How can we identify and realize growth opportunities? That’s the multibillion-dollar question that looms large on the minds of pharma and biotech companies when their drugs enter the maturation phase. In our experience, pharmaceutical and biotech companies take one of two broad approaches to address this problem: understanding and addressing the provider, patient or payer barriers or diving deeper into field force effectiveness to improve the customer experience. The choice of approach depends on whether marketing or sales leadership initiates the franchise-wide pursuit of additional growth opportunities.
While there’s no silver bullet for unlocking growth opportunities, we have seen that an introspective, three-step approach can guide companies that are looking to expand:
1. Look inward. All pharmaceutical and biotech companies either own or license multiple data sources that can help them characterize the spectrum of their customer accounts based on their drug adoption patterns. Broadly speaking, most companies have the ability to identify three types of accounts: the “greats,” the “goods” and the “not so goods.”
In the context of growth opportunity identification, customer accounts can be characterized based on a combination of metrics such as the account-level sales volume, sales growth, market share and market share growth. The choice of metrics for defining the spectrum of customers depends on the market situation. For mature drugs in highly competitive markets, such as multiple sclerosis, market share and share growth can be used in combination to define the customer spectrum. On the other hand, in rare disease markets such as cystic fibrosis with only one or two major drug competitors, companies can define their customer account spectrum through a combination of sales volume and volume growth.
The seemingly simple endeavor of demarcating the not-so-good, good and great customer accounts is in itself a valuable outcome in many situations because it forces companies to look across organizational silos and align on where the growth efforts should be focused.
Given the limited marketing and sales dollars, companies need to evaluate where they should focus their growth efforts: In our experience, companies have generally found more success in transitioning the “good” accounts to the “great” accounts for accelerating growth.
2. Get a “surround sound” understanding of customer accounts. What truly differentiates the good and great customers of a mature drug? This is a profound question with no ready-made or simple answers. We have developed the “four P” framework to leave no stone unturned when it comes to identifying differences between good and great accounts:
- Product advocacy: Advocacy refers to how strongly an account recommends the use of the drug over its competition. This is not only related to the extent of overall use but also the willingness to use the drug as early in the treatment algorithm as possible. Advocacy is also evident from the openness of the practice or the account to challenge initial denials from payers.
- Physician/practice dynamics: The second “P” is about the overall practice. Aside from the more visible differences in practice setting (such as hospitals or clinics), the difference between good and great customer accounts could lie in the level of sophistication of the support staff in handling the complexities of drug access and patient management. Another important aspect in understanding practice dynamics is the general payer mix and influence on individual customer accounts.
- Program utilization: The third “P” relates to the level of awareness and utilization of manufacturer support programs by the customer accounts. While pharmaceutical companies develop excellent patient support programs to help with drug management, neither the patients nor the physician practices are uniformly well-informed about them.
- Personnel effectiveness: The fourth and final “P” relates to the effectiveness of the field force. The focus here is on understanding whether the differences between good and great customer accounts is related to the field force activities and behaviors that address the concerns of the account as a whole.
3. Learn and implement. The identification of growth opportunities from good and great customer account analysis is meaningful only when it’s followed by an organization-wide pull-through effort. We have noted three important success factors for such pull-through efforts.
- Treat growth identification with the same urgency as a new product launch. Growth strategy should be a proactive component of the mature drug management process and not a reactive response to flattening sales. We believe that growth opportunity identification should be viewed akin to new product launch and should start as early as the second or third year post-commercial launch. We recommend a cross-functional growth task force that prioritizes which opportunities the organization will pursue and when. Just as a rigorous launch readiness road map is initiated for upcoming drugs, so too should a growth road map be initiated for mature products. The road map should clearly lay out initiatives, owners and achievable timelines, keeping in mind other market factors such as impending competitive launches.
- Develop a growth playbook. An important aspect of implementation includes developing a playbook for marketing and sales teams to collectively reference on an ongoing basis. This playbook lays out tactical plans for acting on each initiative. It also includes risk factors and mitigation strategies, and serves as the single source of truth as to the mature brand’s direction.
- Monitor effectiveness. This includes setting up mechanisms to gauge the pulse of the customer landscape after rolling out the growth initiatives. Such voice-of-the-customer approaches help companies understand the effectiveness of the initiatives and enable course correction.
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The Framework in Action
Our work with the manufacturer of a 13-year-old, mature biologic drug for a severe respiratory condition serves as a proof of concept for the “four P” framework of diagnosing growth drivers. After hypothesizing granular differentiators in each “P,” we went about systematically identifying where the true differentiators lay through analysis of sales, patient claims, promotion programs, co-pay cards, field intelligence on customer profiles and, most importantly, customer interviews. Given the long history of the drug, the commercial leadership team expected that the differences between good and great accounts would be mostly on the operational areas such as practice dynamics or program utilization. It turned out that the biggest differentiator was on the more fundamental product advocacy.
Despite being the oldest biologic for the severe respiratory condition, physicians widely differed on the appropriate patients for the drug. With this insight in mind, the marketing and sales teams collaborated with their medical team to simplify the messaging and help with patient selection. The reframing of the message was central to the company’s defense against rapidly emerging biologic competition.
The good-to-great growth framework is a practical and actionable methodology that emphasizes looking inward to tap into growth opportunities. It’s designed to quickly uncover growth drivers and puts emphasis on moving from analysis to action and outcomes. It avoids confirmation biases and pushes brand teams to collaborate on realizing growth objectives. In all, pharma companies stand to benefit from a thorough understanding of what makes their client accounts truly great.