Someone should have said “No!” (part 2)

Toughest job in pharma?  Product manager.  When things go well, everyone else takes credit for it.  When things go badly, everyone looks at you.  A product manager has tremendous responsibility and almost no authority.   Long hours, way too many meetings, and lots of people telling you what you need to do. Competitive pressures are intense.

In addition to your real customers the Product Manager must focus on an important internal customer, the sales organization. Despite the tension that exists between sales and marketing, a Product Manager knows to be successful you must satisfy the needs of the sales organization. The sales staff remains the voice of your brand, remains as the key vehicle to communicate your brand’s message and convince prescribers to use your brand.  So when access to prescribers is limited or denied and your brand is under competitive assault and as a Product Manager you can do something about it, then you instinctively spring to action.

This instinct, this impulse can lead to bad decisions, decisions that do not engage your best judgment.  Some one in the room should have said no to “Dine and Dash” and “Gas and Go.”  Some one should have seen this as further diminishing the role of the sales representative in the eyes of the physician.  Even as competitors were engaged in the program, some one in the room should have said:

 STOP!  Let’s figure out a better solution.

I can see this decision process happening.  The logic is, reps can’t see doctors, I must help.  Doctors need gas for their cars (or need to feed their families) so I will induce doctors by paying for their gas while my rep spouts the core message while their car is getting filled up.  (I never knew; was the oil checked at the same time?) We already feed them lunch, so why not dinner.  Come on, have we have gotten to the point where we believe the sales rep brings no value to the prescriber?

“Dine and Dash” and “Gas and Go” were wide spread in the industry. Lots of people made bad decisions.  Lots of people said yes, when they should have said no. These programs were reported in the Wall Street Journal.  (Not a bad barometer for decisions, how does it look in black and white in the Wall Street Journal? This one did not look good.)  It was so wide spread that it warranted a prohibition in one of the iterations of the PhRMA guidelines.  We don’t need guidelines; we just need to use good judgment.  We just need someone to say no.

Someone should have said “No!”

My brothers and I grew up with the admonition from our parents to “Use your best judgment.”  I am sure our family was not the only one that tried to live by this tenet reinforcing that you know what the right thing to do is, so do it.  And about the worst thing my Mom or Dad could say to me was “You did not use good judgment” meaning that was not a very good decision.

In pharma we have too many examples of times when we should have used our best judgment and we did not.  Decisions were made when some one in the room should have used their best judgment, some one should have said no.  These decisions contributed to the deterioration of the reputation of our industry, eroding relationships with other partners in healthcare.

Let’s try to use our best judgment on this situation.  A company (let’s call it Big PharmaCo) makes an important discovery and brings a new product (let’s call it product A) to the market that can make a big difference for patients with a serious disease.  Product A has some problems, mostly tolerability, and drugs in the same class come to market quickly and relegate this drug to a second or third line.  It turns out however, that Product A improves the effectiveness of other drugs in its class by enhancing their pharmacokinetics, allowing lower and less frequent doses of the competitive products. The dose for Product A that improves the effectiveness of other drugs is just one quarter the full dose all but eliminating the adverse reactions associated with the drug at full dose. Big PharmaCo discovers a better compound in this same class and takes advantage of the PK benefits of Product A and develops a combination product.  The combination product is a superb drug and becomes the market leader in the class.  Patient advocacy groups, active in this disease area, applaud the efforts of Big PharmaCo to bring improved therapies to the market.  Great story so far.

Competitors continue to develop drugs in this class and take advantage of the PK boost of Product A.  Here comes the point where Big PharmaCo uses unbelievably poor judgment.  Someone makes the recommendation to increase the price of Product A FOUR-FOLD.  In a chronic disease area, requiring multiple drugs for successful therapy, some marketing wizard recommends that the price be quadrupled.  And worse, the senior marketing management advances this recommendation and it is approved by the executive management.  Let’s make it even worse, the executive management of Big PharmaCo  is led by a person who is also a senior executive on the Board of PhRMA.  This is a true story; you can’t make up stuff like this.

Here is the rationale of Big PharmaCo and I want you to try to say this with a straight face.  The dose of Product A is one fourth what we had originally planned when we priced it (many years ago), so it makes sense to us to raise the price FOUR-FOLD.  We were the lowest cost drug in the class, now Product A is comparable to other products. Oh by the way, there was not increase in the cost of their combination product, and the pricing decision impacted the cost of therapy for all the competitive products that required Product A for its pharmacokinetic enhancement.

So how do you think prescribers saw this decision?  Bewilderment!  How do you think patients saw this decision?  Greed!  The company destroyed their reputation and relationship with prescribers and patient groups.  What were they thinking?  Why didn’t someone in the room say “You know I don’t think it is a good idea to raise the price of our drug FOUR-FOLD!”  Why didn’t anyone use their good judgment?  It is these kinds of decisions that impact how the public looks at our entire industry.  Not as an industry that is dedicated to improving outcomes for patients while making a profit for our shareholders, but rather as an industry where profit comes first, patients and physicians be damned. 

 The denouement of this saga:  One of those competitors that needed Product A to improve its profile, was launched grabbed the market leading share, replacing Company A’s fixed dose combination product.  The competitor’s product was a good product, well marketed but not good enough to overtake an established market leader.  Except perhaps, a market leader who used poor judgment.

The Pharm Horsemen – The Conqueror

As 2012 approaches, the fervor builds. The coming of the apocalypse. The end of time. A spiritually-charged restart button. I’ve seen the buzz. The movie, books, websites, and t-shirts. 2012 is a pivotal year for many reasons: political, social, and economic. And within the chaos, lies our industry. It’s our time, Pharma. You can ride (or continue to ride) one of the destructive horses I will describe in the coming weeks or blaze your own trail.

When you are faced with the challenges we must tackle, the dire comparisons are inevitable. Damnation and apocalyptic scenarios are just tongue-and-cheek, right? Not necessarily. Ask your weary 30-something friend, Joe/Jane Product Manager, how they are sleeping these days. He or she will probably tell you of recurring nightmares about warthog-man beasts with ripped shirts, bulging muscles, fiery breath and bloodshot eyes chasing him/her to the edge of the proverbial cliff.  He could describe the moment before he awakes each night, right before the beast reaches to push him off the ledge. Looking back terrified, he tells you he pleads desperately for the beast to stop. Yet, the only thing he can manage to scream are the three letters written across the beast’s torn, bloodied shirt.

R.O.I.!!!!!!!

The following morning, Joe/Jane returns to the office with sales on the brain. He calls his District Manager in Ohio: “DM, go after that other segment we never said we would, and do it with the same number of reps and with our current messages. Oh, also, try and pull all the scripts away from the top, second and third-tier drugs ahead of us in this class.”

And just as the DM is about to hang up the phone, confused and angered by the product manager’s request, Joe/Jane says:

 “Oh, and DM. Find a way we can take some market share from Starbucks.”

This brings me to my First Horseman of the Pharmaceutical aPRODUCTlypse:

The Conqueror. The Seller Dweller. The Rep Misleader. The Door-to-Door beater.

The urge to conquer all is human and business nature. We want to be everything for everyone. Consumer products, too. Coke wants to be a drink that unites the world. Apple , Google , and Microsoft  want to be your operating system, your gaming system, your phone, your media source, your search engine, your life caster. GE wants to power fighter jets or make Clark Griswold’s Christmas lightshow a reality.

Although extremely successful, even the above mega-brands, despite their efforts, cannot conquer all. I know many marketing managers in Pharma understand you do not give an SSRI to a child with ADHD and expect his test scores to improve. But it has become more and more apparent that the need to meet sales goals causes pharmaceutical companies to look outside the lines and damage their brands when if they examined their market earlier and more deeply, they would never have to resort to unethical or misleading sales and educational practices.

Your drug has a place. If you are 5th to the market, you may be late to the party, but the party isn’t over. Don’t be a party crasher. Don’t enter and immediately flip on your AC/DC  record, grabbing everyone to join you in a desperate head banging fit. The partygoers were enjoying a long mellow run of Yanni’s greatest hits. It’s not your place. Bring a variety of your music to “feel out” the crowd, work you way into the conversation, interact, stop by the spiked punch and karaoke machine and make some noise in due time.

Although cliché, the overused party analogy does convey how pivotal it is for pre-launch education, launch promotions, and post-launch marketing and medical education to guide your brand with consistency. Your patient advocates will begin spreading your scientific message early. Your key opinion leaders will enhance these messages with case experience. And this consistency will breed value.

There are so many tactical ways to approach each of these important phases in your product’s cycle. I won’t give those trade secrets away here.

But please remember, the next time Alexander the Great Product Manager sits down at your brand strategy meeting, tell him to put down the Quintuple Venti Shot Lightly Flipped and Heavily Whipped Starbucks cup, have a ice water, and stop stretching your brand thin.

Next post in the Pharm Horsemen blog series coming soon.

Parroting the Core Message

The consequences of not living up to our values…

Part of pharma’s precipitous plunge to the basement in physicians’ eyes was because of the growing dissatisfaction at there being way too many reps with way too little of real value to say. I strongly believe this decline in the perceived value of a sales rep was in fact a primary cause (rather than a secondary result) of the breakdown between the drug industry and its most important customers.

For most physicians, the quality of the relationship with a particular sales rep (if there is one) forms the basis of their perception of the company and the brand. Starting in the 1990s sales staff sizes exploded. High prescribing primary care physicians would have multiple reps calling on them—often trying to sell the same blockbuster product. Sales-force–sizing exercises predicted that more details achieving a greater share of voice would lead to increased market share. Home-office, commercial types began impersonally describing sales forces as faces—faces in a burgeoning crowd. This characterization turned out to be prescient. Prescribers began to see the stream of sales representatives as mere faces without substance that provided very little information that helped them manage patients or get better outcomes from the valuable drugs hiding in the reps detail bag. To dam the deluge of faces spewing superficial sales messages, physicians began to limit representative calling time. Eventually, some physicians chose not to see representative at all.

The industry completely missed what its customers were saying. They were not saying, “I do not wish to better understand how I can use a drug to the benefit of my patient.” Rather, they were saying, “Unless you bring me value, I cannot afford to spend time with you.” Seeing the reductions in call time, sales and marketing managers began to design and implement selling approaches to accommodate ever abbreviated exchanges with prescribers. Core messages have always been a key aspect of any marketing plan, characterizing the primary value of a brand to set it apart from its competitors. But they got abused and bastardized, becoming the sentence or two parroted by the sales rep. Reps became simply a walking delivery vehicle for a short commercial message. Is there any mystery why doctors finally said, “No more?”

Of course, there is a solution. But change needs to happen soon, before all the doors close. It starts with a revitalized belief that our industry does, in fact, offer important products and technology that result in better outcomes for patients. I believe this, and guess what? You believe it, too. For many pharma companies, this tenet forms the essential value in their mission statement. Imagine if you were to craft your marketing and sales efforts to be consistent with your corporate mission and approach your customers framed by these ideals:

Improve the quality of human life. Use innovative products to ease suffering. Patients come first. Put the needs and well-being of the people we serve first.

Go check the plaque in the lobby of whichever corporation you happen to work for. We already have the words. We have the core message. Now it is time to, once again, put it into our actions.

Blockbuster drug, it’s so hard to say goodbye

Blockbuster drug, it’s been a long road. You’ve given me all I’ve ever needed… global dominance for more than 10 years, exponential growth, accolades beyond belief.

Blockbuster drug, I love you more than my kids. But you had to break my heart. You had to start to die and when that clock strikes 12 on December 31, you will no longer be mine.

Blockbuster drug, I wasn’t ready for this. You have been on life support for a while now. And I saw all of the signs. 

But who can say no to a sure thing? I knew I had to plan for your departure. I tried to lobby for a patent extension. I was promised another just like you, when your time came up. And everyone around here kept saying when you were gone, we’d continue like nothing happened.

What about a reformulation, someone said? An extended release version would surely get you a new patent. And even though marrying you off with a complete stranger seemed asinine at the time, at least it would have kept you around a little longer.

Sadly, a dose of reality has slowly started to come into focus. There was no patent extension, despite millions spent on lobbying. The pipeline has proved not very rich. And approval of the successor drug was held up for more than a year with severe manufacturing problems.

I guess I could take the easy route and share you, but I’m not into open relationships. Next time, I won’t be so close-minded about the future, if there is a next time. 

What are biologics, anyway?

Blockbuster drug, it’s time to say goodbye. When you cross over to the other side, remember me, because no one else will.

– VP of Marketing

diary of a mad marketer 3

Diary from January 10, 2013…see next video of our future pharma marketer below.

Almost caught the shelter on fire this morning—I set one of my comic books too close to the propane stove and—whoosh! I forgot to stash a fire extinguisher down here but fortunately I was able to beat the fire out with an old sales aid. It was the one with the smiling woman on the front cover—you know the one. After the fire was put out I looked down at the sales aid and the woman’s face was sort of scorched and distorted by the flames. Kind of a cool, edgy look if you ask me—the kind of thing we never got from our agency. Nobody ever wanted edgy at our place— No, we stuck with “Keep smiling with Smileor-EX” or “Life is Energy. Fresh” or my personal favorite: “If you’re happy and you know it, Smileor-EX.” Repeat it until you want to puke. Our brand colors changed over time. We had 50 different presentations touching 300 committees, chewed up, spit out, with no consistency whatsoever. How could we not see what we were doing? I stared at the woman’s scorched face for about ten minutes before I realized how much time had passed. I think I’m starting to lose it.

My grandfather told me he built a fallout shelter in the basement during the Cuban Missile Crisis—cinder block walls and bricks on the roof supported by beams and plywood. Designed to keep out radiation, of course. That’s not the issue for me, obviously. I just need to keep out of sight and not attract attention. I wish I had a pet down here to keep me company—maybe I could catch some spiders and crickets down here and keep them in a jar as pets. I wonder what they eat? Maybe the spiders eat the crickets……maybe I could train them.

Diary of a Mad Marketer 2

Diary from January 8, 2013…see next video of our future pharma marketer below.

This might not be so bad after all. I’ve got enough books and magazines to keep me occupied for awhile, and three months worth of food and water. The satellite dish seems to be really screwed up, though.

Who am I kidding? I’ll go berserk down here! What I really want to do is go back to work—sit in my cubicle and work on sales force tactics like I used to. But the company doesn’t need people like me now—when Smileor-EX went off patent, we thought we’d have the typical pharma restructuring. Wrong! Instead we got a “paradigm shift” from senior management—from now on we’d be more “customer-centric.” They should call it a “paradigm shaft” if you ask me. I’ll shift their paradigms! The only shift I noticed was the one that shifted my butt right out the door. They said we were on “indefinite leave,” but that’s a nice way of telling us we’re toast. Oh, well—even if I still had a job it wouldn’t be safe to go to work right now.

The one thing that haunts me is the big question—where did we go wrong? Or did we? How did pharma become the enemy? Nobody complains when someone makes millions on teeth whiteners, iPhones, or designer luggage. But try to make a living off something important like curing disease, and suddenly you’re public enemy #1. People now trust used car dealers more than us! Depressing.  That’s all until tomorrow—time for dinner. I wonder what kind of wine goes best with Vienna Sausage?

Diary of a Mad Marketer

Diary from January 2, 2013…see video of our future pharma marketer below as well.

A little better organized now—still getting over the shock. Can’t say I didn’t see it coming…at least I was partly prepared. Think I have water enough non-perishable food—well stocked with Vienna Sausage, that dried beef stuff in a jar, and something called Potted Meat Product (better leave that for last). The internet has a lot of good resources for maintaining shelters. Most are circa Cold War/Cuban Missile Crisis, but checklists were useful in getting ready (what’s Mix Trix?).

Not sure how long I’ll have to stay down here—it’s just not safe up there. Everything we did seemed to go the wrong direction. When we tried to sell into a big market, they said we were ignoring rare diseases. When we tried to sell into a smaller or orphan drug market, they said we were charging too much. When we had the 5th drug in a class, they said we were selling a “me-too.” When we were first in a market, they said we were using “monopoly pricing.” What do these people want! It’s like they didn’t trust anything we said or did!

That’s all for now—I need to try out this chemical toilet (I wonder how you empty this thing….).

Making the Case for Pharma Marketing

Time out! I know in my past few blogs I have focused on some thorny issues regarding how pharma goes about its business—trust, value, and communication issues. However, I want to take a few minutes in this article to blow my industries’ horn loud and clear. That is, the pharma industry has and will continue to do some absolutely miraculous work in terms of our overall healthcare, longevity, and well-being.

I could argue that over the last fifty years, the research and discovery of new medicines and treatments for a wide variety of diseases has improved the lifestyle and longevity of billions of people over the entire earth. I could also argue that because of these therapies and medicines, the world wide costs of healthcare have dramatically decreased if compared on an annualized and standardized dollar cost.

There is also the case that could be made for physicians and researchers who have become emboldened because of the work of pharma to delve further and deeper into the understanding of diseases and body systems that help them develop innovative new thinking about the human body itself. This of course has led to even further discovery and disease management. Just look at the improvements made in the areas of cardiovascular disease, cancers, neurology, and infectious disease to name a few important areas.

There is a further consideration that we all must also acknowledge if we are to understand how this all comes about and how it will continue to evolve in the future. While it shouldn’t be viewed as such, there is that “P” word—profit. When, especially in the course of American history, did profit become an ugly subject?

Let’s face it: The profit motive is what drives the engine of American success. While there are many of us who love science and research simply for the pure joy and knowledge of understanding, there are virtually none of us who can live for free—that’s where the profit part comes into play.

The pharma industry is no different. It takes vast amounts of resources, people, and money todiscover, develop, and yes, market, those efforts and fruits of the pharma pipeline. It could certainly be said that pharma derives much profit and reward from its efforts—pharma is typically among the highest percentage profit industries. But let’s make that the topic of another blog. Let’s just focus now on why pharma needs profit.

Everyone will likely agree that pharma needs profit for the scientists, the labs, the buildings, and the other necessary infrastructure it takes to do business. However, some of us will part ways when it comes to marketing and the costs of such efforts. Let me tell you why that marketing effort is absolutely essential.

Why pharma needs marketing:

• There is a need to educate all healthcare professionals about the product, its clinical data, where and when the product should be used, and how to discuss the disease and treatment with their patients.
• Pharma can and should differentiate its products from competitive products and therapies. By doing so, healthcare professionals and patients can make informed decisions on what works best for them.
• Pharma and KOLs are the most informed and experienced when it comes to understanding the science, data, and disease process as it relates to the use of a product. They should be the ones to tell the story with fair, transparent, and credible balance on all sides.
• Finally, only through the marketing process can pharma earn a fair return and profit on its investment into research and discovery. If that motive is removed, there is no incentive to innovate.

Agree? Disagree? Have another perspective? Let me know how you see it.