In Lemony Snicket’s A Series of Unfortunate Events, Violet Baudelaire’s magical hair ribbon is the inspiration for all her brilliant inventions as her siblings battle to escape the clutches of the evil Count Olaf.
When she loses the ribbon and gets captured by the Count, she’s forced to improvise with a piece of fabric bitten from a white medical coat. The improvisation works and, with a bit of cunning, the Baudelaires finally break free from The Hostile Hospital and continue their journey to safety.
Okay, the story isn’t the most obvious metaphor for the challenges facing pharma companies as they try to launch new medicines in the COVID-19-19 era. But there are similarities. Because when the promotion of a newly launched medicine has for so long depended on the magic of the field force, losing the opportunity for face-to- face interaction is like a Baudelaire losing a ribbon in a threatening situation. The risks are real. The only option is to think hard, adapt quickly and build on what you learn.
So what are the launch lessons from lockdown? Let’s take a look.
Pharma launches: consistently inconsistent
First, let’s be clear: pharma’s launch performances in the life before COVID-19 weren’t pulling up any trees. The numbers tell a consistent story. In 2013, McKinsey/Evaluate estimated that around two-thirds of drug launches don’t meet sales expectations in the crucial first year on the market – and 78% of launches that fall short of year one forecasts continue to do so in year two. In 2019, an IQVIA study concluded that fewer than 10% of 282 drug launches in ‘must-win markets’ between 2010 and 2016 could be regarded as ‘excellent’ – a bitter pill to swallow when ‘launch excellence’ is supposed to be one of the industry’s top priorities.
More recent studies are just as damning. McKinsey’s analysis – outlined in its December 2020 report, ‘Ready for launch: reshaping pharma’s strategy in the next normal’ – revealed that 40% of worldwide drug launches between 2009 and 2017 failed to meet their two-year forecasts. Moreover, out of 86 launches scheduled for 2018 onwards – with anticipated sales exceeding $300m – every single one had been disrupted by delays, lost revenues, or both.
The pandemic has only thrown more fuel on the bonfire of challenges pharma companies face at launch. McKinsey reports that, as COVID-19 struck, in 50 of the 86 disrupted launches, companies lowered sales expectations by more than 25% – representing a 9% decline in the net value of the 86 medicines and a total loss of $10bn globally.
Pharma’s track record of launching medicines isn’t quite ‘A Series of Unfortunate Events’, but its performance is variable at best. Despite this, launch models have barely shifted. McKinsey suggests that that traditional model is losing effectiveness, and the numbers back up the claim.
The COVID-19 catalyst
On the face of it, the disruption caused by the COVID-19 pandemic was the last thing industry needed. Being forced to bring new medicines to market without the face-to-face firepower it’s relied on for decades hardly inspires optimism. However, there’s an argument that lockdown restrictions have liberated pharma’s commercial model, forcing companies to accelerate towards omnichannel engagement that has, until now, been more rhetoric than reality.
It’s way too early to measure the true impact of COVID-19 on pharma drug launches, but it’s clear that the industry’s over-reliance on in-person meetings is on borrowed time. That said, I wrote similar statements back in the late 90s, when commentators were predicting the demise of the field force and a total rewiring of pharma’s commercial model. That recalibration is at last happening and it’s long overdue. COVID-19 was the catalyst – and its implications for launch strategy are likely to be significant.
In its December 2020 paper, McKinsey highlighted five linked imperatives to create the conditions for a successful launch: rapidly personalised content, analytics-enabled engagement, innovative patient channels and services, nimble front-line operations and closed-loop execution. These critical success factors will be familiar to many as the underpinning arguments to omnichannel thinking that has been gaining traction for some time.
Key qualities of launches in the ‘new normal’
But what else have we learned so far from the COVID-19 experience at launch? What are the key qualities we see in launch leaders and how do they relate to a post-pandemic world? Here are seven common characteristics of successful launch strategies.
1. An authentic purpose
Stephanie Hall, Founder and Managing Director, Uptake Strategies – and a member of the judging team for PMEA’s Award for Excellence in New Product Introduction – believes that first and foremost, launch leaders have an authentic sense of purpose. “Leaders have a vision of success that isn’t just about meeting commercial targets, it’s about capturing people’s hearts – patients and doctors – and understanding what they’re doing and why.
“Successful teams connect everything to a shared purpose, and they communicate it clearly both internally and externally. The whole cross- functional team is aligned around values and purpose, rather than just classic key messages. And it’s authentic too; strong teams with an authentic purpose have a resilience, togetherness and enthusiasm that’s infectious at launch. That drives performance.”
2. Courage
Authenticity of purpose is a strategic imperative that doesn’t just unite internal teams through launch planning and execution, it runs all the way through to creative communications – when making that all-important emotional connection with customers is a key determinant of launch success. Isabelle Geoghegan, Client Partnership Director, Purple Agency, says that launch leaders have the courage to appeal to the heart as well as the head.
“The most successful brands are much bolder at launch – but much of the industry has room for improvement. Lots of launches feel ‘samey’ – they’re driven by generic launch plans that churn out the same messaging around safety and efficacy and traditional materials to support the rep. But a generic approach will likely give you a generic result.
“Health is incredibly emotive – it’s about people and patients – so we need to think beyond the data and focus more on unlocking the emotion that drives our brands. Pharma’s always relied on sales reps to do that emotive sell, and they do it well. However, those human attributes are a casualty of the shift to virtual, making it harder to create the emotional connections that trigger great engagement. The most effective remote interactions focus on ‘conversation’ not ‘presentation’, centring on patients rather than products. If we can get to the heart of what matters most for patients, messaging that connects with – and solves – that problem, it becomes much more powerful.”
3. Organisational alignment: the cross-functional team
The role of the cross-functional team, aligned around a clear patient purpose, is critical. “Our ultimate goal is to develop the best solutions for patients, so everything has to be centred around them,” said Simon Hackett, Global Growth Director, Ashfield Health. “You need a strong strategy, a clear brand narrative, an understanding of how audiences behave and creativity to engage them
in the most effective way. To get all of that right requires cohesion and integration. The days of business functions operating in silos are over. Organisations need to have a singularity of thought and purpose running through them, linking everything together. The continued separation of church and state – medical and commercial – won’t help us deliver the omnichannel experiences our customers expect. There are regulatory sensitivities we must acknowledge, but launch excellence only comes from working together, right across the piece. COVID-19 has enabled that, almost overnight. Launch leaders already did it.”
4. Lean and agile teams
Being lean and agile is also important. According to Stephanie Hall, there’s much we can learn from rare and orphan drug launches in this regard. “Drug launches in rare diseases are often led by small, lean teams,” she said. “Because they generally have smaller budgets, they think carefully about where they’re going to invest resources, and they work super-tightly together. Obviously, if you’re a small team and in constant communication, it’s much easier to flex and change than it might be in a bigger environment. But that’s the challenge. If you’re working on a big brand at launch, how do you bring that agility to the way you work? It’s key.”
Simon Hackett agreed: “There’s much talk about the importance of agility and the need for truly cross-functional teams that can be brought together quickly at the right time. Those teams, no matter which part of the organisation they come from, need the same customer insights, an understanding of different customers’ journeys, and where and how they interact. The most successful launches demonstrate shared understanding across the cross-functional team. COVID-19 has inadvertently helped, because suddenly everything’s more virtual and accessible. It’s lowered the threshold for getting everyone ‘in the same room’ working together, sharing insight. We’ve become much more agile.”
4. Digital excellence
After decades of persisting with a rep-centred model, industry’s adoption of digital is finally accelerating. “Pharma has long known that it can’t rely solely on rep engagement and that an omnichannel approach is needed from launch,” said Isabelle Geoghegan. “Despite this, industry has largely stuck to the tried-and-tested. This has heavily influenced customer behaviours, with many healthcare professionals (HCPs) less inclined to look online for information at launch because they know they’ll get it from the rep. COVID-19 has changed the game. HCPs are increasingly enamoured by the convenience of virtual content, with many believing they now have access to much more information.
“Incredibly, a recent survey from Accenture indicates that HCPs are now more likely to prescribe new products early because they’ve got greater access to information on launch products and more time to learn about them. Increased digital engagement is encouraging companies to think much more about the whole user experience at launch. Leaders have recognised the need to create seamless omnichannel experiences and are maximising interactions at all the touchpoints customers have with their brands. As we move towards hybrid models of engagement, those omnichannel experiences will likely still have the rep at the centre, but digital excellence has never been more important.”
5. Customer experience thinking
Simon Hackett says the acceleration of digital is improving insights – and launch leaders are leveraging data to consider customer experience (CX) principles at launch. “Greater use of virtual tools has caused an avalanche of data that teams are now tasked with interpreting. As companies enhance their analytical capabilities, the quality of our insights is significantly improving – and we can only benefit from that at launch.
“The uptick in digital adoption – and the insight opportunities that come with it – has, perhaps for the first time, seen pharma companies start to build CX principles into their launch strategies. Until now, refined CX has been largely associated with the usual suspects such as Apple and Amazon – with concepts like customer journeys, sales funnels and customer conversion far removed from the pharma reality. COVID-19 has moved the goalposts. It’s forcing teams together earlier and encouraging them to adopt practices that have been used elsewhere for a long time. Companies are rethinking their commercial models, and concepts like CX and omnichannel are finally – and genuinely – permeating launch strategy.”
6. Investment in launch planning
Proper investment in launch planning is crucial. “Companies have always done lots of planning but what they typically end up with is a fairly static base case and assumptions,” says Stephanie Hall.
“However, the past year has seen the biggest disruption in health, with major changes in every disease area. The pressure on healthcare systems is only going to continue – and the impact on drug launches and access to medicines will be pronounced. It’s therefore no longer enough just to write a base case and make some assumptions – you need to do proper scenario planning. That means looking ahead and considering what might change in your priority markets. What scenarios could play out, and how can you plan for each of them? Doing that scenario planning – and being able to track change and alter your course – is vital. The trick is to ask good questions, frequently. Because change is constant.”
There are, said Stephanie, four phases of launch planning: analysis, strategy development, tactics and measurement/control. “Analysis is about insight – what’s the customer journey, what’s happening, what’s changed and why? Strategy is ‘where do we focus and with whom?’ The tactics is the ‘how’. That’s where good scenario planning comes in – thinking, really practically, about what you do in each given scenario. And finally, how do you track and measure it to know when your plans need to flex? All these phases need proper investment, up front – and all the way through.”
7. A singular focus
Finally, launch leaders are laser-focused – with customer engagement often the result of bold choices. “The most effective launch strategies are brave – in their messaging, targeting and creative communications,” said Isabelle Geoghegan. “If your messages just rely on safety and efficacy data – or your target patient profile is too broad – you’re unlikely to get the engagement you want, even with the best omnichannel plan. It’s the same with channel planning. There’s so many channels out there, you don’t need to use every one. Courage at launch is about being selective. Identify your audience and understand what drives them emotionally – then focus your ideas on that singular purpose and really make them sing. In the post-COVID-19 era – with healthcare systems facing significant pressure –clarity of focus will be crucial to launch success.”
Preventing A Series of Unfortunate Events
COVID-19’s long-term effect on pharma’s commercial model – and launch strategies – is likely to be enduring. A total return to rep- dominated engagement seems fanciful, with a blended model of digital and in-person interaction tipped to take its place. The medical representative will almost certainly remain at the centre, to orchestrate activity – but hand-in-glove alignment with medical and marketing teams will be critical if companies are to maximise every interaction in the customer journey and create seamless experiences that help HCPs meet patient needs.
That direction of travel marks the final departure from The Hostile Hospital metaphor. In the Lemony Snicket drama, Violet didn’t keep the medical coat fabric that saved her from Count Olaf – she rediscovered her lost ribbon and returned to old, familiar habits whenever she needed help. It’s a luxury pharma doesn’t have. If the industry wants to prevent new product introductions from becoming A Series of Unfortunate Events, it needs to learn from the lessons of lockdown – and change its commercial model for good.