How to unleash the power of Positive Deviance

Jeff Dubin
Jeff Dubin

Jeff Dubin
owner, Green Meridian LLC

What does saving Vietnamese children from malnutrition have in common with pharma marketing? It may surprise you to learn that an approach pioneered in Vietnamese villages by two Save the Children workers was used by Genentech and Merck Mexico to help boost sales of Xolair and Fosamax respectively.  This approach, Positive Deviance (PD), involves finding out what works and replicating it throughout an organization or community. Sounds like a typical best practices project.  

However, two key features distinguish Positive Deviance from a best practices project:

1) Learning from what's working within one's own company rather than at Company Y.

2) Ownership of the process by front-line employees, not senior management.

PD proponents believe that the Positive Deviance approach overcomes an organization's resistance to change by charging those employees management wants to change with the responsibility of figuring out the best way how. By the end of the proc­ess, employees are less likely to voice a common protest of project recommendations: “These really don't apply to us.”

How might PD be used by pharmaceutical sales and marketing? Imagine the case of a drug that has poor managed care access in parts of the country.  On average the drug's market share is lower in these areas.  Positive Deviance isn't interested in the average though. PD asks, “Are there any areas with poor access that are exceptions to the rule with higher market shares than could reasonably be expected?  Which ones? Why?”

Did PD work at Merck and Genentech? The results were mixed. While the approach helped sell more Fosamax and Xolair in the short-term, PD did not take root in either company.  Positive Deviance demands a lot from those involved and time is scarce at big drug companies.   Also, the PD process flies in the face of Big Pharma's bias towards standardization. However, PD has been integrated into the practices of other US organizations, such as Goldman Sachs' Private Wealth Management unit and the VA. One thing is clear: if Positive Deviance is going to find a place in Big Pharma it needs to become more “pharma friendly” without losing the elements that make it effective.

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