Tom Brady and Atul Gawande: Designing a Different End Game

Tom Brady and Atul Gawande, two Bostonians with wildly divergent careers, both take the same approach to designing a different end game; they flout the conventional wisdom to achieve their objectives. For marketers wanting to change the trajectory of their brand, company, industry or career, these two prominent Bostonians show the power of doing things differently.

Tom Brady, the New England Patriots quarterback, has always been vocal about wanting a different end game, one that would keep him playing high-level football in his 40’s. So according to a recent New York Times Magazine article, Tom defies conventional training practices designed at building strength in favor of those that create more pliable muscles. He credits his unique training practice with sparing him from career ending injuries, ultimately enabling him to win 4 Super Bowls (so far).

Atul Gawande, Boston surgeon and best selling author, challenges the more medicine is better medicine dogma that runs deep in our American cultural veins. Gawande addresses the literal “end game” in his best-selling book Being Mortal, to propose a radical new approach on appropriate care in our last years. Rather than doing everything possible to ensure maximum patient safety and longevity, Gawande contends that instead, a doctor’s role is to ensure that people leave this earth in a way that respects their values and priorities.

To do this, physicians and family members need to understand what constitutes quality of life from the patient’s point of view. In one example, Gawande tells of a daughter’s surprise at her father’s definition of quality of life as “being able to eat chocolate ice cream and watch football.” Her father had been a professor emeritus so she assumed he would not have wanted to live unless it was as a fully functioning intellectual. It was this knowledge that helped her make an entirely different choice for her father when faced with a life and death decision by her father’s surgeons.

I wasn’t so lucky with my father. The idea that more medicine, more effort, is not always appropriate was a totally foreign concept to me for most of his illness (and most of my life). So the poor guy cycled in and out of the hospital to rehab a number of times, getting weaker with every visit. By the time a palliative nurse friend of mine, helped me to see the light, it was too late. Having made the decision to bring him home after our post-dinner talk, I received a call the next morning that he had died in the Rehab institution.

While I can take comfort that my father seemed to enjoy all the attention he received at the Rehab facility, I often wonder if he would preferred a different ending. With my 88-year old mother, I have an opportunity not to make the same mistake.

The lessons of Gawande’s Being Mortal and Tom Brady’s historic Super Bowl victory transcend their individual career choices. Their work is testament to the truth of Einstein’s definition of insanity–doing something over and over again and expecting a different result. These two different men offer the same valuable lesson about the need to challenge the status quo to achieve a different result.

In the pharmaceutical industry where my company, extrovertic, does most of its work, there is a lot of organizational dogma about how to drive sales. It includes “HCPs write prescriptions, not patients,” or the time honored “the sales representative call is the best way to reach physicians.”

I know a lot of talented and progressive marketers who are confronting these doctrines on a daily basis. It’s hard work to be the one constantly going against the grain. But the experiences of Tom Brady and Atul Gawande are proof that a successful end game is worth the fight.

Three Prescriptions for Patient Centricity

Patient Focused. Patient Centric. Patient First. There are lots of buzzwords companies use to describe their aspirations for a renewed focus on patients. But as my 8th grade Latin teacher once told me,

“The road to hell is paved with good intentions.”

Whatever phrase your company uses, here are three prescriptions on how to “walk the talk” of patient centricity in 2015 (and avoid a dance with the devil)

1. Fully infuse the voice of the patient into drug development. Historically, patient marketers are among the last to join pre-commercial or even launch teams. To be more patient focused, teams need to be staffed with patient experts early in the game.

And once in the game, patient marketers should make development of customer service and adherence programs the first order of business. As payers and patients have to increasingly make cost/quality trade-offs, it is critical that marketers can prove that their patient services actually make a difference in adherence rates, patient experience and clinical outcomes.

In fact, patient services already a factor into 3rd party purchase decisions. For example, according to a Duke physician I heard speak at a conference, Eliquis, a medication in the very crowded stroke prevention category, was chosen over competitors because the brand had the strongest co-pay assistance program.

Or just listen. Patients in clinical trials are already shaping opinions of the drug through their online conversations. An extrovertic social media analysis found an average of 30,000 patient conversations taking a place every month by patients involved a clinical trial.

2. Partner with providers and payers to meaningfully improve the patient experience at the point of care. HCPs, Integrated Delivery Systems and Payers are going to be judged on outcomes and patient experience. Pharmaceutical companies have the know-how and resources to help their customers meet the triple aim of improving patient experience, lowering costs and driving better outcomes. Take a look at all the governmental metrics requirements and pick a few to partner on.

It will also be important to have an expansive definition of point-of-care, both in terms of place where care happens and the people who provide the care. Care is now being highly distributed, it’s happening at home, at the retail pharmacy, at work, at Costco and at urgent care centers. And with the looming primary care physician shortage, care will be increasingly be delivered by nurses, physician assistants and even lay health workers.

And let’s not forget the increasing role patients are playing in their own health with the explosion of wearable technology and the whole quantified-self movement. The point of care is now everywhere and the smart pharmaceutical marketers will be conducting pilots to figure out how they can add to the patient experience.

3. Adopt a cross-channel patient experience framework to conduct marketing activities. A good patient experience is one that is consistent throughout every interaction, whether it be through a website, a phone call or in person meeting. Many of these touchpoints are managed by different functions in a pharmaceutical company, yet to the consumer it all comes from the same company. So the company has got to start acting like one company.

And this one organization needs to be reoriented towards driving patient satisfaction rather than driving sales. Driving satisfaction doesn’t mean revenue generation takes a back seat. There is a whole body of literature that proves that higher customer satisfaction scores result in higher sales and profits, in industry after industry.

But first the voice of the patient needs to be heard. This will require an integrated system of collecting patient feedback in a way it can be acted upon. For example, how well is the medical information call center doing in meeting patient needs? I would guess most marketers don’t know.

So take these 3 Rx’s and make 2015 the year that pharma companies turn patient centric talk into action. (And to my eighth grade latin teacher, Mr. Riggs, I really did “disce diligentius.”)

The Orphan Impact: Small drugs drive big changes

Seems everybody’s talking orphan drugs these days. No wonder, according to EvaluatePharma’s 2013 Orphan Drug Report, orphan drugs are estimated to reach 15.9% of total worldwide prescription sales by 2018. But the orphan drug impact goes beyond sales numbers. I believe that the patient centricity blossoming in the rare disease divisions will eventually spill over into the primary care divisions of pharmaceutical companies.

With the big blockbuster primary care drugs, development success lay primarily with company research departments. The halls of Pharma echo with stories of researcher heroics—how the lone scientist kept a molecule from hitting the drug dustbin only to become the next blockbuster.

But in orphan drugs, the heroes are as likely to be individual patient family members as researchers. In some cases the drug literally starts with patient families. Thanks to advances in digital technology and social media, orphan drug patient families play a major role in every aspect of bringing a drug to market, going far beyond traditional advocacy roles. Now individuals are able to leap tall barriers with a click of a mouse to accomplish superhero feats formerly reserved for massive organizations like the NIH and pharmaceutical companies.

Consider the role of patients, families and organizations in:

Disease discovery: Matt Might, a father whose son had a disease entirely unknown to science, leapt over barriers of scientific self-interest to find other patients and give his son’s illness a name.

A well-known blogger in his field, Matt’s post about his quest helped identify patients like his son across the globe. In the New Yorker article, which describes Matt’s disease naming odyssey, a Duke geneticist, who worked with Matt, sums up the new patient paradigm with this quote:

“It’s kind of a shift in the scientific world that we have to recognize—that, in this day of social media, dedicated, educated, and well-informed families have the ability to make a huge impact…Gone are the days when we could just say, ‘We’re a cloistered community of researchers, and we alone know how to do this.’ ”

Research direction: John Crowley funded individual scientists to fill the treatment void when he learned his daughter had Pompe disease. Ultimately John ended up partnering with one scientist to form a company that eventually was folded into Genzyme. And while his story is certainly one of the most dramatic (to the point of being the subject of a major motion picture starring Harrison Ford), John’s ability to drive the course of scientific discovery is becoming more commonplace in the rare disease space.

Product approval parameters: In June 2014, the Parent Project Muscular Dystrophy (PPMD) patient group, submitted the first ever-patient advocacy-initiated draft guidance for a rare disease to the FDA for Duchenne muscular dystrophy. Patients, through organizations like the PPMD, are now directly driving how Pharma should be conducting their research.
Because of the outsized role patients and their families play in bringing a drug to market, building strong patient relationships is a key marketing investment for orphan drug marketers. For example, Biogen Idec, deployed over 15 community managers to support people with living with hemophilia even before they had an approved product.
There are already signs of an “orphan drug spillover effect” on primary care marketing. Consider Sanofi’s community manager position in their Diabetes franchise. Or more recently, that Sanofi appointed a Chief Patient Officer. And this I believe, is just the start of the orphan drug effect.

Soon the patient centric tactics of Rare Disease marketers will be highlighted in “marketing excellence” meetings all over Pharma. Then questions will come during marketing plan presentations about “why can’t primary care teams start building patient relationships like their rare disease counter parts?” And before you know it, the small seeds of patient centricity will finally blossom throughout Pharma.

How design thinking can elevate the patient experience

Finding purpose in the mundane

What could be more boring than the traditional patient pamphlet?

Many times patient pamphlets are created without the most important ingredient, the patient. The traditional pamphlet is generally a collection of information that the health care marketer wants to impart to the patient. Little thought is put into what the patient wants to know. And even less thought is put into how the patient wants to physically interact with the pamphlet.

A little design thinking could change all that. One of the key principles of design thinking is purpose. Every element should have a customer-focused reason for existing. This requires a deeply rooted understanding of customers and how they interact with a particular object. It is this understanding that can transform the mundane into the marvelous.

One of the best examples I have ever seen is the in-room collateral for the Wanderlust Hotel in Singapore that I stumbled upon at an American Institute of Graphic Arts (AIGA) exhibit. The design team from Foreign Policy Design had a profound understanding of the prototypical Wanderlust guest. The type of guest who checks into the Wanderlust hotel is “curious and interested in discovering, engaging and immersing in new experiences.” They have a desire for personal growth through exploration.

Based on this understanding, the designers reinvented the “almost-useless conventional in-room directory” into a more useful travel tool. The in-room directory was morphed into an itinerary, full of useful local information including “area maps, train and bus maps, local shops and restaurants as well as thoughtful blank pages for notes and sketches.”

The reimagined in-room directory led to a redesigned check-in procedure. As the AIGA exhibit notes detailed, the itinerary “improved the check-in workflow, converting a laborious and dreaded check-in process into something fun, a talking point.”

This proves that one small design element can trigger a cascade of changes that lead to an improved overall brand experience. And the business results? The hotel has been featured in core travel publications including Travel & Leisure, has appeared on almost 500 blogs, and its room occupancy rates have risen.

And no wonder, “Creating a unique customer experience is one of the best ways to achieve sustainable growth, particularly in industries that are stagnating,” according to the consulting firm ATKearny. In industry after industry, higher customer satisfaction has been shown to drive sales and profits.

So back to the patient pamphlet. What is its core purpose? What is the problem that the pamphlet (or for that matter, the website, app or DTC ad) is trying to solve? What other problems does the patient have? Is there a role it can play there? How should it be redesigned?

What happens if the patient pamphlet is reimagined as an itinerary for better health, rather than merely a way to convey basic product information? Could infusing a higher-order purpose into a pamphlet set off a cascade of changes in all marketing activities?

Why your Point-of-Care strategy is half-baked

Conferences and vendor consortiums abound on point-of-care marketing. Yet many solutions miss an important point-of-care marketing opportunity: helping physicians extend care beyond the office.

The idea was first suggested to me by one of the most patient centric physicians that I have ever met, Dr. Frank Spinelli.  Dr. Spinelli challenged the audience at a pharmaceutical marketing conference to help HCPs extend the impact of the patient visit using technology, helping merge the online and offline experiences.

Pharma companies that help healthcare providers extend their patient care will find themselves welcomed in the doctor’s office. Why? Follow the dollar: physician payments are increasingly linked to quality of patient care and outcomes.

So how can marketers plan to extend their point of care tactics outside the office? Begin by reimaging the planning process. Rather than the siloed Patient-Physician-Payer approach to planning, charge an integrated team with a mission to:

  • Help prepare both the physician and patient for a productive office visit
  • Enable the patient to easily obtain any required medicine
  • Support and monitor the patient, after the visit

Rather than rush to the conclusion that “there’s an app for that,” take a step back. New ideas often start with new questions. Here are seven questions to prompt your team’s thinking about extending your point of care strategy beyond the office:

  1. What are the critical activities and information exchanges that must take place during the office visit?
  2. Would any activities or information exchanges prior to the appointment help improve the quality or efficiency of the in office experience?
  3. What are the barriers for different patient types to actually paying for and obtaining the prescribed medicine? How should patients and HCPs be talking about costs?
  4. Are there any other healthcare stakeholders—such as nurses, pharma reps, support groups, or associations—who could play a role before, during, or after the office visit?
  5. What can the physician uniquely contribute to the visit? Is it knowledge? Imparting a sense of caring or delivering peace of mind? Providing a solution?
  6. Are there different sort of “in-the-field” support people that could be provided? For example, clinical nurse educators or lay health workers?
  7. What follow-up activities would help ensure the physician treatment plan is monitored and adhered to? Is there any room for the new wearable technology?

Throwing a bunch of tactics together and hoping for the best will result in a mishmash of results. Answering these questions on the other hand, is a good recipe for an integrated point of care strategy, one that helps physicians extend the care they provide.

Why write boring health care copy?

Learning to write captivating copy from the halls of journalism

Why doesn’t a patient pamphlet grab you like the first sentence of a New Yorker health care article? I believe that it boils down to intent. Pharma copy is written from the point of view of “I have important information I need to tell you.” Journalistic copy starts from the premise of “I need to capture your attention.”

The aim of a news story is to get eyeballs on the page. The objective of a pharma pamphlet is to impart information to the patient. Or in the worst case, just fill the legal obligation to provide the information.

I gave a journalist friend of mine some pharma copy to rewrite. I was curious about the differences in how it would be written, particularly the opening sentences. Even after removing his expletives, you can see how much more engaging the journalistic version is.

Pharma Copy* Journalism Story
While some people in your life may know what to say when you tell them you have ALS, others may not know how to respond—or worse, may say something off-the-wall, or even hurtful The first time John wished he could just say “beam me up Scotty” was when he went to his first Thanksgiving dinner after being diagnosed with ALS. He thought his entire extended family was holding some kind of contest to see who could say or ask the most inappropriate thing.

*Disease state has been changed

The journalistic model of copy writing requires a significant shift. At the end of the day, it is about holding your information to a higher standard—patient engagement. Or as Tony Rogers in his About.com Guide to journalism says, “So when making the rounds of your beat, always ask yourself, “How will this affect my readers? Will they care? Should they care?” If the answer is no, chances are the story’s not worth your time.”

The key concept to extrapolate here is the need to interest and entertain your reader. So here are a couple thought-starters on how to export this idea to development of pharmaceutical information, particularly in the patient space.

  1. Define for your agency “what good looks like.”Gather a few examples of how your product and/or disease state has been covered in the popular and not so popular press. I am riveted by anything that Jerome Groopman writes. Look for good examples of science made accessible. Look for health care storylines that grab people. Compare that to your copy.
  2. Evaluate what is most/least compelling on your website. We have tended to discount “the click” in pharma. But “eyeballs on the page” is the metric used by online media evaluate the success of their endeavors and determine what gets covered in the future.
  3. Hire a freelance journalist to have a “whack” at your copy. Your procurement friends will love you as journalists are about half the cost of pharmaceutical copywriters. And many do a very good job at explaining difficult scientific concepts or MOA’s.

So take a look at your copy. Would you read it if you didn’t have to?

3 steps towards multicultural marketing

Amping up the spend on multicultural marketing is a no brainer given the expected flood of multicultural consumers into the health care market. However despite the rational arguments for investing in multicultural consumers, my fellow attendees at the recent Multicultural Health National conference in Washington D.C. felt selling multicultural investment in a pharmaceutical company is still an uphill battle.

The data supporting the business building opportunity of multicultural marketing keeps getting stronger. However, the funding for multicultural marketing programs within Pharma still seems to be managed according to the LIFO accounting principal, last to be funded, first to be cut. This has to change.

It is estimated that over 40% of the 33 million newly insured Americans by the health care exchanges will be multicultural consumers. Additionally, there are a multitude of ACA initiatives aimed at the different health care stakeholders designed to better serve the multicultural consumer including:

  • Patient Surveys: There are Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys specifically designed to assess the cultural competency of providers. It now matters that consumers feel respected and actually understand what the HCP is telling them. Materials in multiple languages will no longer be a “nice to have.” Your payer and HCP customers will demand them.
  • Multicultural HCPS: ACA expands initiatives to increase racial and ethnic diversity in the health-care profession. Companies will need to have plans for communicating to an increasingly diverse HCP universe.
  • Government Offices:  ACA elevates key multicultural health organizations within important governmental offices such as the National Institutes of Health (NIH) and the Department of Health and Human Services (HHS). That means these multicultural organizations have more power to put policies in place that effect drug coverage and marketing.

As the marketplace shifts to better serving multicultural consumers, so should pharmaceutical marketing departments. Here are three ideas on how to get started:

  • Consider reviewing the CAHPS cultural competency questionnaire and brainstorm how your product and service offerings can benefit the patient experience.
  • Partner with an institution to help them raise the cultural competency of their staff. For example, The Cleveland clinic has a multi-faceted approach to building cultural competency from physician education to forging ties to the community.
  • And last, but not least, protect your multicultural investment. How about a new accounting principle? FILO anybody? First In, Last Out.
Thanks for letting us share,
Dorothy

Scrap the core vis-aid, it’s a patient-payer world

This is the twelfth and final blog post in a twelve part series that transforms ideas from the marketing world at large into practical plans for pharmaceutical marketing in the time of health care reform.

There’s a strong patient and payer bent to the topics I chose for this blog series. That’s because I believe we are coming to the end of physician marketing, as we know it.

From now on, it’s going to be a patient-payer world.

There will of course be communication to physicians. But rather than providing 20 glossy pages parsing minute differences between drugs, I believe promotional efforts will increasingly revolve around improving the patient experience, outcomes and costs. And payers, not physicians, will be the primary arbiters of what constitutes acceptable results at a good price.

In the future state, there will be virtually no “work around” solutions for products that don’t have a real value story.

And I am not alone in my views. At a Marcus Evans conference I attended,

Kurt Graves, CEO Intarcia, said the decision to launch a product now comes down to one question, “Is there enough value in this product for payers to pay for it.”

Physician marketing will also have to change, according to Steven Pal, Corporate Vice President, Global Strategic Marketing at Allergan. In his Marcus Evans talk, gone says Pal, are the days of the large mass-market field force. Instead, companies need to deploy, “smaller, more agile sales forces that are more attuned to customer needs.”

Patients will be at the forefront of any value equation in the future. In fact, according to Ben Haywood, co-founder of PatientsLikeMe, it will be patient value that defines market value, His company is helping industry incorporate relevant patient reported outcomes (PRO’s) into their drug development efforts.

Patients are finally getting the information they need to assess the price/value equation for the healthcare services they consume.  The Health and Human Services Secretary release of the irrationally variable costs for common in-hospital procedures was a first good step. Across the country, the public’s eyes have been opened to the need to price shop, given the wide variability, even within the same city.

And quality of services, long held to be outside the ability of most patients to evaluate, is more readily available and digestible. For example, in Minnesota, patients can compare how individual clinics fare in helping patients meet their diabetes management goals.

Pharmaceutical marketing in the future will need a radically different game plan, one that is decidedly patient and payer oriented. Healthcare is evolving as we speak. Substantial change will happen regardless of how the Affordable Care Act, popularly known as “Obamacare,” is implemented. The outsized and often irrational costs of our current system have brought us to the place where the status quo is no longer possible.

As the popular saying goes, “People don’t change when they see the light, they change when they feel the heat.”   Pharmaceutical marketers are now feeling the heat with shrinking budgets and sales forecasts. My intention with this blog series is to provide a little “light at the end of the tunnel” by demonstrating how others have addressed similar problems. Extro-analogs aren’t brain surgery. All you have to do is use the 3 e’s:

  • explore industries beyond pharmaceuticals
  • extrapolate the core idea, eliminating the excuse of regulatory limitations
  • export the idea in a “pharma-safe” way into your marketing

I hope this blog series is helpful in sparking some new ideas and thinking. Let me know! Love to hear your comments. 

Thanks for letting us share,

Dorothy

R&D: 4 lessons in change from inside the R&D organization

This is the eleventh blog post in a twelve part series that transforms ideas from the marketing world at large into practical plans for pharmaceutical marketing in the time of health care reform.

Change in Pharma is possible.

To become a believer, you only need to explore what is happening in R&D organizations across the country. After the lost decade of drug development where too much money was chasing too few good opportunities, big pharma R&D has shaken up drug development. Gone are the large evergreen budgets. Gone is the stovepipe R&D organization that operated independently of any commercial considerations.

In May of this year, I attended Convergence East, the Life Sciences Leaders Forum held on in Cape Cod, Massachusetts where, extrovertic, was a sponsor. A good portion of the attendees were from the big pharma R&D organizations, including Astra Zeneca, J&J, Millenium and Sanofi to name a few.

Big pharma R&D is using four key strategies to bolster their R&D productivity:

  1. Looking outside for solutions: No more navel gazing for pharma R&D. When asked about what percentage of their drug development efforts were external versus internal, the answer ranged from 30-50%.  To paraphrase a representative from Shire R&D, “the NIH mentality is not going to cut it anymore, too much money and personnel.”
    • This external focus also involves importing leadership that infuses a more entrepreneurial spirit into their organization. For example, Sanofi has hired  biotech executives like Katherine Bowdish, Vice President, R&D on board. Prior to Sanofi, Ms. Bowdish worked at companies like Permeaon Biologics and Alexion Pharmaceuticals, successful biotech companies.
  2. Convening diverse perspectives. J&J has set up four innovation centers around the world designed to create relationships in integrated communities of academics, research institutions, early stage biotechs, venture capital and entrepreneurs. The remit of these innovation centers spans J&J’s three business units: pharmaceutical, consumer and devices. The goal is for J&J to become the partner of choice when there is an opportunity to be commercialized.
  3. Investing further upstream: Sanofi is investing in early stage high-risk opportunities that can use Sanofi assets in the process. One of Sanofi’s earliest success stories their partnership with a prominent Harvard professor, Dr. Gregory Verdine, to create Warpdrive bio. Warpdrivebio has a proprietary “genomic search engine” to identify “powerful drugs that are now hidden within microbes.”
  4. Customer focused development: Drug development is no longer a purely academic exercise. For example, to better focus its R&D investments, Cubist takes their scientists into operating rooms with their surgeon customers. Deborah Dunsire, CEO Millennium, spoke about innovation as beginning with the patient; about reverse engineering what is wrong with the patient, focusing on the patient’s unmet medical need and determining what solution would make the biggest impact on the patient’s life?

The same laser focus on innovation must make its way to the commercial side of the business. Change in the commercial model needs to occur everywhere—from reorienting the rabid focus on the physician at the expense of payer and patient marketing to creating new definitions of a pharmaceutical “product” offering. Think about patient marketing, do we really need more branded commercials running on the evening news?

The core idea to extrapolate from these R&D reorganizations is to turn to outside institutions, experts and customers to provide a fresh perspective on your business challenges So here are a few thought starters about how to export these R&D strategies and pump more innovation into the commercial model.

  1. Start from the patient. What are the upcoming changes in how patients consume media, search for healthcare information, pay for healthcare and use healthcare products and services? Once you have a “vision of the future state,” you can start to think about potential solutions.
  2. Gather a group of innovative thinkers from outside of Pharma and let them take a whack at some of your biggest issues. Convening thinkers from various disciplines is a time honored innovation strategy. In fact, I have been invited to participate in an effort to develop new approaches for eradicating polio by a multinational non-profit health organization. This organization is bringing together a group of thinkers from a variety of disciplines and industries to provide a fresh perspective on an intractable health care problem.  
  3. Create a portfolio of early opportunities. Allocate a portion of the annual budget to new and evolving technologies. Traditionally, pharma innovation centers tend to have little budget and authority. This has got to stop. Top management has to be actively involved with the change agenda. I have seen too many smart marketers spin their wheels in these innovation centers. Without top management active involvement, innovation just doesn’t happen.

Check back on Tuesday for the twelfth and final post in the twelve part series, “Scrap the core vis-aid, it’s a payer-patient world.” This final post coalesces the arguments for change in the face of health care reform and changing customer expectations.

Thanks for letting us share,

Dorothy

5 lessons in reinvention from Encyclopedia Britannica

This is the tenth blog post in a twelve part series that transforms ideas from the marketing world at large into practical plans for pharmaceutical marketing in the time of health care reform.

It’s time to throw the book at the pharma business model.

Actually, not one book, but an entire 32-volume set of Encyclopaedia Britannica.

Exploring how Encyclopedia Britannica blew up a 244 year-old business model sparked some ideas about potential life-saving changes to the pharmaceutical industry. In an article entitled, “Encyclopaedia Britannica’s President on Killing Off a 244-year-old product,” Jorge Cauz, the CEO of Encyclopedia Britannica, tells the tale of how the company evolved from a reference product business into a “full-fledged learning business.”

Reading this article, it struck me that many of the key components of their transition had relevance to the type of reinvention required in the pharma industry. Here are a few of the pertinent concepts worth extrapolating from the Encyclopedia Britannica transformation:

  1. Moving to a digital product. Encyclopedia Britannica announced in 2012 that they would no longer offer the printed version of Encyclopedia Britannica. What Encyclopedia Britannica offers now is a complete online suite of educational support products as well as an online store of DVDs, books, online reference books and software. 
    • Encyclopedia Britannica’s drive to digital was prompted by changing customer preferences. They found that  “families became busier and had less patience for doorstep solicitations.”  Customer’s expectations had also risen regarding the quantity and real-time updates. So Encyclopedia Britannica changed their “editorial metabolism,” to enable updated content several times an hour rather than several times a month.
  2. Shifting focus to a different customer group. Over time, Encyclopaedia Britannica’s core customer group evolved from individual consumers to school systems. Now approximately 85% of their revenues come from online curriculum products.
  3. Switching to a new sales channel: Encyclopaedia Britannica’s most painful transformation was to eliminate the 2,000 person sales force. Instead, Encyclopaedia Britannica employs direct marketing as well as a smaller field force targeting the school administrator market.
  4. Bringing in new skill sets.  As Encyclopaedia Britannica went digital, they found new skill sets were required. They needed a different editorial staff that could convey information using multimedia and interactivity. Encyclopaedia Britannica also required “curriculum specialists for every key department of the company: editorial, product development, and marketing.”
  5. Continuing evolution.  Encyclopaedia Britannica did not stumble upon their magic business formula out of the gate. Encyclopaedia Britannica tried CD-Roms, an online version of Encyclopaedia Britannica, selling subscriptions, free ad-supported consumer encyclopedias and a learning portal before developing their online education business.

So how do we export Encyclopaedia Britannica’s transformation to guide pharma’s increasingly urgent need to reinvent itself? Here are some thought starters:

  1. Recalibrate your customer investment portfolio. Just as your personal financial portfolio needs periodic recalibration to compensate for changing market conditions, so does your promotional portfolio. Calculate or estimate what percentage of your brand’s business is really driven by institutions such as payers and hospital groups versus individual physicians. Are you truly matching your investments to opportunities?
  2. Evaluate your sales channels. If your customer focus is shifting, shouldn’t your sales channels change too? There is no question that pharma has reduced the size of the field forces it employs. The real question for me is whether the industry has been aggressive enough in embracing multi-channel marketing. 
  3. Double your digital. According to a study by Publicis/Razorfish Healthcare, 35% of HCPs feel sales reps should use iPads. Isn’t it time to break the print habit? Develop a strategy to help motivate your marketers and sales people to increase their digital adoption curve!
  4. Assess your workforce. Seems to me that the evolution of pharma into a more patient focused business would require an infusion of new abilities. For example, adding customer service and compliance experts to your staffing model.
  5. Allocate a sacrosanct budget for innovation. Here is where I believe pharma marketing and sales have really missed the boat. In most marketing departments, there is little focus on keeping up to date with customer preferences and technological advances. A more structured approach needs to be taken to a) figuring out what are the most promising communication and service innovations and b) identifying appropriate pilots. 

Check back on Thursday for the eleventh post in the twelve part series, “ 4 lessons in change from inside the R&D organization.” In this post, I explore how the ways R&D organizations are reinventing themselves provides a model for commercial reinvention.

Thanks for letting us share,

Dorothy