ACCRETIO (An OPEN Health Company) is now OPEN Health Consulting
OPEN HEALTH CONSULTING outlines a Triple-A framework for a successful drug launch.
It is widely acknowledged that yesterday’s playbook no longer provides the best blueprint for launching tomorrow’s medicines. With a high percentage of new drugs falling short of revenue targets established at launch – and more than three quarters never improving on the trajectory established in their first six months – companies know they must rethink their approach if the value of innovation is to be reflected in optimal returns and effective patient outcomes. It’s no surprise that ‘Launch Excellence’ has become an industry-wide pursuit. The question is: how can companies achieve it? Moreover, with Citeline analysts predicting 138 new drugs will be launched in 2019 alone, how can they achieve it quickly? It’s time to consider a new pathway to launch excellence.
Securing commercial success in today’s modern marketplace isn’t easy. A confluence of factors has meant the healthcare environment – always challenging and restrictive – has become yet more complex. The stakeholder landscape has moved significantly, with decision-making power shifting from prescriber to payer and the influence of patients increasing rapidly. As companies strive to develop targeted value propositions that speak to multiple and diverse stakeholders, the need to interact with the whole healthcare ecosystem is setting a new baseline for launch strategy.
So too is the climate for cost containment. As demand for healthcare increases in line with an ageing population and the growing burden of chronic disease, pressure on health budgets is intensifying, fuelling a global drive towards outcomes-based contracting. Launch strategies therefore need to look beyond clinical data and economic modelling and establish proactive plans to capture real-world evidence post-launch.
In tandem, advances in science and new opportunities in untapped markets have persuaded pharma companies to evaluate their portfolios, leading to a pipeline shift towards specialised products. Today’s new medicines increasingly target smaller populations with niche indications. A good example is the growth in treatments for rare disease; sales from orphan drugs are forecast to rise by 32% in the next five years. Similarly, we’re seeing an increase in the development of advanced cell and gene therapies which present a unique set of challenges. As the trend towards specialised and personalised medicines continues, successful launches will require a more granular understanding of patient journeys and treatment pathways. Encouragingly, many companies have recognised the need to develop this as a core competency, but there is still some way to go.
For pharma, these powerful environmental currents are colliding with ongoing internal challenges as companies reorganise to meet evolving market needs. A combination of cost pressures, resource constraints and the need to align marketing strategies with 21st century models of communication is bringing added complexity to the commercialisation of new medicines. The old rules of engagement are no longer enough to guarantee product sales.
Fundamentally, launch excellence depends on securing a deep, holistic and agile understanding of the healthcare ecosystem. However, leveraging it requires a culture of cross-functional collaboration – both across and outside of the global enterprise – and the organisational ability to unite behind a succinct strategic vision. It calls for a more streamlined, targeted approach to launch planning.
Simplifying for success
One of the most common features of sub-optimal launch strategies is over-complication. It’s understandable. Faced with a complex multi-stakeholder environment, it’s easy to think you need to build expansive and ambitious plans that cover every base. In the digital age, many launch teams have, quite logically, sought to exploit the promise and scale of multichannel communications, only to end up with an unwieldy and often fragmented range of tactical activities that don’t connect at the centre. The scattergun approach is counter-productive. It becomes difficult to measure the impact of each activity and, at times, can lead to mixed messaging that obscures the value proposition. The trick is to keep things simple. The most successful launch plans are crisp and concise, articulating the core activities that align with – and can be measured against – a defined strategic vision.
At OPEN Health, our extensive experience of working on multiple product launches across a range of therapy areas, product classifications and geographies has allowed us to build an evidence-base of the common characteristics of successful launches. Our work, which has seen us shape launch strategies for diverse innovations including blockbuster drugs, specialist medicines and orphan treatments, has enabled us to develop an evidence-based framework for launch excellence that focuses on three key areas:
This ‘Triple-A Framework’, where each component is underpinned by continual customer insight, can help companies develop simple launch plans and focus resources on activities that deliver measureable value against identified unmet needs.
The Triple-A Framework
Alignment is the lifeblood of launch excellence. However, its definition should extend beyond the narrow application of aligning resources with target customers. It must encompass a broader, virtuous circle of strategic alignment, stakeholder alignment and organisational alignment.
The primary concern – and ultimately the most important – is strategic alignment. Establishing a single-minded proposition that distils and defines the value your brand provides to the healthcare system is critical to success. This strategic vision is the glue that holds everything together. Moreover, everyone within your organisation – and every subsequent brand decision or communication – must be anchored to it.
However, your single-minded proposition cannot simply be imagined by senior management or exist in isolation; it must connect to your customers and be informed and shaped by the stakeholders who will use, or influence the uptake of, your product. Stakeholder alignment, encompassing the diverse range of customers and influencers across the health ecosystem, is essential. If your central proposition doesn’t resonate with your customer network, or doesn’t align with their challenges or unmet needs, your impact at launch will be minimised. Stakeholder alignment therefore depends on deep, detailed and continuous insight to shape every facet of the development, launch and post-launch phases. The nature of this engagement is explored in more detail in the ‘Approach’ component of the Triple-A Framework.
Organisational alignment completes the circle. Launch strategies, and ongoing brand plans, must naturally align internal resources with target stakeholders in a structured, measured fashion. But operational alignment goes beyond customer segmentation and resource planning – it’s about creating an environment where cross-functional teams across global organisations can work together in pursuit of a shared goal. Establishing a culture of collaboration that aligns teams is vital. The glue that binds them is the single-minded proposition; it’s the beginning and the end of that virtuous circle of alignment.
In the era of value-based healthcare, it’s widely accepted that robust customer insight is the key to unlocking and demonstrating brand value. This is undoubtedly true; faced with a complex and diverse stakeholder environment, customer-centric thinking is the oil of launch excellence and without it the wheels won’t spin. But are companies looking for insight in the right place or through the right lens? There’s room for improvement.
The most effective insights emanate from having a complete view of the whole care pathway. This is at the core of launch excellence. Once again, the optimal approach relies on a broad definition. The ecosystem for your brand encompasses the market environment, the patient journey and the treatment pathway – and further breaks down into distinct, though correlated, pathways for providers, payers and patients. Every component has potential touchpoints with your brand and includes stakeholders that will each have their own view on what constitutes ‘value’ in your disease area. Understanding all those perspectives, and what they might mean for your brand, is essential not only for its successful commercialisation but also – crucially – for its early development years ahead of launch. Customer insight is a perpetual process that can never begin too early and doesn’t stop when a brand reaches the market.
In the past decade, the industry has significantly improved its customer insight capabilities. However, there’s a case for suggesting that some companies could still go further to capture the complete picture. In recent years, the growing importance of market access has meant that, in many companies, efforts to develop a robust value proposition have focused heavily on the payer community. Unlocking access is undoubtedly critical and payers are the obvious gatekeepers. Nevertheless, securing access and reimbursement is only part of the story. If you fail to understand the patient pathway and how your drug fits into it, you may struggle to convert access into commercial success.
Despite the rhetoric, the patient pathway – whilst not overlooked – is rarely given enough emphasis when shaping launch plans. Whilst understanding payer perspectives and funding pathways is considered key to baking the perfect value proposition, the crucial ingredient of ‘patient value’ is too often undercooked.
Improving performance in this key area requires a new approach that provides a deep and detailed view of the patient pathway. Companies need to foster a culture of co-creation where cross-functional teams collaborate with stakeholders from across the continuum to understand current pathways and identify barriers and challenges that are stifling patient outcomes. There is growing evidence that pharma is exploring more collaborative models of engagement. For instance, we’re seeing increasing examples of co-creation with patient advisory groups to inform relevant materials and services.
Robust pathway mapping and analysis can uncover the drivers for change and the unmet need that will inform your value proposition. Moreover, it can help you establish and demonstrate where your brand sits on the patient pathway, how this differentiates you from your competitors, and how you can support the healthcare system by delivering unmet need.
Companies’ use of pathway studies is steadily increasing. As the healthcare environment becomes yet more complex and competitive, strengthening capabilities in this area will be central to designing commercial strategies that fuel launch excellence.
In a three-part framework where all components are complementary, the final element is Activity. This crucial area is where the insights generated from your view of the whole care pathway are leveraged to distil the key upfront activities required for a successful launch. In the spirit of designing a simple blueprint, this part of the framework shouldn’t masquerade as a brand plan or constrain the brand team with a prescriptive wish-list of tactics and opportunities. A concise launch strategy will articulate only the handful of core activities that will provide the foundation for a brand plan that drives commercial performance.
The considerations for core activities will be specific to your given disease area and situation. Fundamentally, however, they should be deliberately designed to challenge the business to think and behave differently. The smartest thinking will take a broader perspective that goes beyond the brand and considers opportunities for services that could support the health system, facilitate pathways and thereby increase product utilisation. Some of the most effective approaches in recent years have been built around innovative partnerships between pharma and healthcare providers or the development of value-added services that satisfy unmet need and, in the process, change clinical behaviours.
The potential considerations are varied. For example, will securing access for your brand be helped by an adjacent service or technology that identifies target patients, accelerates diagnosis or supports medicine adherence? Do you need to provide HCPs with education to prepare them, or their patients, for new innovation? Does pathway analysis indicate the need to redesign a service or provide resources to support implementation? Further ahead, what activities and mechanisms do you need in place to capture real-world data post-launch and which datasets will yield the most value? And how will you track post-launch performance to stimulate metrics that align with the objectives outlined in your single-minded proposition?
As discussed earlier, the complexities of the stakeholder landscape, as well as the challenges of the competitor environment, can sometimes persuade companies to design complicated launch plans that detail an exhaustive list of core activities. This is a mistake that can often lead to poor execution or disjointed analysis. Prioritisation is key. The most effective launch plans will harness the insights garnered from a detailed view across the whole care pathway to determine the small number of priority activities that are integral to delivering success. This, in turn, provides a clear and simple framework that allows companies to focus resources and effort on the activities that will drive commercial performance.
Pathway to launch excellence
The road to launch excellence is long, winding and littered with potential diversions that can hold you up or throw you off course. However, with the era of blockbuster medicines consigned to the history books, it’s clear that pharmaceutical companies must consider new approaches to launching medicines if they’re to establish sustainable commercial models that work in the era of value-based healthcare. The key to success is rooted in simplicity. The most effective plans build from a concise, structured, customer-centred framework that can only be developed by considering – and partnering with stakeholders across – the whole care pathway to identify the key areas of focus that will determine commercial success. The approach, quite literally, is the pathway to launch excellence.