A decade or so ago, some oncology organizations may have seen a competitive scenario workshop as more of an optional exercise, particularly if they were launching as the first-in-class product to address a high area of unmet need (as was often the case). But times have changed.
In the case of many oncology launches, products that may be the third, fourth or fifth entrant in the market, such as Tecentriq, the third PD-L1-related therapy to come to market. An increasingly competitive landscape is marked by additional combinations and add-ons, the emergence of "biobetters" and the "chronification" of disease. All of these factors have brought a deep understanding of sequencing—and knowing where your product fits in versus the competition—to the forefront. This is critical for a successful brand strategy.
With the high stakes in today’s oncology market, getting competitive scenario workshops (or “war games”) right is more important and valuable than ever. Aspects of these workshops have factors that should not be neglected, which include the healthcare ecosystem, the pace of launches, the move-up-the-line-of-therapy game, off-label usage, the availability of clinical trials, the decreasing availability of patients, co-promotions, patient services and biosimilars.
Manufacturers conduct a competitive scenario workshop to inform their strategy or tactics—an integral step in launch readiness. The workshop can also serve as a life cycle management exercise to prepare for market evolution due to competitive entrants. There are some best practices to ensure the workshop’s success (both within and outside of oncology), including:
- Determine the goal, and develop your approach and activities to achieve it.
- Gain senior leadership’s buy-in regarding the approach and results.
- Limit the focus of your scenarios and align around the definition of a scenario.
- Ensure cross-functional engagement.
- Identify any quantitative implications based on qualitative discussions.
- Urge participants to approach the workshop with a competitive lens and to be “in character.”
- Keep it engaging with fun, interactive activities, a theme and prizes.
These best practices are a good starting point, but complexities related to clinical development, manufacturer innovation and healthcare ecosystem dynamics in oncology make for unique considerations, in particular when it comes to the scenarios and competitive set. Determining which scenarios will have the most impact is critical: Some scenarios are designed to depict current situations, but many others are designed to simulate a future situation in which things are uncertain.
For example, product-related scenarios typically can be bucketed into two categories: time dimensions, which include considerations such as the timing of product launches or the order of entry, and product profiles, which include considerations such as clinical outcomes, price, safety, dosing and adverse events. In oncology, there’s a higher number of products that receive FDA breakthrough designation and accelerated approvals. This drives some of the variability in determining when companies believe they will launch, or anticipate when others will launch.
As the number of drugs within various categories increases, even in new, innovative spaces like immunotherapy, order of entry comes into greater focus. Being the first, or in the first wave, matters more than it used to, and playing out what happens in terms of different scenarios is important. Since many companies often have multiple drugs in the pipeline, drugs that are launching simultaneously and attempting to move up to first line also present a bit of a conundrum for where to focus the simulation. It’s important to consider competitors holistically in terms of maximizing the full product potential while also appreciating how they might co-position indications or, conversely, seek to convert business to one indication as soon as possible.
From an ecosystem perspective, oncology is changing. Emphasis on value-driven care, including hypersensitivity to cost as well and public outcry—including tweets from political or pop culture celebrities regarding price increases in cancer drugs, in particular—are on the minds of manufacturers as they go to market or operate in the market. Scenario-planning related to these dimensions is sometimes important, particularly when planning for a future world in which it’s possible for bundled care to be a universal reality, and electronic medical record implementation demands full compliance with pathways and guidelines.
There are also considerations about market adoption in terms of the level of influence that patients have with their own treatment decisions. For example, if an oncology company can offer a home-healthcare-based solution for a complex infused regimen, is that differentiated enough to displace a regimen with similar efficacy or even a slight efficacy advantage?
Finally, the competitive landscape in oncology is changing. It’s critical in a competitive scenario workshop not only to define who the competitors are, but also to prioritize them. Clinical trials and traditional chemotherapy may appear to represent competition since they shrink the available patient pool for launching products, yet it’s critical to consider if they truly represent a competitor that a company can really plan or do anything meaningful to differentiate against. It’s also critical to make a distinction between a landscape dynamic that may not change and a pure, primary competitor in order to maximize the organization’s effort and investment in a competitive scenario workshop initiative.
Based on clinical pipelines and community buzz, we’re anticipating a major movement in treatment paradigms based on novel/novel or novel triplet regimens. We’ll see competitors paired together in both competitive and synergistic relationships. There are also peripheral or indirect competitors that muddy the landscape in terms of how companies focus.
Competitive readiness is critical to ensure that an oncology company considers the external landscape in terms of what other manufacturers may do, as well as how customers will react. The increased fragmentation and frenzied development in oncology is exciting for patients and providers. They want choice and options to prolong life and quality of life. With this increased competition for oncology manufacturers, it’s even more critical to get competitive readiness right. Focus on the fundamentals, and lend a keen eye to oncology-specific scenario prioritization and competitive set definition, and you’ll have a recipe for success.