Pharma needs to be patient centric but not treat patients as customers

The global Pharma industry is under serious pressure from a large number of innovator molecules facing patent expiration, a thin pipeline of new drugs, regulatory challenges and pricing pressures. As a result organizations are focusing on newer commercial models, adjusting cost base, strengthening value of medicine, adopting patient centric approach and paying greater emphasis on Pharmerging markets for future growth.  Some of these shifts are new and radical to Pharma industry and Pharma is looking towards other industries for guidance and ideas. Adopting Patient centric approach/philosophy falls under such category of change.

Over the last few years, there have been discussions and few initiatives by Pharma towards patient centricity. The good part is that some of these initiatives have worked well and have helped organizations to take the overall patient experience to the next level. Use of digital channels to reach out to patients, platforms facilitating interactions between patients and physicians and patient’s targeted programs are some broad areas under which all the initiatives can be grouped. Let us look at some of the initiatives:

Pharmaceutical companies have experience with physician-centric models where they can be said to have physician market knowledge. Medical Science Liaisons (MSLs) usually fulfill the role of championing the voice of physicians within Pharma. Unfortunately, however, Pharma is lacking when it comes to Patient-centric champions who understand what consumers think and want. Eyeforpharma.com

  • Didget from Bayer: The new Didget bllod glucose monitoring system rewards kids for consistent testing with fun games they can play online or through their Nintendo DS.  The bottom line is “Test, Play and Win”, because being rewarded for testing is a simple win
  • Paitentslikeme.com: PatientsLikeMe is committed to putting patients first. They do this by providing a better, more effective way for patients to share their real-world health experiences in order to help themselves, other patients like them and organizations that focus on their conditions. Companies like Biogen, Merck, and Novartis etc are partners to this initiative
  • J&J Health Channel: A YouTube channel by J&J focusing more on sharing patient experiences and helping in advancing health and well being of others around the world. They have weekly focus areas and range from obesity to serious conditions like leukemia etc
  • Myalli.com: GSK’s Alli is a FDA approved weight loss aid. GSK has brought concepts of compliance, affordability, patient experience, discussions and education under one initiative called as MyAlli.

If we review all the above initiatives closely, the common themes are around compliance and persistency along with defining results in patient terms. We will witness more innovations in this area in the coming years as more and more Pharma companies adopt this approach. But with this enthusiasm comes a word of caution for Pharma Organizations.

Pharma should not treat patients as customers. There is a very fine line dividing a patient from customer as we understand. There are some inherent difference between a customer and a patient:

Patient

Customer

Does not undergo the complete purchasing cycle. i.e. traditional   marketing concepts and theory does not work Undergoes the complete purchasing cycle. i.e. Traditional marketing   concepts and theory works
Does not enjoy his/her current status i.e.  People don’t seek out medication without a   reason. Something is wrong and patients want to solve it and get back to normal.   It’s not an enjoyable state Enjoys his/her current status to a large extent i.e. likes to be   pampered
Collects information, but cannot take decision i.e. The patient   cannot make decisions, there are external factors ( HCP, Insurance etc) that   make decisions Collects information to make a decision i.e. this is called informed   decision making

Pharma Co. needs to appreciate the fact that the fundamental premise to their business does not mandate patients to be drivers of sales. Some examples in the market by Pharma Co. do indicate dilution of this premise.

In response to a generic competition; one large Pharma in one of the APAC markets ran a campaign focused towards patients, asking them to question physician on prescribing generics.  Termed as an awareness campaign, this surely seems to miss this objective by miles. It can be debated that the above example also falls under the ambit of patient centricity, but that can only be for the sake of argument and nothing beyond that.

The “empowered and informed patient” movement encourages patients to become informed and to take greater control over their medical care; but providing information, access and independence — so often successful in other consumer settings — do not necessarily drive better care or experience for patients. Walking this tight rope and creating patient centric programs and initiatives is surely a challenge that Pharma organizations are facing.

Chinese Pharma Market: Experienced and Evolving

I was in China for a brief assignment for a Major Pharma. It was Just the right opportunity to understand the Chinese Pharma market. At the onset let me tell all that the China Pharma Market is different when compared to the Matured US or European Market or Developing markets like India. Having said that, this does not by any way mean that the Chinese Market is “Novice”; the correct term to define this market is “experienced and evolving”.

I plan to write a series on this Market based on my experience and discussions with various individuals at various levels in the organization. This being the first in the series, I will focus on the broad highlights of the Pharma Market in China and follow that with much more details on each area.

Sales is Experience based and not Fact based: Having sales reps to promote Pharma products to doctors remains almost universal, but doing it in an organized and scientific manner is not what Chinese reps practice. Segmentation, targeting, territory Management, coverage and frequency are well understood concepts, but hardly practiced. Multinational Pharma companies face huge challenges in terms of leveraging their best practices and creating a fact based culture. To further worsen the problem, the industry is facing a whopping 27% attrition rate.

Availability of Data is a big concern: There are data providers in the market. Cegedim, IMS are available, but the Pharma companies are reluctant to subscribe. Pharma companies believe that such subscriptions are two ways hence the company might lose their competitive advantage by sharing their contacts with these data providers. Data will be important over long-term because the turnover of the sales representatives is still high, resulting in pharmaceutical companies losing important influences with their representatives.

 Lack of Basic IT Systems: Chinese Pharma market is growing at an average rate of 16-17% over the last few decades, and at this rate China will be the world’s largest market by 2020. But recently many Multi-National firms are facing challenges in achieving these numbers and are finding ways to work more efficiently and smartly, whereby saving cost and adding to bottom-line. This would need proper tools to support various business functions. Currently majority of the firms have either had a bad experience with IT systems or are exploring options to have one.

Selling Model is Tender Based: In order to bring the overall cost of healthcare, government has mandated a bidding process at province level. This bidding process is annual, and is mandatory for Pharma companies who wish to promote and sell their drugs in that province. This is an important function in the commercial space for Pharma, as pricing fixed at one province affects the pricing with other provinces and thus also impacts pricing at national level.

Ongoing Government Reforms: The Chinese government continues to invest in reforming its healthcare ecosystem. A key element of these reforms is the essential drug list (EDL), intended to reduce drug costs. The EDL environment has created challenges and opportunities for pharmaceutical companies, pharmaceutical distributors and hospitals, as well as trigger changes in how they operate and compete.

Distribution Network and Challenges: The distribution market in China today is still very fragmented. There were more than 9,000 qualified distributors in China in 2007, including numerous small- and mid-size operators with varying level of sophistication.  Although China distributors are consolidating, they still have much room for improvement compared with peers in developed countries. Huge demand from basic healthcare service providers in both urban communities and rural areas challenges distributors’ capabilities and in light of government regulations, distributors are facing an array of price and cost pressures.

Local Competition is stiff: Although half of the top ten pharmaceutical companies in China are multinationals, none command more than 2.5% of the total market share. Many of the most popular products in China are traditional Chinese medicines and they are growing faster than prescribed drugs. Multinationals are losing share — they’re growing nicely, but they’re consistently losing share.

The Pharma market in China is evolving and with the ongoing government reforms and governments commitment to expand the healthcare coverage to the large Chinese population, there are challenges and opportunities for various stakeholders. The overall environment is undoubtedly becoming more regulated and demanding for key stakeholders.

Mobility Solutions: Pharma Case Studies

“Mobility Solutions” another Buzz word in the market today. This is one subject that has slowly found its way to the board room discussions. Lot of action around this concept… In Pharma also we see lot of action around this.

In Pharma the use of mobility solutions were limited to “PDA” based solutions…organizations were busy assisting the sales force with providing applications on PDA/Tablet to help them perform on the GO. But that was another era… the present era has shifted the focus from sales force to the customers. Organizations have started using Mobility Solutions to take the concept of Patient Compliance and Wellness programs to the next level.  “After all people might leave home without their glucometer but not without their cell phones.” Says Ryan Sysko, CEO of WellDoc, a healthcare company that develops technology-based solutions to improve diabetes outcomes and reduce healthcare costs. These solutions provide information and services at the point of consumption and sending mails just does not fit in the current changed paradigm of how consumers want information and how they consume it.

Case Study1:

Pfizer Canada launched its mobile solution smidge™. This is its first-ever “app” and health motivator. As per the press release “A first for Pfizer Canada, smidge™ identifies and celebrates small, easy actions that impact the body, mind and spirit. As you build momentum over a 21-day period, smidge™ shows you how to do just a little bit more by choosing across six activities that include: Be Positive, Eat More Fruits and Veggies, Train Your Brain, Take the Stairs, Deep Breathing and Drink More Water. “This application is available on Blackberry apps store and on Apple store.  Refer this for more details http://www.marketwire.com/press-release/It-Takes-Motivation-Healthy-Habits-Start-Here-Pfizer-Canada-Says-Start-With-A-smidge-1323863.htm.

Case Study2:

The WellDoc solution is a cell-phone based platform that enables real-time, any-time communication between health providers, physicians, and patients. Patients get reminders on their cell phones to take medication. They have access to live coaches and wireless diaries. Meanwhile, providers can track them as they input information and identify where and when they’re diverging from their plan. The cell phone is used as a device to reach patients, to do things like not only remind them when to take their medications and when to test their blood glucose, but also to put their physician’s instructions in the phone. This product has already being cleared by FDA (http://www.businesswire.com/portal/site/home/permalink/?ndmViewId=news_view&newsId=20100802005216&newsLang=en)

Are these solutions effective? So far, the data is compelling that such platforms can work. In one study, published in Diabetes Technologies and Therapeutics, patients who used the cell phone platform experienced an average 2.03-point decrease in their A1C levels, while the control group experienced a 0.58-point increase. Additionally, patients who used the phone were more likely to switch to brands that offered such a platform, and doctors gave the product a 100 percent physician satisfaction rating, stating that it made the information they could see about their patients more comprehensive.  Similarly for free applications also the date available is quite encouraging. If you navigate to the BB apps store, you will find that smidge™ has a high user satisfaction rate.

Let me know about your experiences and thoughts on such solutions in Pharma. Is Pharma also becoming more socially responsible?

Pharma’s Adoption of Social Channel: Caution and a Sense of Hesitation

Lot is being said about the efficiency and effectiveness of the Social channels (twitter and Facebook) and why organization should define strategies to leverage this “Free Channel”. I would like to discuss the reason why Pharma as an industry is cautious in adopting this channel. I can think of the following reasons:

  1. Can I use this channel? FDA laid out the regulations…but then sporadic incidents like what happened with Novartis sharing widget on Facebook confuses the marketers. They seem to be interested, but reticent in using this channel and defining the optimum channel mix leveraging these social channels. My understanding is that there is still lot of work that regulators have to do to define and answer basic questions around what and how? Some Product companies have come to the rescue of Pharma organizations by providing a sharing widget that can comply with the norms (Read the blog to know more http://social.eyeforpharma.com/blogs/wendyb/new-option-pharma-social-sharing)…. But is that sufficient? I believe NO. Proper operating processes (internal and external) need to be laid out to clear this confusion.

 

  • What should I use this for? Channels are used by marketers primarily to create awareness, Influence and engage customers. With the profusion of channels marketers perform a juggling act of defining the right channel mix to achieve one or more of the objectives. Traditional channels like F2F, Contact Center, Email, D2C etc have had their share of success and failures over the past years. Marketers are still pondering over the use of the social channel as a medium and what services to be provided over this channel. Should we use this as an extension to the Contact Center? Or can this be used as a detailing medium? Or should this be used to launch campaigns? Or can this be used to provide education and wellness programs for patients and HCPs? I see a lot of Ifs and buts around this. @Novartis twitter account is primarily being used for creating awareness around disease area and to promote wellness programs. @AstraZenecaUS and @Boehringer use their Twitter account to promote videos and drugs along with providing awareness and education.So will we see migration of S&M Read more of this post

Cloud CRM – Is this the Panacea?

I wrote in one of my last blogs about how I see the CRM products DNA changing. I also wrote about the two important guidelines that are being followed for product development. The logical extension to that is to explore if these new age/Nextgen products are finding acceptability in the industry.

Off late I find growing adoption among organizations for these new products. I will limit this blog to the Pharma business which I follow closely. Pharma business has traditionally been one of the late/slow adopters to new technologies. The unconventional business model and protection in terms of patents have always made Pharma companies a bit reactive in nature. But today; due the sudden environmental changes (growth opportunities shifting from traditional to new markets) and pressure on creating efficiencies across the complete value chain has compelled them to think proactively. Pharma has become one of the front runners in adopting newer technologies and CRM strategies in particular have been revisited with an aim to provide efficient, intuitive, Flexible, simple and insightful solutions to business.

So does this mean that the earlier solutions that were deployed after years of hard work and spending Millions of dollars did not meet the above criteria? Yes and No. Yes because these solutions were designed and built as if the world will never change. No because they did what was expected out of them and in many cases were very efficiently. It became a humongous task to maintain these solutions and organizations were faced with a bigger challenge of keeping these solutions in sync with the changing business needs. They were running a race against shifting finish line.

Getting back to drawing board and creating the drivers for the new solution started in various top 15 Pharma companies. The high level drivers that are common to majority of them are;

  • Increase effectiveness
  • Increase productivity
  • Enhance agility in responding to changing business needs
  • Lower operating cost
  • Increase operational efficiency
  • Reduce overall TCO

So the writing on the wall was clear… A. Get rid of the existing solutions B. Evaluate Cloud based solutions that meet majority of the criteria.

Few of the top Pharma companies have already taken this decision and are in an advanced stage of deploying their solutions (Refer Veeva site). So will these solutions act like a panacea? These solutions do tend to satisfy majority of the drivers that organizations have laid out, but is there something that the organizations are missing?

At the face of it and going by the trend in the market it seems that this time organizations will get this right.

Note of Caution:

  • Do not repeat the mistake of complicating the solution on the pretext of providing efficiency and enhancing productivity. (Customization is no longer a limitation of Cloud based solutions)
  • Look at a larger timeframe and see the spread of CAPEX and OPEX to take decisions on TCO
  • Evaluate what is the best deployment model (on premise/On demand or Hybrid)
  • Think over “Does it make sense to have a global solution or bouquet of solutions based on common philosophy?”
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