’ is profound – it goes much beyond product features, benefits and intrinsic values. It is motivated by – why the brands exist not just for providing a solution to manage or cure a disease, but also to meet a crucial need in society.

Studies have unfolded, with better stakeholder connection – and greater share of their mind, ‘purpose driven brands’ help improve brand loyalty, resulting into increased revenue and profit. We will see below, why in Covid time, this trend has started gathering wind on its sail, and deserves to find its place at the very core of any pharma branding strategy.

The consulting arm of The Beautiful Truth, also echoed the same sentiment in the article – ‘How Pharma Can Navigate Change With Purpose.’ It reconfirmed, at times of external crisis, like the global pandemic, creation of ‘purpose-driven brands’ is vital. Not just ‘for saving and maintaining business, but also for boosting internal team morale, and reconciling public trust.’

The pandemic has redefined the core purpose of a brand:

Another recent article –‘Through COVID-19, Leading Brands Have Found Their Purpose,’ published in CMO by Adobe, among many others, vindicated this point. Acknowledging that the COVID-19 pandemic has redefined the meaning of brand purpose, the paper explained the reason for the same.

In pre-Covid days, many organizations used to build brands following traditional norms – curing or effectively managing a disease is the purpose of a brand. But, since last few years, a growing number of new generation health care customers expect a brand’s ‘purpose’ to expand beyond the product and the company. It has to be inclusive in nature – benefiting the macro-environment, including governments, health care professionals, and the public. With this expectation gathering momentum during Covid time, pharma players would also need to redefine the core ‘purpose’ of a brand. Incidentally, many pharma CEOs also believe, if this trend continues, the image of the industry would probably undergo a metamorphosis.

Surveys vindicate the rationale for redefinition:

Several top consulting organizations have published excellent articles covering a number of critical points in this area. One such paper - ‘Purpose is everything,’ was published in Deloitte Insights, on October 15, 2019. It wrote on how brands that authentically lead with ‘purpose’ are changing the nature of business today.

The rationale for redefinition of brand purpose, also gets reflected in a contemporary Deloitte survey, as quoted in the above article. It revealed the following top three issues that stakeholders identify with, while making decisions about brands: 

Top Issues

% of respondents

How the company treats its own people/employees

28

How the company treats the environment

20

How the company supports the community in which it operates

19

Aligning purpose to create deeper connections with stakeholders:

Especially at the Covid time, if companies try to align their purpose in doing good – for the society, they can build deeper connections with their stakeholders. And, in turn, amplify the company’s relevance in their stakeholders’ lives. From this perspective, it’s good to note in the above Bloomberg article, that one of the top pharma CEOs articulating the same in public. I reckon, increasingly, pharma businesses would endeavor harnessing the power and opportunity of aligning the ‘core purpose of brands’ with societal good, as came out in the above Deloitte article.

Mostly millennial generation favor ‘purpose-driven’ brands:

The initiation of this trend dates back to pre-Covid time with wider usage of internet. However, with the increasing democratization of health care - social media based instant information sharing, the ability to communicate with others as needed, have increased manifold. Consequently, stakeholders, particularly, the millennial generation with a different mindset, aspirations and expectations are expecting pharma players to act more on the pressing societal issues. This makes them lean towards a purpose driven brands and companies. The unprecedented Covid health crisis is acting as a force multiplier in this area.

Another study – ‘Why Customers Are Supporting ‘Purpose-Driven’ Brands,’ published in Link fluence epitomized this evolving customer preference succinctly. It reiterated, ‘It’s no longer enough for brands to deliver great products and experiences. Instead, consumers are demanding for brands to be more proactive and conscious in delivering value to society as a whole.’

‘Purpose-driven brands’ – the latest ‘marketing buzzword’?

This question was conclusively answered about two years ago -  from the 2018 Cone/Porter Novelli Purpose Study. Although, this survey was conducted in the United States, it has a global relevance amid Covid pandemic. Some of the key findings include: 

  • 78 percent believe companies must do more than just make money; they must positively impact society as well.
  • 77 percent feel a stronger emotional connection to Purpose-driven companies over traditional companies.
  • 66 percent would switch from a product they typically buy, for a new product from a purpose-driven company.
  • 68 percent is more willing to share content with their social networks over that of traditional companies. 

Examples of ‘purpose-driven’ pharma brands/companies:

Let me give just two examples each – from pre-Covid and Covid times. The article – ‘Mission-Drive Pharma Brands,’ published by Wonder on January 15, 2018, cited several examples of ‘purpose-driven’ pharma brands. This was based on a research of individual drug campaigns for top-selling drugs around that time. These include promotional campaigns on:

  • Humira: Highlighted the participation in a community food drive, and volunteering in a playground construction project.
  • Lyrica: Highlighted the engagement in a multi-generational interaction and helping others.

Encouragingly, while combating COVID-19, several pharma companies have also displayed a sense of ‘purpose’ to save the humanity from the pandemic, mainly through collaborative approaches. Let me quote below two such examples:

  • On April 14, 2020 GlaxoSmithKline and Sanofi announced a very unusual collaboration to develop a COVID-19 vaccine, expeditiously. This was done for a greater purpose, responding to the critical need of the society – saving millions of lives.
  • Roche called on and campaigned for the governments for focusing on testing and prevention, to maintain adequate medical supplies for health care professionals  around the world. It also urged the health authorities to work closely with the life sciences industry to tackle the Covid-19 pandemic through international collaboration to tackle Covid-19 pandemic.

Conclusion:

Meanwhile, as on October 04, 2020 morning, India recorded a staggering figure of 6,549,373 of Coronavirus cases with 101,812 deaths. Still there is no respite from Covid-19’s unprecedented onslaught on the country. Be that as it may,  coming back to the creation of ‘purpose-driven brands’ in the Covid time, let me quote again from the above CMO by Adobe article, where it underscored:“Never before have brands been asked to show their true purpose and leadership as they are today. It’s inspiring to see companies across industries and throughout the world come together to address some of the most pressing needs brought about by this crisis.”

As Accenture had articulated: ‘In an era of radical visibility, technology and media have given individuals the power to stand up for their opinions and beliefs on a grand scale.’ Keeping this in view, with gradually changing stakeholder mindset and expectations, the ‘purpose of a brand’ deserves to be a critical centerpiece in the pharma ‘branding’ process. Various studies have established – since pre-Covid time, and more during this pandemic – brands, reflecting a robust sense of ‘purpose’ on societal values, people and the environment, connect better with customers.

Consequently, as the stakeholders find these companies walk the talk, they develop a strong and sustainable brand preference, and reward the manufacturers commensurately, both directly and also through word of mouth. Alternatively, if the stated ‘brand purpose’ is not genuine – which customers can quickly find out through digital transparency, they shift their preferences to the deserving ones. Going by this growing trend, I reckon, creating ‘Purpose-Driven-Brands’ assumes a critical importance to win marketing warfare, in the new reality.

By: Tapan J. Ray    

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

 

Aptness Of Pharma Marketing Audit In Covid Days And Beyond

That, Covid-19 pandemic has changed the operational dynamics of many areas of the pharma industry, as compared to the old normal, is being felt by many. These changes generally fall into two categories. Some are broad industry specific changes, giving rise to a new normal. Whereas, a lot more could often be specific changes required by individual companies in the changing times – depending on how these companies were operating in pre-Covid days. The good news is, the industry specific ones are being well deliberated by many domain experts, almost on an ongoing basis.

Most experts are suggesting digital solutions, for a number of problem areas in the pharma industry as a whole. But, the reality is, for rapid adaptation of the new normal, there is also a crucial need to dovetail the Company specific solutions, with the industry specific generic ones. This effort will call for effective use of robust, well-structured and time-tested systems. However, not as many discussions seem to be taking place in this area, as on date.

As I see around, one such comprehensive and well proven approach is ‘Marketing Audit’. This can be effectively used to ascertain Company specific changes, required for successful pharma business operation during the Coronavirus triggered paradigm shift. It may not sound as zesty as a ‘digital approach,’ but remains fundamentally important for pharma marketers, nonetheless.

In this article, I shall discuss the relevance and the key importance of a comprehensive pharma Marketing Audit, in this trying time for business. Its key purpose is to give shape to a cutting-edge strategy in today’s unfamiliar order. Let me begin with a brief background of the same, for better understanding of all.

Marketing Audit demonstrated its perennial importance over decades:

To put it in perspective, let me refer to a landmark article by Philip Kotler, titled ‘‘The Marketing Audit Comes of Age.’ It was published by the MIT Sloan Management Review, on January 15, 1989. In his review of the need for Marketing Audit, one can get a sense of perennial importance of Marketing Audit, proven over decades.

In Kotler’s own words: ‘The marketing audit as an idea, dates back to the early 1950s.’ An executive at Booz Allen & Hamilton, conducted marketing audits as early as 1952. Its importance of improving business results, was captured by an excellent set of papers under the title ‘Analyzing and Improving Marketing Performance,’ published by the American Management Association, in 1959.  

Covid-19 Surveys highlight general trends, not any Company specific:

We all are witnessing these days, how the Coronavirus pandemic is changing the pharma consumers. In my June 22, 2020 article in this blog on ‘Enhancing Pharma Brand Experience in The New Normal,’ I highlighted some of the basic changes required in the traditional pharma sales and marketing practices.’ These were the generic changes in the marketplace involving the stakeholders. To illustrate this point better, let me cite some recent examples.

The pandemic has suddenly accelerated certain trends:

The lockdowns have brought to the fore certain shortcomings of the pharma industry, more than ever before. Consequently, its serious fallout compelled almost all players ‘to evaluate and adapt its roles and responsibilities almost overnight.’ This point was captured in the ‘Survey results: Accelerating digital transformation during COVID-19,’ published by Reuters Events– Pharma on September 04, 2020. Some of the survey findings included the following:

  • Although, adoption of digital engagement has accelerated, pharma’s ability to deliver exceptional virtual engagement and content is being put to test.
  • Customer Relationship Management (CRM), Content Management Systems (CMS) and customer engagement platforms were found wanting and not fully exploited.
  • There will be a greater emphasis on the Connected healthcare customer journey.
  • Providing a unique customer experience will emerge as a competitive edge.
  • The industry must re-direct resources accordingly, and re-tool to make the most of them.

Let’s now examine some India specific findings from another survey in this space.

Some India specific survey findings:

To explore the impact of COVID-19 on the Indian pharmaceutical industry, another survey, conducted by C Com Digital of India, came out with some interesting findings, some of which are as follows:

  • The new normal warrants a strategic shift in the business operation, besides engagement with doctors and patients.
  • Increasingly, drug companies are moving into online business operations from mostly offline operations of pre-Covid days.
  • Many companies are considering dedicating about 5 percent to 10 percent of their marketing budget towards creating webinars and online communications.
  • Teleconsultations and online consultations are steadily increasing and around 42 percent patients are getting their prescriptions in this way.
  • Doctor visits dropped by 5 percent only during March-April 2020 period.
  • Companies are expanding in online patient education, and online field staff training through custom made e-Learning modules.

As we find above, the emerging new trends are all generic in nature – not enough to prepare any comprehensive company specific strategy for success in the prevailing situation. This brings us to the question: What exactly is Marketing Audit and its relevance during pandemic days?

Relevance of Marketing Audit during pandemic days and beyond:

Thus, the extent of changes required on all sales and marketing related areas, during the pandemic period and beyond, has to be carefully and productively evaluated by each Company, separately. No wonder, why a comprehensive ‘Marketing Audit,’ is also considered “a marketing mirror” - so appropriately.

Without going into the theoretical details, let me first try to explain this terminology in simple terms. It has clearly been established that a Marketing Audit helps understanding, both internal and external marketing environments of an organization, in a comprehensive way. Mainly because, it involves an in-depth and data analysis of the concerned company’s business domain, not just to accurately diagnose the new areas of problems, but also to work out a contemporary – cutting edge marketing strategy.

Thus, I reckon, this tool should be effectively used by pharma marketers, as a high potential mechanism in the marketing warfare, especially during the global pandemic and beyond. Still, some can raise the question, what exactly pharma industry surveys will tell you and what those won’t, – and what gaps company specific surveys will help bridge.

The gaps that Marketing Audit will help bridge:

Industry specific surveys on Covid-19 pandemic would tell the Companies where they should aim to reach. However, each Company would still need to figure out where they currently are in those areas, and most importantly how to reach the target point. An effective Marketing Audit will help the Companies get exact information on where they currently are, and how to reach where they want to reach.

As the new normal is changing, it needs to be done periodically: 

The information obtained through a robust Marketing Audit will help address both customer and market needs – on the one hand and honing or reorganizing the company’s internal value delivery systems commensurately, on the other. However, when an unprecedented or a disruptive change, such as the Covid-19 pandemic keeps striking all conceivable entities, very hard, ‘the new normal’ keeps changing. In this situation, most of the past success ingredients will no longer yield results. Thus, to realign the business with changing market demand, pre-Covid strategic blueprint needs to be redrawn, alongside the necessary wherewithal required for the same.

Marketing Audit, therefore, becomes a periodic requirement for all organizations, assuming the importance of a key business success imperative, if not for survival in the new normal. Any delay in this area may lead to significant loss of Company business.

Conclusion:

According to Covid-19 update of Evaluate Pharma, ‘seemingly uncontrollable advance of Covid-19 in India,’ is perturbing. As on September 20 morning, the country had recorded a staggering figure of 5,400,619 of Coronavirus cases with 86,774 deaths, overtaking Brazil the week before.

The above report points out the potential danger of ‘the country’s health care system to buckle under the weight of hospital admissions for the virus.’ However disturbing this trend may be, from the pharma industry perspective, it sends, at least, four clear signals:

  • It’s a long-haul struggle for the business, as Covid-19 is not going to vanish any time soon.
  • The barriers to in-person interaction will continue for an indefinite period.
  • The market dynamics will keep changing, mostly based on Government’s new guidelines.
  • A robust, flexible, contemporary and comprehensive marketing strategy needs to be supported by stronger and time-tested marketing systems for all times.

From the above perspective, one such time-tested mechanism still remains – ‘the Marketing Audit.’ For business excellence during Covid times, it carries a game changing potential, by dovetailing the industry specific generic problems with company specific strategic solutions.

The criticality of ‘Marketing Audit’ does not remain limited just to bright pharma marketers. It also provides an equally critical top management decision support tool, especially for risk-benefit analysis of the corporate business. Thus, relevance and importance of ‘Marketing Audit’, would remain undiluted, not just during the Covid pandemic – but much beyond.

By: Tapan J. Ray   

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

Neutralize Covid-19 Impact on Drug Prices And Market Access For Faster Recovery

Covid-19 pandemic that has not spared any facet of human lives and livelihoods, has also reignited several ongoing debates related to the drug industry. The need to urgently resolve these issues grows manifold, as the real magnitude of this health crisis doesn’t seem to be clear even to the key Government decision makers.

This is vindicated by the research paper, written by government scientists and other experts, published on September 10, 2020 in the Indian Journal of Medical Research. It reveals, India had nearly 6.5 million cases as early as May 2020. Whereas, according to the health ministry, the total number cases stood at around 180,000 in late May. This happened because, ‘large numbers of cases could have gone under the radar earlier this year, because testing was limited to symptomatic patients or states had varying testing rates,’ the paper highlighted.

From the pharma industry perspective, a pandemic of such magnitude is also causing indefinite delay in pre-planned market access of several important drugs and vaccines. Some are due to technical reasons. However, many others are related to their value-based cost-effectiveness in the new normal, when the pandemic has put enormous strain on health expenditure, across the world.

In this situation, past mechanisms of new drug pricing, are required to undergo significant changes. The new yardsticks, I reckon, will be based on two critical factors. The first – the disease treatment priorities, as will be decided jointly by both doctors and patients. And the second – the paying capacity of both payers and individual patients, based on the value that each treatment will offer – again, as perceived by patients.

As it appears, the impact of Covid-19 on the pharma industry will continue till the medium term, if not beyond. Consequently, the concept of new drug pricing – based on well-documented, differential value offerings of treatments, would need to be revisited and recalibrated. This has to be realigned with evolving patient needs. Considering the emerging scenario, this article will focus on the exigency to neutralize Covid-19 impact on new drug prices and pre-planned ‘market access’ – for faster business recovery.

Covid-19 has increased the drug price sensitivity:

The challenge of increasing drug price sensitivity – triggered by the new Coronavirus pandemic, has now assumed a global dimension. A June 18, 2020 study, flags: ‘Nine in 10 Concerned About Rising Drug Costs Due to COVID-19.’ Although, this particular study (Gallup Poll) was conducted in the United States, general public apprehension is no different in other parts of the world, including India, for various reasons.

Even in America, which is considered Eldorado for pharma business, primarily for unregulated drug pricing, is also changing with the impact of Covid-19. The reason being, reported instances of drug prices are rapidly rising, amid the pandemic. As the above Gallup Poll highlights, today ‘a large majority of Americans support direct negotiations by the federal government with the drug manufacturer on the price of a treatment for the disease itself.” Interestingly, ‘significant support exists across all major demographic groups.’

Other specialists on pharmaceutical pricing and market access, also envisage that pharmaceutical companies will be faced with increased price sensitivity, and are quite concerned with the long-term impact of the pandemic on health care systems.

Covid-19 pandemic would seriously impact pharma spending:

As quoted above, several other specialists for pharmaceutical pricing and market access have also pointed out some critical Covid-19 impact areas, including:

  • Tremendous increase in pandemic related public expenditure, could prompt further austerity measures in already strained health care budgets, besides job losses or pay cuts of scores of people for different reasons.
  • The pandemic is likely to result in a redistribution of health care funding towards infectious diseases (e.g. prioritization of antivirals and vaccines) and chronic diseases associated with worsening COVID-19 outcomes.
  • This may result in more drug pricing pressure in other disease areas, besides push for increasing use of similar cheaper generics and biosimilars, unless absolutely necessary.
  • Stricter monitoring of usage of medicines, especially in private hospitals, to ensure their use within the regulatory label and/or within the reimbursed population.
  • Possibility of mandatory price cuts either across the board or for drugs which have been on the market for a specific duration.

The report also envisages, pharmaceutical companies will be faced with increased price sensitivity and decrease in willingness to pay by authorities. Consequently, the key question in this area becomes: What impact will COVID-19 have on the future of pricing and market access? And how to address this issue, effectively? 

Need for an appropriate drug pricing models in the new normal:

Overall scenario for drug pricing model has not changed much, till Convid-19 pandemic overwhelmed the world. The age-old concept of drug pricing, being treated as almost given, is changing fast. As I wrote earlier, it started in the developed world, with newer concepts, such as, Health Technology Assessment (HTA), besides a few others. However, to illustrate the point, I shall focus only on the HTA model. It includes a multi-faceted assessment of the clinical, economic, ethical, legal, and societal perspectives that may be impacted by a new technology, procedure, drug, or process.

Application of HTA in Medicine Pricing:

The ‘Working Paper 6’ of June 2013, on ‘The Role of Health Technology Assessment in Medicine Pricing and Reimbursement,’ published jointly by the World Health Organization (WHO) and the Health Action International (HAI), is worth referring to.

The paper aims to identify and describe the role of HTA in price-setting and reimbursement of pharmaceuticals, with a focus on its use in low and middle-income countries (LMICs). However, as Covid-19 is now fueling the drug price sensitivity across the globe, and not just in the LMIC, this reference will help drive home the point, as one faces today.

While combating health care resource crunch in the face of the Coronavirus quagmire, many countries are contemplating a variety of approaches to maintain affordable access to healthcare for patients. The concept of HTA is one such common approach. It includes pharmaceuticals, vaccines, medical devices, medical and surgical procedures, besides the systems within which health is protected and maintained.

Relevance of a recalibrated HTA in the new normal:

For a new drug, as the Institute For Clinical And Economic Review (ICER) puts it, a final HTA report would attempt to answer the following questions, besides a few others:

  • Is it safe and effective?
  • Which patients benefit the most?
  • Is there a meaningful improvement in health status?
  • Can all people afford to pay who might need it?
  • Will it offer a good value in the long run?
  • What other considerations make it important?

These points need to be looked at keeping in view that Covid-19 pandemic has seriously impacted the health care spending. Thus, the process needs to be recalibrated in the new normal. In any case, HTA has the potential to play a critical role in new drug pricing, by assessing the intrinsic value of medicines that can significantly expand patient-access to care. In tandem, it could maximize the value for money in health expenditure with most efficient allocation of scarce health resources, that most countries are facing today. Nevertheless, there could well be a few company or country specific barriers to capture the value of a drug or treatment, as well. A robust plan for their mitigation needs to be well-thought through, to ensure effective implementation and achieve desirable outcomes.

HTA in India:

At least, on paper HTA exists even in India. The Government of India had created an institutional arrangement called “Health Technology Assessment in India (HTAIn)”, under the Department of Health Research (DHR). It was entrusted with collation and the generation of evidences on cost effectiveness and safety of health care interventions, including medicines and devices.

The key goals are, to reduce the cost of patient care, overall cost of medical treatment, reduction in out of pocket expenditure of patients, besides streamlining the medical reimbursement procedures. Nevertheless, it remains a million dollar question whether India would leverage this system to ensure fair pricing of new drugs in India.

Some pre-requisites to implement HTA – afresh:

In those countries, where HTA for drug pricing and reimbursement doesn’t already exist, there could be several pre-requisites. These may include, as the above paper indicates, establishing a medicines regulatory system, developing and enforcing legislation, employing the appropriate technical expertise, and the allocation of sector-wide financial resources in accordance with the decisions of the organization using the HTA.

That said, the bottom-line is, the quest to arrive at fair pricing for a new drug, could also help ‘market access’, especially in a difficult time, like today’s health care crisis. In that endeavor, let me briefly dwell on the concept of ‘fair pricing a drug’.    

The concept of ‘fair pricing a drug’:

This issue has been well deliberated by many experts around the world. However, let me quote a recent article – ‘Defining the concept of fair pricing for medicines,’ published by The BMJ on January 13, 2020.

The paper articulates, ‘a fair price for a medicine is affordable to the buyer while covering the seller’s costs and providing a reasonable profit margin. Within a fair pricing zone, a specific price may be higher or lower, possibly reflecting differential value.

Interestingly, the authors also noted: ‘Applying the framework to decision making would require access to data on R&D, manufacturing, and distribution costs, which is generally not publicly disclosed. This lack of transparency about costs undermines efforts to assess the fairness of medicines prices.’

The article underscored, lack of transparency in these areas, ‘also exacerbates information asymmetry to the sellers’ advantage.’ It suggested, disclosure can be enforced through legislation, regulation, and judicial action. Or as a condition of receiving public research funds, tax benefits, regulatory approval. Or listing in a formulary for reimbursement. ‘In the absence of disclosure, decision makers may rely on reasonable estimates based on publicly available information,’ the paper concluded.

Conclusion:

As recorded in the morning of September 13, 2020, total Coronavirus cases in India have reached a staggering figure of 4,754,356 with 78,614 deaths, overtaking Brazil. This trend continues going North, as days pass by.

All-pervasive Covid-19 pandemic is fueling severe resource constraints, especially for health care. Amid this complexity, to combat this deadly virus – alongside other non-Covid related illnesses – value added drugs and treatments could help overcome many hurdles in this area. They could help improve cost-effectiveness of treatments to price-sensitive patients, besides other stakeholders.

Recalibrated HTA mechanism, which I have used in this article as an example to effectively overcome prevailing drug price sensitivity, is one among a few others. Importantly, HTA mechanism exists even in India. It can be appropriately used for new drugs and vaccines pricing, if the Government wishes to.

On the other hand, it’s up to individual companies to choose any other price-value model’ that they will deem appropriate, to arrive at a ‘fair value for new drugs’. However, the goal remains common for all - Neutralizing Covid-19 impact on drug prices and market access, to ensure faster recovery of the business.

By: Tapan J. Ray   

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

Shift from Disease Centered Care To Patient-Goals Directed Care In The New Normal

In the initial days of the first quarter of 2020, no one could fathom that just within the next 4 months over two million fellow citizens will get infected by an unknown virus, recording over 45,500 deaths. Many authorities may wish to project or analyze these Covid-19 numbers in so many different ways. Nevertheless, the fact remains, currently, in passing each day India is recording the highest count of fresh Covid-19 cases in the world, alongside the most daily deaths from the virus.

In the early days of Covid19 in India, many expected a remedial pathway to emerge soon – conventional or unconventional. Accordingly, Indian citizens across the country responded to the call of some national leaders by observing some – even unconventional measures, such as:

  • On March 22, 2014, to “boost morale” of doctors and public workers, as urged by the Indian Prime Minister, many people banged pots and pans on balconies across India.
  • On April 05, 2020, again responding to the Prime Minister’s passionate call, a large number of Indians turned off lights, lighted candles and Diyas hoping to dispel COVID-19 darkness.
  • On May 02, 2020, as organized by the Government, the country’s armed forces engaged in a nationwide exercise to express gratitude to doctors, paramedics, sanitation staff and other front-line workers involved in fighting the Coronavirus pandemic.

Gradually, the stark reality sank in, as the old normal faded out in the horizon. Public expectations arguably started shifting from heavenly interventions, as it were, to science-based measures. It has now been generally accepted that there is no alternative to social distancing and wearing a mask at the public places. These should continue, till the ‘silver bullet’ – vaccines arrive. More so, when going for herd immunity “cannot be a strategic choice or option,” given the size of India’s population, as the Government said.

Billions of people have now started hoping for the ‘silver bullet’ to come soon. This sky-high expectation continues to be fueled by media hype – based primarily by the Press Releases of the concerned companies. In the midst of these, comes a word of caution from the apex health body of the world. As recent as August 03, 2020, the World Health Organization (W.H.O) announced, ‘despite strong hopes for a vaccine, there might never be a “silver bullet” for COVID-19, and the road to normality would be long.’

To add some degree of certainty in this humongous – primarily scientific and logistical challenge to save lives, – pharma and biotech industry, as usual, are coming to the forefront. Billions of eyeballs are now glued on to them – following every bit of what they are saying – as the devastating impact of this health catastrophe is profound. Besides individual health, the fall-out of the pandemic is intimately intertwined with livelihoods, nation’s economy, social fabric and adjusting to the new way of living, including new mechanisms for most transactions.

Obviously, this would create a new normal – quite different from the old one – and naturally would include pharma business, as well. In this scenario, patients will assume a much different status, especially in the disease treatment process. More patients would likely to prefer their individual health-goals directed holistic care, which calls for a holistic disease treatment solution. The process needs to be contactless as far as practicable, less time intensive and above all cost effective

In this article, let me focus on this area. I reckon, many pharma players are also evaluating the impact of this shift to achieve business excellence in the new normal.

The current treatment approach and the pharma focus:

A recent paper, published in the JAMA Cardiology on the April 2016, made some interesting observations in this area. Citing cardiology disease area as an example, the authors noted the following, among other points:

  • Physicians’ decision-making process generally ‘concentrates on disease-specific outcomes, following practice guidelines for specific conditions.’
  • Value-based purchasing also largely focus on individual diseases.
  • However, disease-centered framework is ill-suited for persons with multiple chronic conditions, including older adults and the majority of adult health care users of all ages.
  • Disease-centered decision-making results in treatment burden when patients must adhere to multiple guidelines and harm when guideline recommendations conflict.
  • Furthermore, disease-centered recommendations may not address what matters most to these patients – varying health priorities.

The shortcomings of this approach from the patients’ perspectives, besides adding greater value for patients, prompt a need for change. From the current disease-oriented treatment approach, and pharma’s business-related focus in sync with this system.

Habit of visiting specialists at the very beginning complicates the process:

The disease-oriented treatment approach, as it is today, isn’t a legacy issue. In the good old days, General Practitioners (GP) used to examine their patients thoroughly – covering the entire body. Thereafter, depending on the specific areas of need, expert interventions used to be recommended.

However, todays well-informed people, equipped with health information of all kinds, can possibly figure out the broad outline of their health problems. Accordingly, many of them directly arrange appointment with specialists. As most of them are generally not terribly wrong in figuring out the problem areas, specialists’ treatment progresses in the same direction. Other existing health issues, not being of high priority treatment areas for persons concerned, could remain ignored, till these also flare up.

Undoubtedly this approach, even if is made ‘patient-centric’, in a broader sense, by pharma players, would cost more time, more money to patients. Besides, loss of income and increase in morbidity. This is certainly an avoidable situation for all – patients, doctors and pharma companies.

Go beyond ‘patient-centricity’ encompassing ‘patient-goals directed care’:  

The new focus should be directed towards ‘patient-goals directed care.’ This approach, which flows from a very old and a classic concept of  Sir William Osler articulated in the 19th century. This remains as relevant today for any holistic - ‘patient-goals directed care.’ It goes way beyond much hyped ‘patient-centric’ approach.

Sir William Osler once said, “The good physician treats the disease; the great physician treats the patient who has the disease.” The great physician understands the patient and the context of that patient’s illness. Accordingly, I reckon, pharma players new focus needs to be in conformance to this concept. It fits in so well with changing patients’ expectations in the new normal.

As has been evaluated in many studies, although, patient-goals directed care may appear to be particularly useful for persons with multiple chronic conditions, ‘this approach works across the age and health span, making it a compelling path toward value-based care from the patient’s perspective.’

‘Each patient represents a story’ which needs to be carefully deciphered: 

The article – ‘To Be a Great Physician, You Must Understand the Whole Story,’ published in the Medscape General Medicine on March 26, 2007, elucidated the point nicely. It said, each patient represents a story, which includes their diseases, their new problem, their social situation, and their beliefs. A physician needs to understand this story. Accordingly, perform a targeted physical examination based on the historical clues, order the correct diagnostic tests, and interpret them in the context of the history and physical exam. Once the appropriate data are collected, the patient’s story needs to be revisited, based on scientific data.

Revisiting process of the patients’ story includes making the correct diagnosis or diagnoses. The story must reveal the patient’s context – Who is this patient? – What is the patient’s goal? – How might the patient’s personal situation impact the treatment options? And more – as the above article highlights.

Each patient’s story’ is important for pharma companies, as well:

Patients’ disease related stories are of crucial importance to the pharma players, as well, for strategic reasons. Not just to gain insights on the disease manifestation process, but more importantly to facilitate a company’s engagement with them.

Another interesting article has brought out some more important issues in this area. The paper is titled, ‘Patient Centricity and Pharmaceutical Companies: Is It Feasible?’ It was published by the SAGE Journals on March 28, 2017, where the authors underscored, engagement with patients can only be possible, if there is credibility. Elaborating this point, the paper cited two GSK examples aimed at building trust with patients and physicians, as follows:

  • Change in marketing practices: In 2011, GSK eliminated prescription sales targets in the US and introduced a new incentive model for sales and marketing practices based on value and feedback from prescribers; external speakers/ convention travel support was discontinued (2016).
  • Clinical transparency: Since 2013 GSK has committed to promote transparency of clinical research and is a leading example in the pharmaceutical industry—it was the first company to grant access to anonymized patient data. The ‘All trial campaign (2013)’ commits to publishing all trial data; the GSK patient-level data access site has become a multi-sponsored portal (2014).

Conclusion:

As of August 09, 2020 morning, the recorded Coronavirus cases in India have crossed a staggering 2 billion mark, reaching 2,153,10 with 43,452 deaths. The figure keeps climbing – faster than expected, unabated.

The business relevance for a shift from the conventional disease centered care to patient-goals directed care, require deep understanding of the top pharma leadership along with its very purpose, in the new normal. Patients deserve this now, more than ever before, as explained above.

In my view, a changing mindset to align pharma business strategy – from providing a disease-oriented care to patient-goals directed care, is expected to improve patient outcomes manifold. Nevertheless, like what the above SAGE article emphasized, the organization at its end would require defining collectively and with clarity – why is this change now? How it is to be done – step by step?  And what are the results the company aims to achieve?

Consequently, it would help create a large pool of delighted and company loyal customers having strong ‘word of mouth’ advantages. Top pharma leadership’s ‘buying in’ this concept, with an appropriate organizational structure in place, would herald a new dawn of ‘Patient Value-Based Care’ – Convid-19 pandemic notwithstanding.

By: Tapan J. Ray 

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

 

Pharma To Leverage The Art of Turning Challenges Into Opportunities, Now

Since, the dawn of the year 2020, the human population living in different countries, across the world are facing ‘lockdowns in different forms. Although essential, it severely restricts normal daily essential and other important activities of all. A large number of populations in India, is also experiencing the same – for nearly 4 months, almost at a trot, as on date.

The fear of getting infected by COVID-19, fueled by uncertainty about a comprehensive way to surely avert infection and apprehension about what happens if someone gets infected, have been haunting many for several months. Moreover, the possible impact of several related essential measures, such as, social distancing and wearing a mask mostly while being outdoors, on both life and livelihood, is profound. It has already started causing an unprecedented – both physical and mental stress on many individuals, besides the economy of the nation.

Living amid ‘lockdown’ conditions is not just an unpleasant experience for all, it’s almost a ‘prison like’, experience for a vast number of people – particularly, both young and old with comorbidly. “It’s very similar to being trapped in a bunker with no access outside,” as expressed by a person with similar issues, which, may be construed as a universal feeling of common individuals. Interestingly, this was quoted in an article -  ‘What patients need right now’, published in the Reuters Events Pharmaon July 07, 2020. The article also highlighted that many other fellow sufferers, especially non-Covid-19 patients, are enduring pandemic enforced isolation without much hope. “They are staying in limbo until help is available and adapting to the worsening of their health conditions,” the article added.

Further, as captured in the McKinsey article – ‘COVID-19 and commercial pharma: Navigating an uneven recovery,’ published on April 21, 2020 – not just patients, health care professionals including doctors, are also facing unprecedented challenges. Especially, because of the need to address fundamental changes in the treatment of patients with conditions other than COVID-19. This is happening across medical specialties and therapeutic areas, besides of course in advising and treating patients with suspected and confirmed cases of COVID-19.

In some instances, some doctors do also worry about their financial security, as practices and health systems face unprecedented financial issues, the above article emphasized. However, at the same time, many of them are now rapidly adjusting how they deliver care, such as through increased use of telemedicine in different forms and ways, the survey found. Which is why, the support they need from pharma companies is also changing.

Taking cognizance of these critical developments, pharma players would require rewriting their playbook for business operations and for its urgent implementation. This article will focus on this important area of pharma business, by leveraging the art of turning a problem or a challenge into an opportunity.

Leveraging the art of turning a challenge into an opportunity:

Turning a problem or challenge into an opportunity in managing business operations, isn’t a cup of tea of all managers, across domains. More so, when it’s caused by an unprecedented disruptive change, such as the Covid-19 pandemic.

The first and the foremost prerequisite from a manager is a mindset to make it happen – driven by uncluttered thinking, with a clear focus on what needs to be achieved, how and when – step by step. Each element of a change has to be analyzed in-depth – supported by credible data, with possible barriers envisaged on the way. In tandem, weighing the chances of success in these initiatives based on data – and not gut feeling, within a predetermined timeframe will be critical. The net outcome of this process will help pharma players acquire a differentiated competitive edge for excellence, amid today’s all-pervasive quandary.

Under this backdrop, leveraging the art of turning a problem or challenge into an opportunity – in an organized manner, for a successful outcome of the present and future pharma business, appears to be a crying need.

The points to ponder:

Effectively moving in this direction will call for – at its very onset, a careful and unbiased data-based assessment of several critical areas, which will include:

  • Whether customer engagement platforms, medium, processes and also the core content of communication of pre Covid-19 days remain equally relevant today, and will remain so in the foreseeable future, for productive business outcomes.
  • Mapping changes with the extent for each, in all touchpoints of disease treatment processes is important – involving both patients and doctors, and simultaneously capturing their new preferences in those areas.
  • Arriving at what strategic and tactical changes the new normal calls for, to effectively engage with especially, non-Covid patient treating doctors and non-Covid infected patients, for other disease areas.
  • How doctors are delivering care, particularly to these patients today?

Accordingly, the pathway for required changes has to be charted out in detail, specifying the end point of each, on a time-bound and ongoing basis. The good news is, several pharma players have already taken several praiseworthy initiatives to combat this crisis.

What pharma companies have done so far:

So far, many pharma companies – both global and local, have taken some commendable steps to address the immediate fallouts of the crisis. These include,

  • Repurposing old medicines – starting from hydroxychloroquineremdesivir to dexamethasoneand probably beyond. All these drugs are currently being used for the treatment of Covide-19, although conclusive scientific evidences are still awaited – for most of such repurposed drugs.
  • Covid-19 vaccine development started almost immediately, including the homegrown ones.

As the above McKinsey article – ‘COVID-19 and commercial pharma: Navigating an uneven recovery,’ also reconfirms, now most pharma companies are largely focusing on ‘the immediate crisis, including by facilitating access to medicine; supporting HCP, institution, and patient needs in new ways; safeguarding employees; and enabling employees to operate in a new environment.’

The areas where pharma needs to focus more amid immediate crisis:

Another, responsibility of pharma to help tide over the immediate crisis, is to ensure that critical drugs, such as remdesivir, do not go in short supply. And also, avoiding unnecessary hype on a COVID-19 vaccine, which a global CEO termed as a grave disservice‘ to the public.

Nearer home, it also happened – not by any pharma company, but by the country’s premier, state-run medical research organization – the Indian Council of Medical Research (ICMR). The head of the ICMR has announced that India is planning to launch the Covid-19 vaccine by August 15, 2020. This was later retracted under heavy adverse criticism.

Future focus areas need to be in sync with the changing customer behavior:  

While converting several challenges into opportunities in sync with the future requirements of their business operations, drug companies should try to derive the first mover advantages. For this purpose, creative use of almost real-time data will be vital. In this endeavor, I reiterate, one of the top priorities will be to ensure that all touchpoints of the consumer engagement process take into account the changing customer behavior, as captured by data.

To have a productive value delivery system in the new normal, cerebral use of modern technology-based tools and platforms could provide a sharp cutting edge. A similar process may be adopted – even a stage earlier – during the differential value creation process of the business. Nevertheless, the name of the game for the future, would still remain delighting the customers at all the touch points, especially while navigating through strong headwinds.

Another major impact area of pharma business:

The onslaught of Covid-19 pandemic has also resulted in some significant behavioral changes among many health care consumers. These spans across several areas, as I wrote earlier. For example, a number of surveys have revealed that fewer number of non-Covid-19 patients are now visiting doctors’ clinics.

The study quoted by the above McKinsey article highlights some important points in this regard, such as:

  • Among surveyed HCPs, 82 percent report declines in patient volumes, with more than half describing the declines as “significant”.
  • 40 percent of the surveyed patients reported having a doctor cancel an appointment, while an additional 30 percent or so canceled the appointments themselves.
  • Half of surveyed physicians worry that their patients will not be able to receive timely care for new or existing conditions, particularly those that are not COVID-19 related.
  • The overall reduction in volume is widespread, but variation exists. For example, the number of oncology-related visits have declined far less than those related to cardiology or dermatology, perhaps reflecting patient or physician perceptions of urgency.
  • Such data represent a snapshot of a time still early in the trajectory of this crisis, but the HCPs surveyed expect the trends to continue—and to accelerate, potentially.

Another challenge is surfacing, the talent gap to squarely deal with the crisis.

The problem of talent gap, an opportunity? 

While preparing a company to succeed amid new challenges of the new normal, pharma leadership will notice some critical talent gaps in important areas of business. This is indeed a problem or a challenge. But can this also be converted into a new opportunity? … I guess, this is an opportunity of reskilling the company to meet with the future challenges, to move ahead at a faster pace.

In pursuit of this goal, top pharma decision makers may wish to evaluate a well-balanced mix of two approaches:

  • Reskilling competent existing employees for the new world.
  • Hiring new and ready – suitable talents, for immediate results.

Conclusion:

Reuters reported last Friday, with over 1 million Covid-19 cases, ‘India joins U.S., Brazil in the grim Coronavirus club.’ As on July 19, 2020 morning, the recorded Coronavirus cases in the country reached 10,77,874 with 26,828 deaths. According to the Indian Medical Association (IMA), the spike in the number of Covid-19 cases in India has resulted in the community spread of the Coronavirus disease. It further added: “This is now an exponential growth. Every day the number of cases is increasing by more than around 30,000. This is really a bad situation for the country.” The pace of climb continues going north.

Meanwhile, the Prime Minister of India has also urged all concerned to convert Covid-19 related challenges into opportunities. He said, it’s time to initiate reforms in several areas of governance by all the Indian State Governments.

Call it, the Prime Minister’s advice, or a basic management tool – most appropriate to leverage at this hour, the concept is worth considering by pharma players, as well, instead of getting overwhelmed by the crisis. Thus, in my view, it’s about time for pharma companies to identify critical Covid-19 related challenges, both immediate and also of the future – and convert those into opportunities – powered by technology-based cerebral inputs, in the new world order.
By: Tapan J. Ray
Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this

 

In Pharma’s Moment of Truth “What You Do is Who You Are”

It’s a time when pharma industry will be tested, both by its external and internal customers – more than ever before. Looking back, in search of footprints on the sand is no answer either, as there isn’t any. But, a decision on moving ahead has to be made by each drug company in any case – charting a strategic pathway, in search of business excellence, if not for survival. A possibility looms large that the crisis may even overwhelm a company, if any, ill-conceived or ill-thought through steps are taken.

In that sense, the moment of truth has arrived for the industry – a time when ‘what different you do’ in the value delivery process of the business, will decide ‘who you are.’ One’s ability to lead the company or even follow the leadership, to navigate through this crisis, would determine the present and future success of the corporation. This isn’t an easy task. The evolving processes would be challenging to implement, and the traditional mindset may often act as a retarding force, as it were. In this article, I shall explore this critical area with recent examples, as far as possible.

Ability to fathom its most critical component is the bedrock for next steps:

The most critical component in this situation is the ability to make a careful and unbiased assessment of – how different would the ‘new normal’ be from the ‘old normal.’ The focus should not be on the barriers in making the necessary strategic changes, which I hear too often – but how to steer the business through this unprecedented crisis, regardless tough barriers on the way.

Covid-19 threat isn’t going to go away anytime soon:

However, one thing is for sure – no one knows, not just in India, but globally how big the crisis is, and will assume what form, when and how long. Let me give just three illustrations in this area that will be easily understood by all:

  • Initially, experts used to say, face masks are required only for those having symptoms and people close to them. “Masks are not required for those who doesn’t have symptoms. Whereas, the same experts are saying these days, “data now emerging about asymptomatic patients spreading the infection across the country, masks play an important role in containing the spread.” Thus, one is required to wear a face mask always while going outdoors.
  • Explaining the mode of disease spread, earlier, many experts, including the W.H.O, said that COVID-19 virus is primarily transmitted between people through respiratory droplets and contact routes. Thus, a mask is needed when one goes outdoors. Whereas, now the same experts, including the W.H.O, have confirmed that Coronavirus can be airborne indoors. In that case, one may need to wear a mask even indoors.
  • On April 23, 2020 the Director-General of Indian Council of Medical Research (ICMR), reportedly, claimed that the situation is stable, and the country has been able to ‘flatten the curve.’ But on May 09, 2020, Director, AIIMS, reportedly, said, “Currently, the cases are continuing to grow at a flat rate, sometimes even more. So, it is very difficult to predict when the peak will come; but it is likely to peak around June or July…” Whereas, an MIT study, which has also been reported in the press reveals, “India might see 2.87 lakh Covid cases per day by February 2021.”

These instances drive home the point – although a serious threat of Covid-19 infection will continue in the foreseeable future, but the way it will manifest itself, and the fresh precautionary measures that will deem necessary, may change with time. Let me give one more example of increasing threat of getting re-infected by Coronavirus by already infected individuals has heightened today than in the past.

The battle tactics need to be updated:

Strategy for war against Covid-19 onslaught may broadly remain similar. But the battle tactics in the multiple fronts need to be updated on an ongoing basis. This needs to be based on increasing or narrowing of the spectrum of threat and other critical factors, as scientific evidences will reveal from time to time.

For example, as is unfolding today, a large number of already infected people, particularly living in areas with high population density, may not necessarily develop any long-term immunity against the Coronavirus infection. Such a possibility will have a wide impact on any business strategy in the new normal that an organization may contemplate.

The rationale for constantly updating battle tactics:

Let me now focus on the rationale for constantly updating battle tactics based on scientific evidences with a few contemporary examples. The study, published in the Nature Medicine on June 18, 2020, found that individuals recovering from Covid-19 infection may have immunity only for 2-3 months. Although, it may not necessarily be construed that a recovered person can get re-infected, but any vaccine that may eventually come may need to address such issues, which seems to be a tough call.

Alongside, findings of another large research – Spain’s Coronavirus antibody study, published in The Lancet on July 06, 2020, has also cast doubt on the feasibility of herd immunity as a way of tackling the Coronavirus pandemic. As the BBC News reported on July 07, 2020 - based on these findings, Prof. Danny Altmann, British Society for Immunology spokesperson and Professor of Immunology at Imperial College London has made similar comments on effective vaccine development initiatives.

He said, the study would, “reinforce the idea that faced with a lethal infection that induces rather short-lived immunity, the challenge is to identify the best vaccine strategies able to overcome these problems and stimulate a large, sustained, optimal, immune response in the way the virus failed to do.”

“What You Do is Who You Are”: 

As the saying goes: “What You Do is Who You Are.” With this fast-evolving scenario, pharma leadership will need to effectively address a dual strategic game plan to outmaneuver the barriers of the Covid-19 pandemic:

  • Putting in place a robust operating strategy for customer value delivery process of the business.
  • Capturing the details of new Covid19 related ongoing developments to constantly hone the battle tactics in several different fronts.

Both the above processes will involve picking up all such validated research findings, mostly on the run. Mostly because, such issues may impact both internal and external customers of the organization, besides competition. Therefore, factoring-in each of those new developments, while constantly sharpening the war strategy and battle tactics in the fast-evolving scenario, will be of crucial. And, what you think or do in this situation will determine who you are – what type leadership traits you exhibit to face the challenges of the new normal, effectively.

Two types of leadership in the new normal:

Amid challenges of the present crisis, I reckon, top leadership will find two broad types of domain leaders – ‘pro-tradition’ and ‘pro-change’ – both will have successful past track records. They need to be identified for appropriate strategic tasks.

As is known to many, a good number of successful leaders are operating through decades around the concept of physical presence of patients while consulting a doctor or other health care providers. Several of them seem to be still unsure about the extent of organizational and operational changes required to face this unprecedented crisis, head-on. Even today, some of them keep trying to impress others by citing instances of what they did so well in the past.

There is nothing wrong in that. But, the business environment and requirements of those days were different – quite different from today’s demand. Curiously, many of such good leaders, with impeccable past success records, seem to be more bothered about seemingly insurmountable barriers on the way. They are afraid of migrating away or jettisoning the traditional pathway of success. Probably, the fear of failure – after achieving success for a long time, is the reason. I consider these successful professionals as ‘pro-tradition’ leaders.

There are also examples of another type of leaders. They are generally younger, looking forward with a contemporary mindset, nurture a can-do spirit with a resilience to bounce back, even in difficult times. Which is why, any transient fear of failure doesn’t usually overwhelm them. And, these leaders, I reckon, may be broadly termed as ‘pro-change’ leaders.

Keeping aside, past success records or future success potential of pharma leaders, in the current scenario – what they actually think or do in the changing environment to steer the organization out of this never-before crisis, will indeed determine ‘who they are.’

A contemporary initiative sets an example:

Top leadership of several drug companies, such as those at Novartis, is leading the way for a change management as the new situation will demand – by setting examples for others. These leaders seem to be taking note of all changes, as discussed above, while giving shape to a strategy, and reshaping the same based on data, as and when required. Interestingly, more technology professionals are getting attracted to pharma operations during Covid-19 pandemic than ever before, as a recent research report unfolds. This is a good omen for pharma and needs to be leveraged, effectively.

The findings of a new research report:

A new research report from Novartis -  A Powerful Pairing,  emphasizes: “The global COVID-19 pandemic sparked a seismic shift in the adoption and scaling of digital technologies across the healthcare sector at a pace never before seen. Almost overnight, organizations had to dial-up their efforts to develop, manufacture and ultimately bring medicines to patients in a socially distant world.” The survey brings out some interesting points, such as:

  • 86 percent of respondents believe the time has come for digital healthcare, and many of them are interested in taking part.
  • Regardless of the sector they currently work in, the two industries that technology professionals would consider switching to, are technology and healthcare and pharma (49 percent for each). This interest rises to 58 percent for workers based in India and 55 percent for those based in China. They feel, Covid-19 pandemic has made them more aware of medical causes around the world and how important they are. Through work in this sector, they can save countless human lives.
  • 52 percent of technology talent sees innovation potential in the healthcare and pharma sector, with the top reason to apply for a job being the opportunity to innovate through technology.
  • 89 percent technology professionals say that data science is important to the development and delivery of healthcare industry solutions and services.

Conclusion:

Surging ahead to reach a million mark, as on July 12, 2020 morning, the recorded Coronavirus cases in the country reached 850,358 with 22,687 deaths. With a record high of 27,755 daily cases yesterday, the pace of climb continues.

It’s now virtually a writing on the wall that India will have to sail through the unprecedented Covid-19 pandemic for quite some time, where unprecedented leadership interventions will be of critical importance – even in pharma. This endeavor will also call for selective induction of competent technology professionals in all pharma business domains, as required. The challenge involves not just carving out the ‘war strategy’, as it were, against Covid-19, but also continually honing the ‘battle tactics’ in multiple fronts – mostly on the run, for desired outcomes.

The situation calls for taking an in-depth inventory of an organization’s existing human resources, based on success ingredients required to turn the tide, which, I reckon, should also be the starting point in this venture. In this moment of truth – standing at the cross-roads of the drug industry, there is no further room for top pharma leadership to procrastinate the decision-making process. All competent professionals should be taken on board. In tandem, both – seemingly ‘pro-tradition’ and ‘pro-change’ leaders, should be encouraged to realize that in the new normal “What You Do is Who You Are” in the future pharma business.

By: Tapan J. Ray

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

What Pays More: Creating ‘Innovative ‘Customer Experience’ Or ‘Innovative Drugs’?

More innovative a drug is, the better is its business success rate. This was the general perception of around 92 percent pharma professionals in the past three years. Whereas the fact is: ‘Having the best product doesn’t guarantee sales anymore’. This was established by a research study of the ‘Bain & Company’ - covering multiple therapeutic areas, and was published on October 14, 2019.

It showed, when physicians prescribe a drug – its efficacy, safety and side-effect profile initially account for only 50 percent to 60 percent of the physician’s choice, with a declining trend over time. Interestingly, the other 40 percent to 50 percent of it, is based on a range of ‘physician and patient experience factors’, which pharma players need to target in innovative ways to differentiate their brands.

Many pharma companies are now experiencing the harsh reality that more innovative drugs, backed by traditional sales and marketing support are not yielding desirable financial returns. Head scratching has already started among astute pharma professionals to understand its reason for remedial measures. Thus, the number of executives who agreed with the above ‘Bain & Co’ study that: ‘Having the best product doesn’t guarantee sales anymore,’ increased to almost fourfold – from 8 percent to 28 percent in the next three years.

Thus, in this article, I shall explore whether innovation in creating a ‘unique patient experience’ during a disease treatment process, is as important, if not more than a ‘new drug innovation’. Curiously, high failure rate of most pharma players to innovate in this area, isn’t discussed as much as high failure rates in the development of innovative new drugs.

‘Customer service’ innovation – high failure rate – falling short of expectations:

Again, another article - ‘How Agile Is Powering Healthcare Innovation,’ published by ‘Bain & Company’ on June 20, 2019, brought out some interesting points related to this area. Let me quote a few of which as follows:

  • 65 percent of ‘customer-service innovation’ fall short of expectations of the target group.
  • The number of health care executives recognizing the need to respond quickly to changing customer-needs, has increased from 38 percent in the past three years to 60 percent for the next 3 years. But, most of them ‘lack the methodology, and even the language to implement it in practice.’
  • ‘Having the best product doesn’t guarantee sales anymore.’ Thus, healthcare companies face growing pressure to innovate in providing unique ‘customer experience’.
  • The critical point to note, customer needs evolve continuously, and leading companies respond rapidly with innovative new solutions catering to changing market demand.

As the core purpose of working for ‘customer-service innovation’ is linked with creating ‘brand loyalty’, let’s have a quick recap on ‘brand loyalty’ really means for pharmaceutical products, in today’s context.

‘Brand loyalty’ for pharmaceutical products in modern times:

There are many similar definitions of ‘brand loyalty’ for a pharmaceutical product. The research article – ‘Brand Loyalty as a Strategy for the Competition with Generic Drugs: Physicians Perspective,’ published in the Journal of Developing Drugs, on August 30, 2016, defined ‘brand loyalty,’ and articulated its advantages.‘ I am paraphrasing a few of which, as below:

  • The extent of the faithfulness to a particular brand, which is a major indicator of a long-term financial performance of companies.
  • The main advantages of brand loyalty can be defined as greater sales and revenue, a substantial entry barrier to competitors, increase in a company’s ability to respond to competitive threats and lower consumer price sensitivity.
  • ‘Brand loyalty’ can protect against price competition, including branded generics, as it gives confidence to physicians on the perceived effectiveness and safety of a brand – which they usually won’t be willing to compromise with for lower prices.

This brings us to a key question. Are traditional pharma methods of creating ‘brand loyalty’ getting replaced by the key consideration of creating a ‘unique customer experience’?

Creating ‘brand loyalty’ through ‘patient loyalty’ – a new equation:

It’s a fact today that traditional pharma methods of creating ‘brand loyalty’ is getting replaced by the key consideration of creating a ‘unique customer experience.’ This, in turn, is increasing the need of building ‘patient loyalty’, both for a pharma brand, as well as respective companies offering these brands. This is a new equation, where offering a ‘unique treatment experience’ to patients assumes a critical role more than ever before. This needs to be clearly understood by today’s pharma marketer, without any ambiguity.

In traditional pharma marketing, physicians remain, virtually, the sole focus of the branding exercise, as they appear to be the only decision makers of writing a brand prescription. Patients, in general, hardly used to have any role to play in that process. In this scenario, brand loyalty for the doctors – assuming the absence of any malpractices, is primarily driven by the following three much known factors:

  • Physicians’ unprejudiced buying-in a brand’s value offerings
  • Evaluation of opinion leaders and the doctors’ professional counterparts,
  • Quality of disease treatment outcomes.

Nevertheless, before getting into this area, let’s have a quick look at the primary drivers that pharma marketers have been using to boost financial performance of a brand.

Traditional sales boosters of a pharma brand:

The primary drivers that pharma marketers have been using to boost financial performance of a brand can broadly be classified as follows:

  • Multiple ways are followed to make important doctors write more prescriptions,
  • Increase the drug price, whenever an opportunity arises.

These factors still remain important, but aren’t just enough to deliver sustainable performance over a period of time. Thus, a new dimension needs to be added to it.

Add a new dimension to create brand and corporate loyalty:

With the emergence of increasingly more informed and demanding patients, there is a need to create a ‘loyal patient population’, by offering them primarily a ‘unique treatment experience’. And this is the new dimension.

For this purpose, off-the cuff approaches or strategies based on mere gut-feelings are unlikely to work. As I indicated in one of my articles, marketers need to acquire deep insights on their customers to make sales and marketing decisions more informed, than what it is today. Currently available state of the art technology can be a great enabler to facilitate this process.

This is easier said than done, because answering the question – how does a drug company create ‘brand loyalty’, is indeed a tough call. Nonetheless, many different industries have realized, since long, that offering a ‘unique customer experience’, is critical to create a pool of ‘loyal customers’.

I also had written earlier, pharma is still a late learner in accepting various new normal, in a holistic way. Accepting this reality, a sharp focus on creating ‘brand loyal doctors’ in various innovative ways, I reckon, will serve this purpose well. It’s only recently, a few companies have started working to offer such ‘experience’ to patients in the disease treatment process - end-to-end. Ironically, a large majority of them prefer to talk about it more than actually translating the same into reality.

Benefits of ‘brand loyalty’ through ‘unique customer experience’:

There are several advantages of building pharma ‘brand loyalty’ by offering ‘unique customer experience, without diluting the focus on ‘increasing prescription generation through doctors’. The benefits, I reckon, include, both new – innovative products and also branded generics. Let me give below one example of each:

  • Innovative new-products – positive word-of-mouth promotion: Satisfied patients having ‘unique end-to-end treatment experience’ with a new, innovative brand, are very likely to share it with others. This may be done by using different modes of communication, including various social-media platforms. This, in turn, may help both – add to take-off speed – post launch and create a snowballing impact on the brand adoption thereafter.
  • Branded generics – extend the product life cycle and increase growth: Patients who are loyal to a particular branded version of a generic molecule, are quite likely to refuse any change to a cheaper equivalent, even if recommended by the physician. Moreover, they will advocate for this brand to others, using different communication platforms, as indicated above. Continuation of this process will extend the life cycle of the branded-generic, with increasing growth and market share.

Conclusion:

Now, it’s time to get back to what we started with - What pays more: Creating ‘Innovative ‘Customer Experience’ Or ‘Innovative Drug?’ From the above perspective, it emerges that bringing innovative product to markets is, of course important. However, to ensure its sustainable financial success, other innovations, such as creating ‘a unique end-to-end patient experience’ with the brand, in all probability, would weigh more. This is an area which did not receive much attention for a long time, moving beyond the creation of increasing numbers of ‘brand loyal’ doctors, for business success.

Today, increasing consumerism in the health care space, besides pricing pressure, unfavorable perception and sinking image of the industry, is creating a strong headwind – impeding desirable growth of many pharma players. Such a challenging business scenario has prompted a few of them to innovate in designing a differentiated ‘customer experience’ – in a true sense.

Although, a large number of companies are talking about it, most are mere lip-services – a ground-swell in this area is yet to take place. The industry priority, in general, still weighs heavily in developing innovative products, and creating ‘brand loyal’ doctors, rather than cultivating ‘brand loyal patients’, alongside.

By: Tapan J. Ray

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.