Kathleen Drennan says she “grew up in pharma,” and memoriesof her first research job conjure a mix of nostalgia and pride. But Drennan,who served on the product development team at Upjohn for 11 years spanning the1980s and 1990s, also recalls a lack of communication between the R&Dgroup, based in central Kalamazoo, MI, and the promotional division, basedmiles away in another part of town. “Marketing and R&D were oceans apart,”Drennan says. “We hardly spoke to each other.”

A decade later, she sees the situation changing. Drennan,who works in clinical recruiting, has seen a rise in the collaboration levelbetween brand teams and medical groups within clients. “Pharmaceuticalcompanies are making great strides bridging that gap between science andmarketing, but it’s still fragmented,” says Drennan, SVP/managing director atCorbett Accel Healthcare Group’s Iris Global Clinical Trial Solutions.“Companies are still getting marketing people involved way too late in thegame.”

An early brand team

When these two groups do collaborate early in the productlife cycle, as clinical trials are underway and during the post-marketingphase, good things can happen—including optimal product positioning andstrategy, as well as ongoing synchronization between promotional messaging andclinical trial data. It all stems from better communication. Often the vastmajority of this dialogue occurs at the investigational stage, beforesubmission. A cross-functional product team can draw staff with expertise in research,medicine, marketing, safety, epidemiology and health economics to developstrategy for the development of the product.

These sub-teams often begin talking very early in the lifecycle. For instance, right after scientists at Novartis established proof ofconcept for the firm’s new once-daily oral renin inhibitor, Rasilez(aliskiren), an early brand team was formed to participate in internationalcross-functional dialogue about the compound, which is being developed fortreating hypertension.

As aliskiren moved into the clinical-trial phase, the brandteam was ready to look at the data being generated and determine how it fitinto positioning. The frequency with which this brand team met, and its size,increased as the drug moved from phase IIa along the development cycle.(Rasilez, first in a new class of high blood pressure drugs, was accepted forfiling by the FDA in April.)

“When you start developing a product, you do it because youperceive there’s an unmet medical need to be addressed,” says Marjorie Gatlin,MD, Novartis VP, cardiovascular and metabolism, US clinical development andmedical affairs. “That vision needs to be refined as you develop the profile ofyour product and as the world around you changes and medical practice changes.”

“Going steady”

R&D and marketing speak about how the product is likelyto be used, patient perceptions, and the trade-off between efficacy and sideeffects in different populations. They also work together to do market researchand understand how doctors perceive various unmet medical needs. “We like to gosteady,” Gatlin says. “We talk very frequently … working to educate ourmarketing colleagues around the science of the product.”

No courtship is complete without a chaperone. Medicaladvertising agencies can fulfill this role, facilitating collaboration forestablished products and prompting brand teams to request more trial data fromR&D in response to changes in the physician marketplace. “We know whatmight be compelling to physicians and what might be helpful to combatcompetitors,” says Anthony Mastrangelo, PhD, VP, medical director, IntegratedCommunications Corp.

It’s not always prudent to pull data just to counter acompetitor’s promotional messaging, says one agency chief. But if prescriptionsstart moving in response to another drug’s positioning—a signal of marketplaceacceptance—that could prompt such a request. “The vast majority of what we dois about addressing new scientific challenges and answering new scientificquestions,” Gatlin says. “It’s not so much defensive positioning. We’re outthere trying to generate positive science that will help physicians developpositive treatment choices.” To that end, subteams must keep up with theliterature, maintaining close contact with researchers and thought leaders onwhat is available to help provide important information to practitioners.

Although R&D endeavors to work closely with themarketing brand team to understand the desired product positioning, some jobsare not shared. Designing trial protocols and selecting investigators is thesole responsibility of medical and remains independent of marketing.

Toward a “cohesive continuum”

In contrast to the fragmentation that characterizedDrennan’s first pharma job, drug companies are evolving to place more emphasison internal communication. They have to, with the drug development processaveraging 10 years and upward of a billion dollars. The expectations of themarketplace, practitioners, and payers and patients are that there is going tobe data on which to base decisions. The market does not tolerate me-too drugs,and companies with a commitment to innovation and quality medicine and sciencemust incorporate innovative communication.

But is it happening across the board? “From a clinical trialperspective, I’m seeing more marketers sitting on a clinical team early on andthen a clinical person involved in trials sitting on a brand development teamso that there’s more didactic discussion about how this drug has evolvedthrough the life cycle,” Drennan observes.

But she also sees companies waiting until mid–phase IIItrials to start “ramping up the launch,” though it would behoove them to startearlier. According to her, the old divide between science and marketingpersists in some firms. “In the old days, it was segmented and fragmented,”Drennan says. “It was us and them. We’re moving into a more cohesive continuum.But it has a ways to go.” The more cognizant marketers are about a drug’sclinical trials, and the more clinical people understand the promotionalchallenges of a new product, the better, she says. “It will mitigate the riskof having another Vioxx suit, of having something be misinterpreted, of havingsomething fall through the cracks.”

Moreover, marketers’ interest in product development must startearlier. “We forget,” Drennan says, “that the minute that potential new drugfor prescription use is ingested by a human, you’ve just started your brandlife cycle.”

Constant communication

Dialogue flows easier for new products but can be morechallenging for existing drugs. “When you are launching a new drug, you have tohave all your positioning and messaging sewn together before launch,” saysMastrangelo. “Whereas, if a drug has been around for seven to 10 years, themarketing team can almost lose track of what trials are being conducted.”

Keeping current can be a major challenge as medicinecontinually evolves, especially globally. Whenever Mastrangelo has seen teamswhere global and US are in lockstep, the process is much smoother. Even forfirms where there is little resistance to multidisciplinary communication, it’stough to get all the parts working together. “The hardest thing is making surewe’re fully aligned on prioritizing,” Gatlin says.

At Novartis, not only are key people located in the samebuilding, they’re situated on the same floor. “That kind of proximityfacilitates the dialogue and knowledge exchange,” Gatlin says. “It’s thehallway conversations. It’s the stopping into each other’s office. It’s thee-mails. It’s constant communication, an ongoing, iterative process.”

These are promising signs for Drennan, who sees a future ofmore cooperation among pharmaceutical brand team, product development andagency account team members “understanding what it takes to get a drug to thepoint of launch. We’re definitely going in that direction.”  

From the June 01, 2006 Issue of MM+M - Medical Marketing and Media