Achieving Launch Excellence in Asia-Pacific Transcript ... - IMS Health

Achieving Launch Excellence in the Asia-Pacific Region
TRANSCRIPT:
IMS Insight Online Interview
IMS Expert: Anthony Morton-Small
Hello and welcome to the IMS Asia-Pacific Insight interview. My name is
Andrew Crothers and I am here with Anthony Morton-Small, of IMS
Health. Anthony has over 12 years of pharmaceutical industry
experience. He currently is the Practice Leader for Commercial
Effectiveness consulting area in IMS Health and specialises in designing,
managing and implementing commercial effectiveness, promotional
effectiveness and performance management solutions.
We are going to be talking about the challenges that face
pharmaceutical companies today when launching new products in
markets in the Asia-Pacific region, and shed some light on certain
aspects that these companies should factor into their planning. What
should these companies be doing to increase their chances of a
successful launch?
Hello, Anthony.
Hello, Andrew.
I’d like to open our discussion today with some facts and figures and get
your take on that.
Sure.
I have here results from a study that IMS HEALTH conducted between
2007 and 2009 and it states that only 61 of some 8,600 products
launched in that time period met IMS’ criteria for launch excellence.
That seems to be extremely low.
Yes, in Launch Excellence study, we found that launch success declined each
year as the survey went on. For example, in 2007, 2% of products, 88 in total
outperformed in more than one country following launch while that figure
dropped to 1% or only 14 products in 2009. There are a number of reasons for
these low take-up rates. It really boils down to how well companies know their
markets and how they deal with new challenges in the local markets.
That’s interesting. You mentioned new challenges. This implies that the
launch environment is changing then?
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Yes that’s right. Companies are acknowledging, but not yet consistently
responding to, the new demands of the changing launch environment. The issues
are essentially threefold. Firstly, we are seeing different decisions makers today.
The traditional prescriber-based sales model is ineffective in commodity markets.
Companies need to address all stakeholders and not simply the prescribers these
days.
I see.
Secondly, there are different market dynamics. Fewer launches today are
achieving an even modest therapy market share of let’s say 5% in their first year.
We are seeing today that even the best market share uptakes are not as high as
previous years.
What would be the reason for that then?
Well, really it is to do with a decline in the impact of the traditional market model
externally, and internally it’s more to do with a lack of preparation and readiness
to launch as well as a failure to align objectives, and identify and incentivise
payers & policy makers.
I see. You mentioned a third reason for launch failure?
Yes, pharmaceutical companies are faced with differing timescales in different
countries. Companies need to understand the optimal range and timing of
prelaunch activity at a global and at the country level. Most importantly,
companies are not capitalising on opportunities presented in the first six months
of launch, and our research and experience shows that the sales seen during this
crucial period determine sales thereafter.
So companies really need to make an impact in the first six months of
launch.
Actually I would say now that we can narrow that window even further to the
first three months as we have seen in our 2008 study that within the six-month
window there lurked an even shorter critical time frame; on average, three
months is the period in which a launch agent establishes its share of the dynamic
market in its therapy area. In other words, it has become evident that sales
efforts in the first three months tend to determine sales trends for the first two
years of a product’s life cycle.
Really, it’s as short a period as that? That’s a real challenge then.
Well, yes it is. But it is within the power of companies to make a success of a
launch by being fully prepared while adapting to the dynamic market to ensure
that the initial launch trajectory of a new product is created by the drug being
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prescribed for new patients, by having existing patients switched to it or by
being added on to their existing regimens.
OK, so we have identified the 3 issues facing companies launching new
products. How should they be addressing them, since you say that it is
in their power to make a difference?
Well, taking the first point about dealing with different decision makers,
companies should have a powerful and pertinent value proposition for the
product that is compelling and differentiated from the existing therapies in the
category. This means ensuring their messaging are consistent yet adapted to the
different decision maker audiences, and aligned through country communication.
That can be quite a challenge. Can you give any advice on how this can
be done?
Yes, of course. For example, to do this successfully with payers, pharmacos need
to understand payer motivations such as budget impact, cost-effectiveness and
therapeutic value to meet the value criteria necessary for optimal approval. It
comes down to understanding and catering to your audience.
OK, so getting the value proposition for the product right for each target
audience is crucial. What specific actions should companies be taking
prior to launch to communicate their value proposition effectively?
Firstly, companies need to identify who is responsible for the funding flows and
formulary decisions for the related disease areas both now and in the future.
Then they need to identify the decision makers controlling these funding flows
and understand what drives their buying decisions. From here they can craft
their value proposition for new products during the Phase Three of clinical trials,
and keep building momentum and interest throughout the trials and beyond in
terms of real world patient outcomes and value over other therapies.
Right so it is an ongoing process.
That’s right. And during the launch process they should be segmenting payers
and target areas of the value dossier accordingly. Obviously they also need to
build the commercial go-to-market strategy in tandem.
And what about dealing with the different market dynamics you
mentioned at the beginning?
Companies need to build long-term launch strategies for non-prescribing
customers through an effective stakeholder engagement strategy. This is
required to drive market expansion. They need to consider all stakeholders such
as policy makers, payers, patients and prescribers. It’s not enough anymore to
target just prescribers.
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So the key is to target all stakeholders then.
Exactly right. Roche is a good example with the success of their oncology
products in a many geographies. They were basically more prepared. They found
a local strategy in each country, they made a success of engaging all
stakeholders, and that includes patients, they worked out how to best work with
payers in the local context.
So it proves it can be done with more preparation and an in-depth
understanding of the individual market. But how do companies manage
the different timescales?
There needs to be strong governance of the launch strategy across functions and
geographies with a focus on quality and timeliness.
I see, so everyone working to common objectives and strategies
relevant to their area.
Yes that’s right. Basically it comes down to the right internal alignment and
measurements of the launch strategy. Companies that have succeeded at launch
did well in building alignment into their planning process, creating enterprisewide
launch focus, and benchmarking and tracking performance consistently.
So the launch process needs to be managed from the top down.
Not necessarily, but centrally driven yes. Certainly senior management
leadership is crucial for setting the broad direction. When launches have been
unsuccessful, we have seen that wrong expectations have been set in terms of
over promising or ignoring potential. Also there tended to be an insistence on
global policies being followed that work in the US or EMEA perhaps but don’t
work elsewhere. As I mentioned before, it all comes down to knowing your
market.
A case of one size does not fit all.
Precisely. Companies need to work out the dynamics in individual markets and
work that market locally.
So, you’ve mentioned an interesting point, that what works in one
market does not work in other countries necessarily. Let’s look
specifically at the Asia Pacific market now and the localisation that
needs to take place.
Well, as I’ve just mentioned, the crux of the matter is knowing your market and
being able to adapt your strategies to local markets. Failures in the past clearly
resulted from the failure of companies to capitalise on opportunities.
What kinds of opportunities were typically missed?
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For example, the companies failed to develop a deep understanding of the
indigenous economies, historical trends, cultural predilections and public policy
among other things. The launch was compromised in each case as a result. They
needed to consider that the approaches they had been using in Western markets
might not fit local circumstances. What will work in the US for example is not
necessarily going to work in Korea.
Of course. So homework was not done then.
To a certain extent, yes, but you have to remember that these markets were
generally unknown territory. And other factors contributed as well, such as an
absence of clear forecasting data in these emerging markets, compounded by
the fact that the majority of patients were undiagnosed, under compliant or
under served. With a lack of data on the true healthcare system in the target
country, it is difficult for pharmaceutical companies to adequately plan launches.
And of course there are the challenges faced with Asia being such a dynamic
market.
What do you mean by that?
Well, markets in Asia are changing all the time. So launch principles have to be
revised more often than would be necessary in a traditional market, which isn’t
going to change much over time. To give you an example, the market in China
has changed beyond all recognition from the market it was a year ago, so launch
principles that were used last year simply won’t be appropriate today. In some
countries, the landscape changes so fast that strategies have to be revised even
during the launch process itself.
So what kinds of changes take place in these markets that can have
such an impact on launch success or failure?
It can be introduction of new regulations, government reforms, changes in
insurance regulations, or more drastically, policy change as a result of a change
of leadership following an election can change the potential success and entire
outlook for a launch overnight – for instance in the US with the passing of the
Healthcare Reform legislation creating expanded coverage for uninsured
Americans. In the Asian context, the healthcare reform activities in China as well
as is the impact of mandatory drug pricing controls on generic supply driven by
the recent elections in the Philippines.
I see. So how can pharmas be better prepared to launch?
At IMS Health, we have identified the five drivers for launch uptake in any
country are Advocacy, Approval, Access, Adoption and Adherence. But in
addition, companies need to consider what we call the Three As of pharma
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marketing; Awareness, Accessibility and Affordability. Let me just quickly cover
these one by one.
Certainly. You mentioned awareness as being the first of the three.
Yes, Awareness. MNCs need to actually create the market for their drugs by
educating patients and physicians on the benefits and value of this medicine over
others, and as mentioned before, all stakeholders. To do this, they need a
thorough understanding of disease states, therapeutic options and the potential
fall-out of non-compliance. Innovative outreach programmes are needed such as
key collaborations, sponsorship of a family network support, language translation
and so on.
And the second A, which is Accessibility?
Accessibility to medicines (in terms of healthcare infrastructure) is a major
challenge as there are substantial variations in availability between say urban
and rural environments in emerging Asian markets. Companies, therefore, need
to pay particular attention to local access to diagnosis, prescribing & dispensing
stations and distribution channels to ensure their products are economically
supplied, targeted accurately and get to market where there are access
challenges.
I would suppose relationship building would be a critical component of
their strategy?
Actually, no not necessarily . Sometimes quite the opposite in emerging markets,
in fact.
Oh really?
Yes. Companies need to realise that relationship-selling is not always going to
work as well in these emerging markets, where the local manufacturers will have
the relationship advantage. They need to be prepared to prove their products
value over local therapies through in-country clinical trial data, which may
require additional investment.
Yes, I can see how that will be a major difference to marketing in their
established markets. And the third A, I am guessing, would be
Affordability.
That’s exactly it. Naturally pricing is a concern in any market but it is
particularly sensitive in APAC, where inflation, GDP growth, rising incomes and
elevated expectations make price a crucial buying decision. GlaxoSmithKline in
India is a prime example of a company operating a local pricing strategy across
its portfolio. In China, we see different pricing strategies between urban and
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ural markets. MNCs can also meet the challenge by partnering with local
manufacturers and suppliers and seeking possible tax exemptions.
That’s an interesting point. So applying the three As is crucial when
launching in APAC. What assistance is there for companies available
from IMS HEALTH?
Well, IMS HEALTH is well positioned to help MNCs avoid common pitfalls and
strengthen the three Foundational Success factors of determining and optimising
their product’s value proposition, effectively and efficiently engaging
stakeholders, mapping out resource allocation and monitoring and driving
performance, as well as aligning and preparing these organisations for launch.
I see. You mentioned common pitfalls just now. Can you give us some
examples of what these typically are?
Yes, certainly. What we see often is that companies don’t tend to learn from past
launch mistakes not just in targeting their audiences better, but also they tend
to under-estimate their own constraints, they don’t give themselves enough time
to prepare, and don’t adopt a consistent framework to drive the launch execution
process to ensure plans are followed through.
What can happen as a result?
They can fail to get their product listed on formulary, or payers won’t accept
their value proposition, or they could fail to forecast the demand in Asia, or fail
to drill down to the base of the socio economic pyramid, to the patients, and
understand patients’ capacity to spend on medicines. These are all issues IMS
HEALTH can help companies avoid.
I suppose companies can also take advantage of IMS’ in-depth
knowledge of the market they intend to launch, and services to help
them achieve better success as they prepare to launch into those
markets.
Very much so. We are well positioned to assist in a number of ways. As you
mentioned, we have deep therapeutic market knowledge and competitive insight
so we can advise on the complex competitive dynamics in today’s changing
markets. Secondly, we can advise on marketing approaches to take in individual
markets.
Your analytical tools are also known to be pretty effective.
Yes, using IMS Radar Dynamics, APLD, primary market research and enhanced
promotional audits, we have country-by-country evidence-based insight into
marketing tactics and success drivers.
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Right. As well as supplying the needed information, how else can IMS
HEALTH add value to the launch process?
Our clients are up against competitors that may have significant resources and
effective marketing and sales force spend. We have designed specific
methodologies and tools to help our clients’ investment stays focused and
effective by optimising investments in the commercial planning and execution
stages.
Great, well, this has been a very interesting topic. Is there any
additional advice you would like to give before we wrap this up?
Well, in summary, I would say that MNCs should adopt a 5-tier strategy for entry:
One: Act Fast, Two: Understand, Three: Differentiate, Four: Tailor and Five:
Execute. And know that your success is dependent on the first 3 months of
launch.
Each of those points is self explanatory, and I would imagine each are
equally as important. So let me just repeat them again. It’s Act Fast,
Understand, Differentiate, then…?
Tailor to the market and Execute well.
Tailor and Execute. OK. So, in summary, achieving launch excellence
really depends on understanding and catering to the local market,
engaging all stakeholders and aligning strategies for launch success.
Anthony, thank you very much for talking to us today and providing an
enlightening insight into the challenges and solutions to launching
pharma products in the Asia Pacific region. Thank you.
It was my pleasure. Thank you Andrew.
Contact Us!
For questions or comments regarding this IMS Insight online interview, please
contact info.sg@sg.imshealth.com.
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