Pharma marketing in Japan: From information to insight
Sandra Disse, head of new product development in Japan for Novartis, and Simone Thomsen, chief marketing officer of Lilly Japan, on using patient insights to build brands
By on Apr 18, 2012The practice of collecting client insights has arrived at a crossroads in Japan. Traditionally, pharma companies have focused their research on physicians and have done so primarily via quantitative techniques, such as surveys with closed questions. Additionally, global pharma companies operating in Japan typically take insights from global headquarters and validate them in a top-down manner in the local market.
But internal and external forces are starting to challenge this order. Japan has ramped up its regulations and restrictions when it comes to pharmaceutical reps fostering relationships with physicians outside the office. That means traditional relationship-based customer management is significantly curtailed, which places a new onus on detailing and delivering messages to physicians that are on point and responsive to real needs.
“This should signal the end of ‘me-too’ products that look much like competitors but gain market share just on the strength of your relationships,” says Sandra Disse, head of new product development in Japan for Novartis. “Moving forward, we can’t afford sloppy messages that aren’t relevant and memorable, which means we have to be better at insights.”
Japan is a specific market with strong domestic players, and therefore the American or European landscape can’t be entirely translated to the Japanese situation. Many domestic products satisfy physicians, and the level of unmet need is often not as strong as in the US, Europe, or China. As a result, international companies are starting to realize the value of developing what Simone Thomsen, chief marketing officer of Lilly Japan, calls “a truly local, customer-oriented strategy. Japan is a key market, and companies have to understand that from the global perspective right from the beginning.” (For more on the Japanese pharma market, see Dr. Bates’ Talkback: Is Japan the new re-emerging pharma market?)
Finally, the emergence of an empowered patient voice in Japan, largely fueled by vibrant online communities, has added a third challenge to the old order. More and more, patients are leveraging their collective voice to petition for drugs not yet available in Japan, liaising with opinion leaders and physicians to get foreign drugs developed locally.
Likewise, patient concerns about price and side effects are wielding more influence on physician prescribing behavior, impacting the pharma bottom line on both ends. “We really have to care about our patients, what type of burden they’re under, and how do we deliver the maximum value for the money,” says Disse. “All of this is pushing for much more patient research.” (For more on pharma and online communities, see Special report: Pharma and social media.)
“If we’re honest about wanting to shape a local strategy based on consumer experience,” says Thomsen, “then we need to make sure that when we develop a strategy from the beginning, we have real insights from consumers, both patients and physicians.”
Driving insights
If it’s real insights companies are after, they need to start with questions and unknowns rather than with answers or assumptions. What are physicians really talking about in Japan today? What do they need? How are they responding to patients? What are the biggest frustrations on both ends? Quantitative techniques like surveys only glance as these real insights. Companies therefore need to shift to more open-ended, exploratory, and qualitative techniques in the early stages of client research.
Focus groups can be effective for accomplishing this, as can monitoring online conversations in chat groups and Web forums where patients speak more freely. Disse says it’s critical for companies to start prioritizing more qualitative research across the board, and the sooner the better in the drug development process, ideally as early as Phase I. “We need to start doing insights as soon as we have proof that the drug works in humans,” she says. “That way we differentiate our products not only in how they’re marketed but in the way they’re developed.”
Thomsen adds that the input from the market, and the true needs of patients and physicians, should get filtered into clinical trial development. That way you not only ensure an innovative product down the road, but also a clinical trial that addresses the healthcare system in a way that’s relevant to physicians and patients. “This is how our mission ‘Passion for Patients’ works in a real business setting,” she says.
Observations versus insights
There’s a temptation when collecting insights to go only as far as the information permits on its surface. You seek out statistics about a drug or a market, and once you get them you stop. Even companies pushing toward more qualitative techniques are often guilty of this. But Disse and Thomsen both argue that stopping at mere observations, versus driving down into the true insights, is a major miss.
“As an industry we’ve been talking for so long about insights, but still we see many cases where observations are being called insights,” says Disse. “We need to continue to educate on the difference and strive toward the true insights.”
An observation, she continues hypothetically, would be that patients in Japan with a certain disease struggle with compliance. You could even dig up a fact, say, that 30 percent of those patients drop a certain drug after three months. The insight is delving into why that’s happening. Is it because that’s just the inherent nature of patient behavior? Or is it because in this case patients are responding to something in particular? Maybe they don’t see any perceived effect? Or maybe they see such an effect that they feel cured? Or is it price? Whatever the answer, these are the insights that companies must pursue.
“The winning companies will be the ones who seek out real insights, not observations, and then embed those insights into everything they do, from the way they develop compounds to the way they market them once they are approved,” says Disse.
Thomsen echoes that sentiment. Lilly recently set up a series of Web conferences for physicians to discuss key topics and challenges within their disease categories. Preliminary research showed client interest, yet initial turn out for the Web conferences was mediocre. The observation would be that, unlike interest, attendance for such an event is mediocre. The insight would be to take it a step further and investigate why there was such a low turnout. Was it because when it came to act, physicians were, in fact, only moderately interested in the webinars, or were there other factors at play?
It turned out that physicians didn’t feel comfortable participating in the Web conferences during working hours, because they had patients and waiting rooms and other pressing matters. If the Web conferences were in the evening or on a weekend, however, they would be able to attend. Lilly collected this insight physician by physician, then verified it by focus group, and implemented a change in the scheduled times of the Web conferences. Attendance immediately spiked.
“When does information become insight?” Thomsen says. “That’s what we need to train our marketers to recognize.” An example like the Web conferences, she adds, “shows that if you really want to deliver a great experience for your customer, you need to go the extra mile.”
Embracing the patient voice
Pharma has traditionally tried to understand patients by way of physicians. This is partially out of necessity, as stringent regulations limit interactions between pharma and patients, and partially out of a basic business reality: Physicians, not patients, drive the pharma business model and, while patients matter, their voices have always been secondary.
Then along came the Internet and patients uniting and sharing and influencing clinical trials and the broader drug-making process. In this new world, listening to patients is critical. What’s more, despite the regulations, it’s actually doable thanks to the same forums that have empowered patients.
Social media monitoring, for example, is an excellent way to monitor patient sentiment without overstepping boundaries. “It’s very helpful to listen to what patients are saying when it comes to their journey, the coping, the setbacks, the successes,” says Disse.
“If we understand that journey,” adds Thomsen, “and really look at some of tensions and frustrations they have with treatment options and the broader disease, we can ultimately make sure that the product we offer and the support we give responds to that.”
Examining social interactions through the lens of linguistic research is an opportunity. Don’t just examine what patients say, study how they’re saying it, what words they use, what tone. Pharma is generally much better at speaking physicians’ language than speaking patients’ language, but in the modern market, support materials, programs and websites, product labeling and packaging, and the way physicians describe those products to patients all need to cater to patients.
In addition to social monitoring, companies can set up online focus groups with moderators and patient advisory boards with the heads of patient groups and thought leaders. They also can use projective techniques that study behavior and ethnography, and they can do internal simulations with employees in an attempt to build understanding.
“It’s very important to create some empathy,” says Disse. “It’s always different when it’s not your experience, but simulations can help employees better understand patient pain and struggles with issues like disease symptoms or long visits to hospitals. It’s had a strong influence on the morale of our team and their passion.” (For more on simulation and selling, see Pharma sales: How simulation can help reps sell.)
Tips for executing the transition
When companies want to pivot, often they bring in new talent to help steer the change. In redirecting client insights, outside expertise certainly can help. Disse says that many pharmaceutical companies, including Novartis, have started focusing specifically on consumer goods, as that industry has an unparalleled track record of collecting insights and can help raise the bar internally for pharma insight creation.
From a management perspective, Disse advises that new talent must be made to feel welcomed to the team and integral to the new operation. “It’s always a problem making sure they feel accepted,” she says. “People with a diverse or different style coming from a less regulated environment can easily be made to feel like outsiders. We have to include them and make their expertise acknowledged by colleagues.”
Another way to pivot is to do so externally by way of agencies. Some agencies and vendors are excellent at insight gathering and development, and some follow standard procedures that lead to less impactful results. As pharma begins to demand deeper insights, some agencies have added capabilities to answer the call. “It doesn’t actually matter which sort of insight you’re looking for as long as have the right selection of agency with the right focus,” says Thomsen.
Disse cautions that, as companies and agencies start to probe deeper into patient matters, it’s critical to have adverse event reporting ironed out, internally and externally, as well as compliance with patient privacy regulations and the new promotional code, for example. (For more on adverse event reporting, see Adherence Arena: Overcoming the fear of adverse events.)
“When it comes to regulations, your employees and your agencies really need to understand how far they can go and what they can and cannot do,” says Disse. “Once they have that, they shouldn’t hesitate and should go full speed ahead within the limits.”
Finally, to pivot successfully, companies must take the raw insights and use them to drive better product development and marketing. Lilly has started providing support tools and educational programs for marketers, the medical team and market research.
“It can be overwhelming to have so much information,” she says. “But the most important thing is that you have one strategy and one belief that it all feeds into. It’s all about the customer experience, and each of the touch points that physicians and patients have with our company, our service, our product, need to follow that belief.”
“It requires a lot of push, enthusiasm, and conviction,” says Disse. “But we always have to keep in mind that there is a duty to develop the best product for our patients, so we need to understand from our physicians and patients exactly what they need.”
For more on Japan, see How pharma can help improve cancer treatment in Japan, Sales force effectiveness Japan: Getting relationships right, and 3 steps to delivering personalized medicine in Japan.
For more all the latest on pharma marketing in Japan, join the sector's other key players at Marketing Excellence Japan 2012 on May 15-16 in Tokyo.
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