- prescribe it,
- pay for it, and
- use it.
- intensifying therapeutic class competition,
- disclosure rules on promotional spend, and
- access and reimbursement controls driven by a selective—and often contradictory—definition of "value."
PE: Posing questions about the "end of marketing" suggests you both are a bit pessimistic about the future of traditional practices in marketing new medicines.
Is there a right philosophical and tactical approach for an industry confronting challenges like these?
Sharma: Our question is inspired less by a sense of pessimism than by a recognition of opportunity, and at the same time, a concern that marketers may not be adapting fast enough to some of the new realities. The signs are everywhere—we're in a period of transition even more profound than that shift 30 years ago from the sales model to the marketing model. The industry is already bidding farewell to
- the "blockbuster" as we once defined it—i.e., drug therapy for common ailments or widespread prevention—and
- embracing the concept of niche market products, often priced at a much higher premium.
We also know that the regulatory environment will be increasingly inhospitable to drugs that have small incremental benefits; it's clear that payers are looking for differentiating value that they can measure right out of the gate. That explains the swelling ranks of orphan drugs (nearly 200 of which could be approved in the next few years alone), and it also accounts for a new interest in drugs that work very well on only small sub-populations of diagnosed patients. Everyone understands that they need to reframe what commercial success looks like and rethink how to get there.
It's not so much that we are defining unmet medical need differently; it's that we are defining solutions differently, in terms of a higher certainty of benefit or showcasing a solution that carries a unique value proposition.
McDonald: We actually think there is plenty to be upbeat about. One cause for optimism is the science—which ultimately drives everything. Strides in cell biology and advances in proteomics are helping us reconceive big diseases as a series of smaller targets that we aim to hit with greater precision. Science, social policy, and economics are all leading us fundamentally in the same direction—toward a new way of thinking about the drug-value proposition.
"Marketing 2.0" in the pharmaceutical industry is no longer about just saying that our product is different and hoping customers will see it that way. It's very much about making it so—and then about finding our way at launch to customers with a "conversation" that actually helps create the value rather than just promoting it. All of which means we need to develop new, end-to-end processes that shape both the "genetics" of our new drugs and the "epigenetics" of the launch environment.
Susan Schwartz McDonald, PhD, is President and CEO of NAXION, a Philadelphia-based marketing and research firm. She can be reached at email@example.com.
Sanjiv Sharma is President of InflexionPoint LLC, which specializes in commercial strategy and launch support. He can be reached at firstname.lastname@example.org.