Believes and misconceptions in pharmaceutical industry, how to get ahead

Pharmaceutical industry has its typical behaviours, its intricacies, its believes and its dogmas just as much as any other industry. In this little article I intend to challenge and question some of those and maybe start a discussion with you. 

Our environment and customer universe are changing. Changing in a different way than many companies believe. That means that we are most likely training our people to do things that don’t work, marketing our products in ways that don’t resonate with our customers and we ask them to do things they probably don’t want to do. Whilst we do a lot of market research and have large data mining departments trying to figure out patient pathways, we end up not really knowing what to do with the results or interpreting them in a way that fits our believes and dogmas and our ‘experience’. 

Despite all the data available about prescriptions, formularies, pathways, we stil cannot work out when patients are on combination therapies. When they actually stop treatment or just skip picking up a script or when they alternate picking up the scripts of their different medications which makes matters even more confusing.

Formularies are dictated by acquisition cost. Affordability is not the same as cost-effectiveness and frankly few people on local level care about cost-effectiveness. The concept that a Ferrari is probably the most cost-effective car there is (it even increases in value over time) doesn’t mean that you can afford buying or running one. That's also where the models go wrong. So we chose the cheaper alternative well knowing that it is less good but it will do the trick, somehow, or we tell ourselves that. Why do we still ask our field forces to tell our customers that our product is more cost effective. And what does that really mean? Ask 10 people what market access actually is and you’ll get 11 different answers. 

We focus our efforts on generating new patients to go onto our therapies and we still haven’t worked out a cost-effective way to actually increase adherence and somehow appeal to patients to not just stop taking their pills after a few months or listen to a family member advising them to just not take something anymore. As a result as a society we most likely waste millions of pounds on medication simply because people do not follow instructions or are given a too complicated message. Is writing patient information leaflets the solution to that? 

I do know that patients show up in a surgery with high blood pressure and have an additional drug prescribed in many cases because they are probably not taking the first one and of course don't mention that to the doctor. 

Anyway, all these things can be part of follow up blogs. In this one I would like to focus on a few assumptions that drive pharmaceutical industry behaviour. If it sounds familiar to you, that would be great. Change it to get ahead.

Doctors will use the most effective and powerful product first line. Somehow we constantly seem to expect that customers will chose our more effective product over the others. I would argue that this differs a lot between healthcare professionals. As a rule of thumb I would postulate that the more chronic diseases an HCP treats versus more acute medicine, the more they will use the less efficacious products first so they have something to switch to if needed. Higher efficacy is also in their thinking still very often linked to more side effects and that’s where the ‘do no harm’ rule comes in. So we do market research into prescription drivers and they say efficacy and safety. How surprised are we when it actually turns out that convenience is the key driver in certain disease area or for a certain class of medication. 

Your customers will understand your over engineered product claim, a.k.a. what you think to be particularly clever is not going to make a difference. Internal positioning statements are generally the products of medical, marketing, market access and who knows what other department chipping in to get every possible advantage into one statement. Unfortunately they miss a key ingredient of positioning; versus what. Positioning is not the same as saying ‘A is a new first line treatment with X,Y,Z properties, delivering …’. Make it simple, make it clear, make it realistic and workable. No over engineering, too much stuff on a page doesn’t work.  

Relationships sell. Do they really or do we hope and think they do? What they probably do is buy you airtime with your customers. Physical access to them because they are willing to make time for you or your company. That doesn’t mean they will prescribe your products. In a follow up article we should probably also discuss customer loyalty. Or maybe that would be a nice discussion subject.  

Prescribers will chose your products because of your portfolio. Same thing as with relationships. Your heritage in a therapy area or the clinical trial strength shows that you are committed to this disease area. Again, that will get you access and a listening ear. Maybe some help and support around formularies. That is not to be confused with assuming that they will prescribe your products.

Next time we should talk about share of voice, the call, the fact that we treat all our customers more or less the same despite massive opportunities with iPads and other technologies and we should address the value proposition more.

The conclusion of part 1 (and most likely also of part 2) will have to be that we should make things simpler, more straightforward for our people and for our customers. Focus on the things that matter, find out what we really need to know and make decisions. And you know what, if it doesn’t work, get up and try something different.