How is it possible that new medicines that have gone through so many medical trial processes, regulatory checks and business plan calculations can still fail when they are brought to the market?
Kurt: Indeed, we see that around half of the launches in recent years did not even reach 25% of expected peak sales. Many new medicines fail to meet sales expectations in their first year on the market. And what is worse: those who fail in the first year continue to underdeliver in the next two years as well. It’s very hard to bend an initial negative trend. We have seen a potential blockbuster in prostate cancer treatment expected to be used in 7300 patients in the first year landing at 500 patients after eight months. They have had to inform their investors with revised forecasts.
Joeri: There is no single cause for the failure to meet sales expectations. A commercial launch of new medicine is a complex process where many things can go wrong. We have analysed disappointing launches and success stories. We have then structured our findings complementing my academic marketing insights with Kurt’s real world experience. The main conclusion is that there are many different causes for failed launches. There are many pitfalls to avoid.
Can you highlight some of the pitfalls or success formula for us?
Joeri: We see that sometimes customer insight was lacking whereby customers can be patients, healthcare professionals, insurers or authorities. That should not be a surprise, but we see that still today pharma companies embark on the launch without a compass: they have failed to do their market research properly. What are the expectations of the patients? Are the healthcare practitioners convinced of the value of the treatment? Have we checked if authorities agree with the necessary budgets for the innovation? At Trilations we are advocates of rigorous market analysis, also in pharmaceutical launches. If you answer these questions with your assumptions, you are bound to go wrong somewhere. Understandably, lots of energy and effort has gone into medical questions of efficacy and safety but the dynamics of the market merit proper attention too.
Kurt: Another phenomenon we have seen on several occasions is lack of realism. It may seem surprising that things such as too much enthusiasm exist in tough business environments, but they do. Companies need to take a step back from their initial excitement, raise the right questions and become objective. Is this new compound a medical breakthrough or a gradual improvement? Maybe it’s a “me too”? Market research can assist in finetuning the perception of the benefits of the launch product on more objective grounds. This is one of the assets our launch teams have on offer. Furthermore, success rates are higher if pipeline plotting is done carefully. The new drug needs to be typified and assessed, so that the launch plan can be tailored to the specificities of the new medicine within the context of an existing therapeutic practice. For example, if you have an innovative product for the treatment of an orphan disease it’s important to convince the medical profession, but you need to engage early enough with budget providers.
What is your main advice for pharmaceutical launch teams?
Joeri: Kurt and myself developed a launch methodology, including both strategy and implementation plan. Starting from Trilations’ core values that include deep industry knowledge and the advanced market analysis tools that we use, we centre our launch program around a small number of key factors. First we create a clear, concise campaign communication platform that outlines the value of the drug for patients and society. This is better than focusing on countless product details and messages. You want to explain that a new cancer medicine is as effective as chemo and comes in the form of an oral pill. This has great value for patients and eliminates hospital time. You demonstrate the value of the product and ease pricing discussions. Linked to this is the design of your communication matrix: you need to address every stakeholder through the proper channels at the right time. Make sure the medical profession is in line with what you are going to say to patient organisations, prepare the payer community well in advance etc.
Kurt: Another important element in any launch is to start early and win the pre-launch years. As soon as clinical trials reach phase IIa you must start lining up your allies in the field and create awareness about the new development. Who will be the advocates for the new arrival? What are the benefits for patients? For the doctors? Do we see doubts in people’s minds? Does it solve a public health issue? How will the current and future competitors react? Do we need health practice or policy change? Identify, prioritize, and address the stakeholder segments and networks. And remember that pre-Launch stakeholders are often very different from post-launch stakeholders. A rigorous market research methodology can provide you the basis for a robust launch strategy. The case of the launch of a product for certain heart conditions in the US comes to mind. While the strategy was designed to demonstrate benefits of the launch product over the existing similarly priced medicine from the competition, delays in approval made it happen that shortly after the launch the competitor product went off patent and the new product found itself competing with cheap generics, which is a totally different situation. It’s as if you’ve placed your cavalry ready for attack in an open plain, but suddenly the terrain has turned into a swamp. There is more to consider than just medical improvement.
Joeri: Yet another important factor is the competitor environment. You need to know what is happening in the worldwide pipeline of your disease area. What other products are likely to reach the market? A good framework to map the landscape is no luxury. It includes scenario planning for other arrivals on the market, perception management, preparation for competitor moves. Many companies are researching the same diseases and the fight for the market starts already in the research phase. All in all launching medicines on the market requires a good methodology and lots of preparatory work.
Trilations’ Joeri and Kurt are hosting a two-day course on commercial launch success in pharma in collaboration with C.E.L. for pharma.
Don’t miss the opportunity!
6-7 October 2020 in Zurich
