Global Report: Planet Pharma

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Every pharmaceutical company that launches globally needs to utilize an intelligent campaign, a campaign that is relevant to the needs of that marketplace and which contains information that moves the market to its best possible solution, notes Angela Rossetti, assistant vice president, global business manager for Wyeth. “The big challenge in executing a global campaign is to keep in mind that the markets outside of the US and Europe are becoming more and more important every day,” she says.

She points out that governments, particularly those outside of the US, will not have unlimited funds to spend on drugs—so every drug must count toward improving the health of the population. “A global promotional campaign,” she says, “must communicate that understanding and fulfill that need.”

Rossetti's sentiments resonate loud and clear at a time when the global pharma market forecast is gloomy. IMS Health reports that the value of the global pharma market is expected to grow 2.5% - 3.5% on a constant-dollar basis in 2009. That's two whole percentage points lower than they reported in October of 2008.

Is this the consequence of a depressed global economic environment? That's partly the case. But you can also lay blame on familiar culprits such as patent expirations, greater generic penetration and fewer new product launches.
IMS's updated forecast predicts global sales exceeding $750 billion for the year, that's down from $820-plus billion that was forecast in fall 2008. Yet despite all of the somber news, according to IMS's Market Prognosis, the industry is expected to rebound by 2010.    

According to Murray Aitken, SVP, healthcare insights, IMS, there is a clear correlation between demand for medicines and key macroeconomic variables such as GDP, consumer spending and government expenditures. Aitken notes that the worldwide financial crisis has contributed to record-low sales growth this year. And while the industry is not recession-proof, Aitken asserts that it is insulated to a greater extent than other industries where spending is more discretionary.

While the US market is expected to contract in 2009 with pharma sales declining by 1%-2%—in contrast, pharmerging markets (China, India, Korea, Brazil, Mexico, Turkey, Russia) are expected to grow collectively at a 13%-16% pace through 2013.

In its Pharma 2020 report, PricewaterhouseCoopers cites data from McKinsey that estimates that private healthcare spending by urban Chinese consumers will grow at 11.6% a year for the next two decades, creating considerable opportunities for pharmaceutical companies and healthcare providers.

In the midst of all this economic uncertainty and market volatility, pharma companies and their ad agency-partners still have to develop global marketing campaigns. What's the key to developing a successful global campaign? What are some of the obstacles in pharmerging markets? Of course there is no one right answer. In fact, there are myriad options and opinions when it comes to deciding the best way to navigate and the new global landscape.    
“As you're dealing with different clientele and different customers in these emerging markets and also within the US and European markets, you're seeing that folks are driving toward the value-based brand differentiation,” says Mike Keech, director, advisory pharmaceutical and life sciences group, PricewaterhouseCoopers.

Keech adds: “It's that perceived and beneficial brand value that folks are striving to find the right balance of that message and demonstration in these emerging markets. And they are using a number of tactics to do that.”

Global case study
Wyeth has a rich heritage of innovation in the hemophilia market. It is the only pharma company that produces recombinant-only products for both hemophilia A and hemophilia B patients. This makes Wyeth well positioned to both advance the treatment of hemophilia and to introduce other biologic-based therapies into the market.  
 The vision for the company's hemophilia franchise is to launch its innovative therapy, which is approved for the control and prevention of bleeding episodes and surgical prophylaxis in patients with hemophilia A. The product is plasma/albumin-free, nanofiltered and does not contain any added human- or animal-derived materials.

The strategic plan included a commitment to biologic and anti-hemophilic therapy excellence; understanding and succeeding in a unique marketplace; a vision for balancing a global positioning; and a global launch with a truly personal touch.

The campaigns for the Wyeth hemophilia A products required a strong collaborative effort between Wyeth and and its advertising partner Juice Pharma Worldwide. Rossetti comments: “We wanted to do this right. We wanted the agency to be on board early, we wanted them to hear firsthand what the challenges are from the source: patients, families, physicians and nurses.”

But achieving that goal wasn't without formidable obstacles. For starters: Would a cookie-cutter approach to a global launch be the best way to serve patients, as well as best for the innovative therapy?

Wyeth and Juice had to understand several market dynamics: competitive marketplace differences, plasma-based products lead in some markets, while recombinant-only products are the sole competitors in other markets and the implications in the markets where social democracies pay the full cost for certain therapies and not for others.
Another challenge was the unique regulatory filing approaches for each individual country, which resulted in the necessity to establish two distinct brands: Xyntha in some countries, and ReFacto AF in others. Although the positioning was global, the brand name differences resulted in the creation of two different campaign executions.
Xyntha was launched in the US in September 2008. ReFacto AF received EU approval in February 2009 and is expected to launch in the EU within the next several months.

Biologics are complex.  Wyeth and Juice had to factor in several elements when planning their launch including: manufacturing turnaround and distribution, ensuring that patients have continuity of therapy through a transition; maintaining a balance between ensuring minimum waste of phasing-out predecessor products, while not stocking out; and understanding the delicate engineering of timeline characteristic in producing biologics.   

The Wyeth team wanted to stay connected to their local hemophilia communities and worked closely with their affiliate offices to understand each local market's needs.
“Like any global launch for small molecules or biologics, there's the same concern of getting everyone's voice heard,” says Lois Moran, president at Juice Pharma Worldwide. “To maintain adherence and sustainability, we embarked on a new way of tackling a global launch with the vision of personal touch approach.”

With the Xyntha and ReFacto AF campaigns, all affiliates were stakeholders and participated fully in debates and in mapping-out strategies. The Wyeth hemophilia A team leveraged the latest technology to ensure affiliates' input was maintained throughout the crucial early stages via video conferences with as many as 20 countries participating. From an agency standpoint, Juice joined Wyeth in London to participate in workshops and discussions around global strategy, positioning and brand personality development. “The goal from an advertising communications standpoint was to achieve global harmony with one global positioning, and yet be relevant and compelling,” says Moran.

“And I think one of the challenges we had is that, as a biologic, we have to work very carefully to make sure that we are producing the product in the correct amounts, delivering it at the right time, and working with the different payer systems worldwide to achieve acceptance. Biologics are much more complicated than purveying tablets or capsules,” says Rossetti.

Part of Wyeth's philosophy with the hemophilia A therapy campaigns, notes Rossetti, is the notion that growth in this marketplace needs to be firmly grounded in humanitarian aims. With approximately 75% of the world's hemophilia population left under-treated or untreated, manufacturing hemophilia therapies provides a platform to help not only make life better, but to make life possible.

Rossetti says there are different needs worldwide in delivering hemophilia therapy—developed markets have a different set of circumstances and pose different challenges; developing markets must deal with the basics of educating physicians on diagnosing hemophilia and treating patients, in addition to delivering product, and doing so with the economic constraints of emerging economies.

“There was a great deal of complexity in this launch,” says Rossetti. “The FDA works on one timetable and the European Medicines Agency (EMEA) works on another. And some of the other markets that we are working with outside of Europe take their cues from the EMEA.”

In the US, utilizing social media is also part of the marketing strategy. “We are very excited about using social media and using it responsibly. One of the key characteristics of this marketplace, particularly in developed markets like the US, is extremely high-patient involvement in their therapy,” says Rossetti, who adds, “that these therapies are life-changing and they will help people to live more normal lives and that's a significant change from the way it was for patients before these therapies existed.”

Although Wyeth is currently in the middle of the European launch of ReFacto AF, they are always learning and improving their approach. “I think that if there is one lesson to be learned is that you must listen,” says Rossetti. “You must listen to your marketplace. That certainly includes the physicians and the nurses, but also the patient and their families and particularly in Europe and many other parts of the world where the government pays for these products, you must listen to the governments. And you need to understand what's important to all of them and try and meet their needs for information.”

Moran says that among the lessons learned from this campaign, is that when faced with daunting challenges, anything is possible if you have the right partnership, you map out a vision and you have the right teams on it. “When you have all those pieces in place,” she says, “it's doable, it's possible and it's fun.”

Experts weigh-in
Richard Nordstrom, CEO, McCann Healthcare Worldwide, points out that there are many reasons to encourage the development and implementation of global communications for healthcare clients. “The ROI on activating implementation of global-to-local has been well documented. Companies spend an enormous amount of money investing in clinical trials that generate evidence at a global level.”  

Ed Wise, chairman and CEO of Cline Davis & Mann says that the challenge in developing a global campaign is the need to satisfy two constituencies: The global team which requires a consistent positioning, look and feel for a campaign and the local affiliates who require a campaign that meets the specific needs of their market.

 “Everyone would agree that the key to developing a successful global campaign is to ensure buy-in at the local level, but what is the most successful way of accomplishing that?” adds Wise. “We believe it's by enabling the free flow of ideas and information across markets and incorporating local thinking into global campaign development.” CDM, says Wise, does this by involving its local agencies and local client teams from the very start of the process. “By gathering information and insights from each market we ensure the ‘voice' of the local affiliate is clearly represented during strategic development resulting in an ‘informed strategy.'”

Once the global campaign has been chosen, the local adaptation process begins and the local agency applies its knowledge of the market, the regulatory environment and customer insights to maximize the effectiveness of the global campaign at the local level.    

For Judy Capano, chief strategy officer, Wishbone/ITP, in order to execute a successful global campaign you need to appropriately gather the insights from relevant marketplaces. “Make sure that you don't search for the lowest common denominator and that instead, you try to elevate and tease out the best, highest quality insight to guide the development of your positioning, your message and your strategy.”

One of the biggest challenges they face as marketers, along with their partner marketers—the pharma companies—is communicating across countries and cultures. “Getting that strong global branding, integrating marketing strategy structuring the resources in order to get consensus so that you get rapid sales uptake in any country,” says Laurie Myers, SVP/account director, Regan Campbell Ward • McCann. Myers notes that, in general, where you have a global environment, you have to have open communication between headquarters and a local market. “I have colleagues that are cross-culturally trained. They've lived in the culture and so they can speak to me and I can translate the strategy and then they can speak to their thought leaders and their colleagues that are in that country.”

And what are ad agencies hearing from their pharma clients when it comes to launching a successful global campaign?

“Clients' number one concern is they want to connect better with their customers at a local level,” says Phil Deschamps president and CEO of GSW Worldwide. “They want to achieve this as cost effectively as possible by changing the model. They recognize that they need to go regional but are concerned about how to develop a campaign that's centralized that doesn't have to be executed 13 times, and yet make it relevant for the local markets to be able to respond to and also drive product sales.”

One of the biggest challenges of launching a global campaign, says Colleen Hindsley, VP, worldwide account director, Regan Campbell Ward • McCann, is managing the shear number of stakeholders involved within the global organization and at the local level against the need for solutions that meet the challenges raised by local conditions. “Implementing a global campaign can be a complex process. Like everyone, local marketers have goals to accomplish. Therefore, global marketers have to have a wide view of the global market situation.”
And to make things even more challenging for ad agencies, not all pharma clients are alike. They come in different shapes and sizes and have different needs. “Large pharma multi-national organizations are going to have a different set of needs then a biotech company, or a US-only specialty pharma company,” says Capano. “We don't have one solution for one type of client—it varies based on our clients' needs.”
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