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Four steps to turn around a flagging pharma brand

Published on 21/02/11 at 12:25pm
Alex Blyth

The glamorous end of pharma marketing is undoubtedly around the launch of a new product. Everyone is excited and optimistic, you hope the product represents a step forward in treatment, and that clinicians will be intrigued and eager to try your new medicine.

Much gets written about how to make the launch a success, and rightly, because a good start can make or break a brand.

But what happens if, even after a strong launch, your product starts to falter?

How can you arrest a slowdown in growth? In short, how do you turnaround a flagging brand?

Diminishing points of differentiation and increasing competition mean this is a situation pharma marketers will face more and more.

Of course, each case will be different, but there are some lessons we can learn from previous experience.

Let me introduce to you a real life case study, which in the interests of discretion I will call Brand X. The name doesn’t matter; the case study provides an illuminating insight into the value of a strategic, hypothesis-driven, investigative approach to research - over more traditional, broad market research - and the lessons that can be learnt in how pharma uses research to drive decision-making.

Brand X was a new treatment for a specific type of cancer launched in a European market, and which 18 months post-launch was showing the symptoms of sub-optimal strategy and execution, both in terms of flattening growth and a high variance in the success reps were experiencing. Turning around a situation like this requires insight into why the brand is faltering, from which a strategy can be developed that will tackle the genuine issues, not just the ones which senior management’s ‘gut instinct’ says are causing the problems.

The difference, as we will see, can be significant.

Four stages to fixing the problem

There are four stages to this kind of task. First, we had to diagnose the issues holding back Brand X. Then, we had to develop strategies to overcome those challenges. Next comes the need to value the strategy uplift that is possible and the resource commitment required.

Finally, it is vital to present an evidence-based business case and ensure the seamless execution of the strategy.

Brand X had got their product to market a little quicker than a competitor’s product, but when the competitor did launch, they were better organised in coming to market. So Brand X had the opportunity to be seen as first mover, but unless customers were both aware of them and had a positive view of them, they ran the danger of becoming the Betamax to their competitor’s VHS; and anyone over 35 will remember that although Betamax came first and was the better format; VHS achieved a critical mass and market ubiquity by putting effective marketing behind the product.

So what was going wrong? The key to finding out was effective and insightful research. Naturally, we started off with an internal workshop where we developed a number of hypotheses as to why the brand was flagging.

But that view was bound to be skewed, so we then went out into the field and attempted to validate those hypotheses by talking to current and former reps, urologists and key opinion leaders. What became very clear was that the issues identified in the internal workshop were not validated by the field research, and issues that senior management thought were holding the brand back were not the ones customers regarded as important. Senior management seemed convinced the failings were down to two main issues: ineffective execution in the field, and price. Through the research, we were able to disprove some of the potential issues, for example value per patient not being maximised, compliance issues or simply not getting first patients on the product.

In the end, the research uncovered a raft of key issues to address, and we categorised them into four sections: product perception, organisation, market and strategy & execution. This approach gave us a whole shopping list of factors to tackle. Some of the organisational issues were particularly telling, and in many cases it was these which had not been identified internally.

Insufficient centrally-driven activity, poor communications, a too short-term mindset and a lack of investment in becoming a ‘urologists’ company’ all pointed to key failings which had little to do with rep performance - giving the lie to the MD’s initial assertion that “the problem is in the field!”

That said, there were some issues with the product itself. Not fatal ones, but ones which required a different approach in order to play to the product’s real strengths. One perceived disadvantage is that Brand X has a more regular depot. Because of this, the only urologists who liked Brand X were those who liked to see certain types of patients more regularly anyway - others saw it as an unnecessary strain on resources in the surgery and an inconvenience for the patient, who is reminded of their cancer monthly.

The answer to this is to identify the kind of patients who need to be seen monthly, such as newly-diagnosed patients requiring more advice, or anxious patients requiring more support, as well as those who visit the surgery more regularly for other treatments.

Equally, identifying doctors who are more holistic-type treaters, the kind of doctors who like to keep a close eye on their patients anyway. In this way, you start to turn a perceived inconvenience into a competitive advantage.

Problems with brand messages

Conversely, what the company saw as the product’s big advantage - that it could be used straight away without the need for pre-treatment agents - turned out not to be much of an advantage, simply because the health system in Brand X’s market moved so slowly in any case.

So selling to this supposed advantage was not going to be effective.

So if the product itself was neither the cause of flagging sales nor presenting a particular point of competitive differentiation, what of the market? This is a market where not much had changed in a long time, so doctors’ choice was amongst products which were pretty much all the same. It became clear that they were most likely to use the one sold by the rep they liked most.

This meant the company had to own the reps who owned the relationships, and particularly those who had existing relationships with high prescribers.

This would require consistent and continuous contact, and support for training, seminars and congresses. In this way, relationships could then be leveraged to gain business with new clients.

Again, the research had identified a potential problem in achieving this: because of limited investment and a lack of consistent effort, the company was not viewed as a urology partner, driven by poor geographical coverage of reps, frequently changing personnel both in the front line and at HQ, and the absence of a centrally-driven strategy.

As a company, they were failing to gain traction. They were not seen as a long term partner, but rather as people who were there to make a quick buck - that phrase was actually used, unprompted, by one of the urologists the research targeted. And that rather suggested that the whole culture of the organisation was awry, something which inevitably had not come out in the internal workshop!

Lack of communication aggravated the problem. The reps felt ignored and unrecognised, in truth they didn’t really believe in the product proposition and especially not in their company.

This situation was not helped by two sales managers having been fired within 18 months, an error of focussing on the symptom of the underlying problems in the organisation’s attitude to investment in the area, and lacking a credible proposition in the market.

A study of the adoption ladder proved that an unmotivated sales force was not performing.

Nearly 30% of doctors visited were not able to remember the product (!), and then 50% of doctors who did try the product in a small number of patients, did not end up using again. A lot of that was down to the reps not getting them to try the product with the right patients. In essence, it was being used as a last resort, and it is hard to win in that situation.

Being positioned as last resort means that when your product is used, it’s probably not going to work.

So a key task was to get the drug prescribed for the right kind of patients, playing to its strengths, so that doctors would see the benefit of using it.

The company had been obsessed with pushing benefits such as the fact there was no need for multi-therapy, price, and the reputation of the company; but the research showed that these were either of little importance, or not areas in which Brand X could effectively compete.

By concentrating on control, the level and speed of testosterone reduction, and the good side effect profile, the company would be able to present compelling arguments which actually mattered to the clinicians in certain patient management situations. They could win a valuable segment if they would only give up trying to change behaviours to win the whole market; based on an attribute that was of little significance in most situations.

Investment and re-positioning

Perhaps the most serious shortcoming identified was a lack of investment, which meant resources were being stretched too thinly to build relationships that could deliver. This had allowed a competitor to muscle in on the market, but the necessary solution wasn’t simply to throw new resources at the problem, rather marshall resources which could be afforded more effectively on the segment they were credible to win in.

We recommended targeting urologists who wanted to ‘make a difference’ to patients, who should be seen more frequently anyway, by giving them rapid control of the disease.

Recommendations included building regional centres of excellence (we called them ‘strongholds’), where Brand X could make itself impenetrable to the competition. Built around KOLs who would support the brand, these specialist strongholds could then be used as a base to expand into other hospitals. Coupled with this was the recommendation to allow investment to be correctly directed locally around a global agreed positioning strategy. Included in this was to create regional development directors, who would have the autonomy and the authority to make sweeping changes locally.

This way, if something out of the ordinary was required in the field, it could be made quickly by someone holding a local kitty to support the stronghold.

The lesson here is to never assume your hypothesis about why a brand is flagging to be correct. In Brand X’s case, the original hypothesis was that the price was too high, and therefore competition was causing it to struggle.

Whilst there were some elements of truth in that, it was missing the vital truth: the corporate strategy was undermining the business.

Serious organisational issues can be missed when you have no competition, however, once a competitor comes along, a brand’s success can be compromised. Brand X’s survival had been due to lack of competition, which had blinded the company to ongoing failings.

At the very top level there was a need for some serious investment to get solid structures in place, and a constant viable strategy - which they needed to keep to - which played to the strengths of the product, and recognised that they couldn’t have every patient.

All of this only became clear because the company’s own hypotheses had been challenged, and then tested and validated with quality research. Trying to put together an action plan to turn around a brand without having that kind of insight is a surefire route to failure - without objective evidence you will just be another voice in a room.

Too often decision-making in pharma is driven by hunches, wishful thinking or just plain guesswork. It doesn’t need to be like this; the best decisions are always taken on the basis of testing those hunches, gaining fresh insight and letting the evidence decide.

Alex Blyth is a managing consultant and head of Marketing Sciences at The MSI Consultancy. Contact him at

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