Pharmaphorum
| Cassandra Rix
The cost-constrained healthcare environment continues to demand that pharma
demonstrates convincing incremental brand value. At the same time the hurdles
to gaining reimbursement or coverage and allowing clinical uptake are becoming
more complex and without doubt the absolute requirement to engage more payer
stakeholders in launch preparation is clear.
We are all well aware that launching a product with a compelling Brand
Value Proposition that resonates with multiple stakeholders has become
fundamental to gaining reimbursement across Europe and insurer coverage in the
US. With some success, pharma has risen to this challenge, designing better
clinical platforms to generate the evidence to demonstrate the outcomes
required by an ever-changing customer base, and subsequently bringing new
brands to market more effectively even within diverse healthcare systems.
But what of those brands that have been successful in meeting the
requirements and negotiating the hurdles to achieve reimbursement and coverage
at launch or soon after but then fail to meet the projected financial
expectations? After rigorous, evidence-based processes to demonstrate the value
of our brands, why does this happen? Surely the imperative (at least in
England) of funding nationally approved treatments should guarantee local
uptake? Unfortunately, the truth of the matter is that it does not. The same
legislation that requires NHS payers to provide funding for treatment approved
by NICE also demands the balancing of ever tightening budgets. National market
access, whilst increasingly well understood and achieved through the
demonstration of evidence-based cost-effectiveness, is not the only game in
town.
A new set of rules
National level endorsement, approval or even recommendation of a particular
treatment or product is no guarantee for local access or clinical uptake: a
product that makes health economic sense might not be affordable at a local
level and the information that drives national support does not necessarily
compel stakeholders in different regions to agree to local funding.
In the UK, NICE or SMC recommendation does not prevent local payers from
challenging funding for brands based on the question of affordability and real
world value. The rationale applied by NICE for example does not always
translate in a similar way to local commissioners and payers required to manage
a specific population with specific needs. What does a QALY mean to a local
commissioner or pharmaceutical adviser who has to weigh up the benefits of a
new intervention for the population in their region, against the cost of other
interventions competing for the same scarce resources? It seems not as much as
industry has been led to believe.
Playing the game
To agree to fund a brand within their local population, stakeholders need
to understand the financial impact of use in specific patients. If use of the
brand in addition to or rather than the current standard of care calls for
financial investment, payers need to consider where they are within the current
annual planning cycle. For example, it may be necessary to apply for additional
budget mid-year (unlikely to meet with success) or divert finance from other
sources (a considerable challenge in its own right, for discussion in another
article). To increase the likelihood of success, it is therefore much better to
prepare stakeholders for a budget impact in the midst of their financial
planning for the next year.
This may seem like a simple solution, however we need to remember whenever
this is undertaken, considerable resource and effort from stakeholders is
needed to drive the process. Persuading these individuals to take action when
there are many other priorities to consider is a real challenge. Therefore,
they will do this only if they believe there is true value in what they are
committing to pay for.
What is value?
As described earlier, providing clear information on the financial impact
of a new treatment is a key success factor in gaining interest from local
stakeholders. However, this is not the only key step. Local stakeholders must
also be convinced of the brands value to motivate them to find available budget
within cash constrained environments.
Perception of value for these stakeholders depends on both their local
health economy situation and their personal objectives. Successful
communication of the Brand Value Proposition relies heavily on them feeling
considered and understood as individuals and what drives their decision-making
being evident. Only once they believe you understand their individual
challenges and can help solve them, will they be likely to consider the
potential value that your brand could bring to their patients.
A multitude of factors drive value for each stakeholder audience based on
their local health economy’s financial situation, their personal needs and
current understanding of the given therapy area. Only by uncovering and
speaking to the individual value drivers of each stakeholder can we develop a
Brand Value Proposition that will resonate with them collectively and be
flexible enough to motivate them individually.
Mapping the right message to the right
stakeholder
Generating in-depth understanding of market dynamics is vital to uncovering
these diverse stakeholders’ value drivers. It is possible to identify common
value drivers across different customers and to segment stakeholders according
to their characteristics, much as Pharma has traditionally achieved with
clinicians. This stakeholder understanding and segmentation facilitates the
development of segment specific Value Messages that can then be used to build a
relevant story that both consistently communicates the Brand Value Proposition
and addresses the different needs of each stakeholder group.
The core Brand Value Proposition should reflect the ‘essence’ of the brand
whilst underpinning a flexible communication approach that can be moulded to
appeal to different customers and form the ‘shape’ of conversations led by
field-based teams.
Furnished with this insight and a route map through the Value Proposition,
teams can then use their local knowledge to match customers’ needs and value
drivers to the most relevant and resonant messages. This will lead to
compelling communication of the Brand Value Proposition, supported by
appropriate financial information to demonstrate budget impact and
appropriately presented clinical data.
Whether at launch or at different stages into the life cycle of brands,
developing a Value Proposition and a suite of associated Value Messages that
all stakeholders can identify with is essential in order to generate local
market access and drive product uptake.
Clearly, successful implementation of brand communications depends above
all on matching the right messages to the specific needs of individual
customers based on their role in decision making. Pharma are beginning to
understand that to meet this complex challenge it needs to get under the skin
of their customers and work in partnership or co-creatively to create Value
Propositions, Value Messages and indeed the models that demonstrate financial
impact to ensure resonance with them – which will ultimately drive success for
our brands.
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