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Beyond The Spiel
Pharma companies are now offering more than just the medicine, which means marketers have to go that extra mile too.
Increasingly, the spoonful of sugar that helps the medicine go down is more sophisticated patient services, as pharma goes far beyond the pill to ensure uptake of their products.
Such services are also changing the ways drugs are marketed, as marketers focus on value-added services in a bid to differentiate their product in an often-saturated market.
“If you look at any biologic in the market you will find extensive patient services,” says Bozidar Jovicevic, VP Global Head of Digital Medicines at Sanofi. “Patient services have become like a ticket to enter the market for biologics.”
Such services typically include specialist nursing, patient hotlines, educational material, videos and apps, to name but a few.
“The majority of really innovative drugs these days are biologics, and they are expensive to develop, costing millions to bring them to market,” says Geert Reyniers, Vice President Digital Health Integrations at Novo Nordisk. “They don’t work in a one-size-fits-all way anymore and are often difficult to use correctly.”
Services add value, says Pieter de Muynck, Global Marketing Director at Actelion. “Because there is so little differentiation between the anti-TNFs, for example, physicians choose one over another not because of data or efficacy but because of the extra bells and whistles around it, the services provided, the information provided. You build a stronger value proposition than in the old days, when it was just about coming up with messages and trying to convince physicians on efficacy and safety.”
Increasingly, the pharma industry is confronted with discrepancies when it comes to their clinical trial results and what they see in the real world, says Reyniers.
“You will see big responders and poor responders and non-responders. Because of that big difference there is a need to better identify which patients respond better to treatment than others, and how doctors can predict better responses in some patients than others. The goal is to collect data from these good responders so that RWE can be provided to payers who are more and more reluctant to pay huge amounts of money for innovative drug. Not because they are not innovative enough but because it is not necessarily clear for whom they work and who they don’t work,” he asserts.
The relatively new area of digital health is opening up a whole new avenue for marketers keen to advocate for the merits of a medicine, Reyniers adds.
“Some companies call it drugs-plus or digital medicine, and it has become a way to work with devices and sensors and wearables and connect these with lab results, put all this data together and analyse them through software and analytical tools and techniques. This allows us come up with ways to show that the drugs we bring to market, which we know can have tremendous benefits and be lifesaving, that they actually work in the patients we want them to work,” he explains.
The impact of this changed offering on the role of the marketer cannot be underestimated, but De Muynck sees it as offering a plethora of advantages.
“Competition is so tough, the differences between products are so subtle and there are very few differences in terms of the data we present. The value proposition must now go far beyond just the drug itself.”
De Muynck believes the industry is taking this on board and promoting value-added services in all its interactions with external stakeholders.
“I have seen it before at Roche, where we tried to do a lot with beyond the pill. Now at Actelion with one of the brands I am working on now, we are not just looking at the drug itself but how we can make the overall experience as attractive as possible for the patient. That means looking at things like apps, how to make sure that the drug is easy to use, how do the patients who get through a titration process as easy as possible… there it is quite a strong focus from the organisation not only on the advertising side but also budget-wise in terms of investment.”
The old tenets of marketing are evidently evolving, and marketers will have to get more creative, says Reyniers. Until recently, these value-added services could potentially be used to extend the lifecycle of a drug, but as the boundaries between drugs and technology become increasingly blurred, marketers will have to think about how they embed them into their messages at the earliest stages.
“Today the majority of these technologies are developed after the drug hits the market, often marketed as an add-on or something that can optionally be used in conjunction with the drug,” he explains.
“More and more, these technologies will be built into the clinical development programme of new drugs currently in development so when they hit the market those technologies hit the market at the same time and it may even be mandatory for them to be used together as they are part of the drug label. It is definitely an evolution that is happening rapidly. This impact on marketing is being seen across the lifecycle of a drug.”
A pharma marketer today is a very different animal to a pharma marketer 20 years ago, Reyniers says, adding that this ongoing change can mean it is a “culturally sensitive area”.
“First of all, you need to demonstrate that your drug works and market access is your challenge. These tools first of all help you to get market access – this is of course more and more fundamental because without market access you don’t need marketers.”
A new string to the marketer’s bow will be playing their role in educating the users of those technologies, he says. “Some of them are to be used by physicians only, and pharma companies have no experience in educating physicians in technologies so that is brand new. For marketers, the days where you had a drug label that you could promote are maybe not gone, but there is much more coming into play than telling a doctor about the clinical study involving your drug. Doctors play a fundamental role in this in terms of the adoption of these technologies.”
“Selling” the value of these technologies to patients is another consideration, as many of the will be patient-facing in the form of an app. “Often those technologies work with an app or a phone or whatever and go direct to the public. You can do direct-to-consumer advertising in the US but not anywhere else. Marketers may need assistance in terms of co-promotion from the med tech companies.”
According to De Muynck, beyond the pill opens up a whole new world of potential in pharma marketing. “I wouldn’t say it makes it more difficult, it just makes it more interesting. Now there is an opportunity to look more into what are the needs exactly and come up with creative solutions that really differentiate your drug.”
The new type of commercial strategy this necessitates will rely on close collaboration between commercial team and the developers of the technology, he adds.
“It means extra work but it all starts by really understanding what truly matters and what makes sense to the patients and is appreciated ultimately by the physicians. It is always possible that you provide a service to patients but the prescribers are not aware of it or don’t value it, or even think it is something you shouldn’t do as a company and then it can be used against you. I have seen many examples where we thought we had something that would be valued by patients and by physicians and it cost a lot of money but in the end it didn’t really make a difference – either it wasn’t useful or it wasn’t communicated properly.”
Yet Jovicevic does not see them as a major differentiator, saying despite the heavy investment in such services, many are not necessarily outcomes-focused.
“The biggest problem I find with those patient services is that they are not performance-orientated although they cost a lot of money. Companies providing them often don’t have a way to show that they positively impact people’s health, improving adherence, efficacy, safety. The business impact is not clear – you need to show they are meaningful for patients and the business.”
Reyniers disagrees, however. He believes that the true advantage of these beyond the pill services is that they do highlight issue such as adherence and outcomes, data on which is increasingly important in a world of constrained drugs budgets.
“We now know it is clinically proven that with that technology you can identify responders. What those things do is they also track adherence, persistence, and dosing. This combination of digital health and drug, that will differentiate the commercial offering for pharma as the business model evolves.”
There are several ways companies can benefit from patient services, says Jovicevic. Evidence of enhanced adherence via real-time information on how the drug is used will deliver increased differentiation of the drug. He also sees intellectual property as a major boon of the shift towards digital medicines. “There may be instances where the services themselves become stand alone products, and pharma companies begin to charge for that.”
Reyniers is in firm agreement, although he believes this is still some years away. “Some of those solutions will become stand-alone solutions that will ultimately turn into a profit-maker by themselves. The med tech companies are getting there but the question is whether pharma companies will go in that direction… maybe in 10 years’ time I can see some of them beginning to monetise these technologies as a standalone product.”
Right now, marketers can capitalise on the innovative technologies being wrapped around their products, whether old or new.“You are less dependent on how the drugs are being developed, on whether we have the right data… as the marketers you have to take a bigger chance to show what you can offer,” says De Muynck. “You can have a bigger impact as a marketer by creating beyond the pill services – really it’s about thinking of all the different stakeholders, from patients to payers.”
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