Crossing the Pharma Chasm. Why do Pharma launches fail?

Launch excellence in pharma

The 2019 IQVIA Launch Excellence white paper has come. The top line messages present a challenge to all Pharma brand leaders and Launch Excellence experts.

The current state of pharma launches

• Less than 10% of launches are categorised as ‘Excellent’ (IQVIA definition).
• 2 years into launch, only 5% (Primary Care), 8% (Specialty) of launches demonstrate excellence in all the top 7 markets.
• 80% of launches fail to improve on the sales curve set between the first 6 months and two years post launch.

Even though...

In the last decade, the industry has established launch excellence teams to address this vital stage in a brand’s lifecycle and invested significantly to improve performance. Despite a presumed focus on the 3 basics (still difficult to achieve) of Launch Excellence i.e.

• Company preparation
• A competitive share of voice
• Market Access

Brands are generally not improving their sales curve beyond that achieved at 6 months.

Why are pharma launches failing?

I believe this launch “failure” is driven by not addressing the growth audience’s needs. In researching this idea, I was drawn to the many similarities proposed for the innovative technology industry in the book, ‘Crossing the Chasm’ by Geoffrey A Moore [2].

Understanding 'Crossing the Chasm' in pharma

The principle behind “Crossing the Chasm” is that high-tech industries failed to account for the different customer behaviour between the early adopter and the early majority. Thus, the seller falls into a chasm of despair as customers failed to adopt and purchase their brand-new, shiny, tech item, despite initial success.

In the Pharma industry, at launch, we naturally focus on communicating the product's key benefits to high potential prescribers. However, in my experience, we rarely take account of those individual’s drivers (personas) and sales curves often flatten. So, although the innovators and early adopters appear to accept the key messages, the early majority do not.

This is compounded by:

• The demise of face to face Rep time
• The increasing complexity of treatment decision making
• Healthcare professionals short on time
• An information overload

All driving challenges to the previous Pharma Sales and Marketing communication models, resulting in stagnating launch growth.

The role of behaviour change in adoption

Behaviour change in individuals and teams is critical to success.

Changing behaviour is a critical part of new brand adoption. Whether this is the patient changing behaviour, an HCP changing the way they perceive and treat a patient, or the way a payer perceives the need in a particular condition - all are being asked to change their behaviour and thinking. Clearly, behaviour change in individuals and teams is critical to success.

However, the Pharma industry continues to lag behind other industries in addressing adoption behaviour. If we do not know: a) the needs of each of the segments, b) what their preferred channels are and c) when and how we should reach them, should we be surprised that our communication personas do not work?

The problem of segmentation but not profiling in pharma

Pharma colleagues often segment the market and accounts by volume of patients, or class of drug that go through that account and then segment by accessibility.

This certainly gives us a valuable idea of the potential we could capture, overlaid by any competition pressure and the reality of today’s access issues.

However, I rarely see colleagues question the adoption profile of that account or the individuals within.

In other words, if an HCP is classified as a target customer, they could be either Innovator, Early Adopter, Early Majority, but rarely a Late Majority or a Laggard. Even though a local rep Medical Science Liaison or Key Account Manager might intuitively know, most marketing departments still provide them with a wonderful, one size fits all adoption messaging detail aid.

But it is not only sales; medical educational material is also generic and often fails to address different behaviour and learning needs.

Although great strides have been made with patient materials, many of these are still delivered for the masses.

Different stages of customer adoption in pharma

The Innovator

I am sure many of you know of an innovator, someone that needs little persuasion or information to prescribe because they were comfortable with the available information for their decision making. Innovators are rare, classically <3% of the overall population, and from a prescribing perspective fight to have their independence of choice and make rapid decisions based often on little more than the clinical data.

The Early Adopter

In Moore’s Crossing the Chasm, the chasm occurs mainly between the early adopters and the early majority.

From a technology perspective, the early adopters need to know someone else has purchased the item and that some information is available on how to use it. Whereas, the early majority need to be told by a peer of the benefits and want a trial use before adoption. I believe this is similar in pharmaceuticals as well.

From a Pharma perspective, early adopters readily absorb the early clinical trial material and if they have permission to prescribe (Market Access having been achieved) they will adopt the new product, where they see fit. Their behaviour is that of seeing the issue and then fitting the product into that solution.

This may not be the ideal positioning our marketing teams would like (eg 4th line rather than 2nd line) but the sales team are happy as they are up and running. However, at 13% of the population, these customers are never going to push the sales line on the rapid upward curve that business performance aspires to.

So, we continue to promote those same claims and messages that won us early success, but the early majority just do not bite, and we wait…and wait. This is the chasm.

The Early Majority

In technology terms, the early majority rely on peer approval and evidence of usage by someone they trust, they also need “permission” to buy. In Pharma terms, the early majority need reassurance from several sources:

• From experts they recognise about the place of the product in therapy
• From guidelines and protocols, reassurance that it is ok to replace their current prescription option
• From colleagues and formulary so that there are few barriers to usage of a positive first experience with the product resulting from use in the right patient population.

Gaining these reassurances and communicating them effectively is, in my opinion and experience, where most brands begin to fail. This is no better illustrated by data (I have used and seen but cannot share) that demonstrates clear differences in customer behaviour and channel preferences between early adopters and the early majority.

This difference is visible across most specialities. In the last 10 years, my observation of launch excellence and multi-channel excellence is that marketers do not anticipate this and often miss the opportunity to adjust the communication messages and channels relative to customer behaviour and customer preference.

Addressing the gap in pharma launch excellence

What could you do to address this?

Mind the Gap: Recognise a chasm might exist and establish KPIs and Insights that capture the signs the chasm is approaching based on customer adoption.

Plan for Success: Plan your segment penetration and learn from previous launched brands. 

Prescriber Value Story: The value proposition for the prescriber, as opposed to the payer, and how this is conveyed to customers and more importantly, by whom, will assist the transfer from Early Adopters to Early Majority.

Channel Flex: Develop a communication platform and approach that allows the brand to address the different customers in a country at different time points in their journey with the brand. In other words, personalisation.

Challenge Team: For Launch Excellence Teams, is there a case to extend their challenge remit to when the brand has gone into the early majority?

Do you agree with my hypothesis?

What examples do you have where this might have been proven or not? Please share in comments. Alternatively contact me for further discussions.