Marketing for Our Modern World
Pharmaceutical marketers, on both the client and agency sides, are good at a lot of things. We can develop and maintain vast multichannel campaigns that reach consumers through the right channel at the right moment. We can develop virtual sales rep aids that are so engaging, informative, and visually spectacular that they make those old paper handouts look like, well, paper handouts. But there's something a bit surprising that some still do not fully grasp.
Many brands and agency partners are not good at communicating with patients or HCPs around market access issues. Too often we do not make useful connections between overarching brand objectives and issues of market access until we are displaced from a large plan like Aetna or a PBM like Express Scripts. Then it is too late. This is odd, because most of us have highly adept and motivated market access teams right down the hall that are busy analyzing data and segmenting customers for those very same brands. Technology has evolved to make all of this easier and more automated, yet marketers struggle to make the most of it.
It's a strange phenomenon. Brand teams are pulling out all the stops to get their messages out to patients and physicians while market access teams are doing the same to positively influence access decisions with their payer customers. Rarely — I wouldn't say never, but rarely — do the two compare notes in order to jointly develop and execute fully integrated, technology-enabled marketing plans that anticipate and overcome reimbursement barriers to help patients start and stay on treatment.
Don't believe me? Ask yourself these simple questions:
How frequently does your brand proactively communicate market access information to a patient or a physician beyond just “formulary wins” or to activate a co-pay card?
How often does your reimbursement information appear prominently within your visual aid or rep message sequence?
How often do you use your market access team as a source of insight into the various phases of the reimbursement journey?
If your answers are all the time, very, or a lot, then congratulations — but you are the exception. Given how central both access and reimbursement have become to the entire pharma ecosystem, patients and physicians are now forced to think about market access just as much as they do anything clinical. But very few brands seem to be doing the same in their communications or in their interactions with their own market access teams. And therein lies the disconnect, one that is stunting brand performance from small biotechs to big pharma.
PATCHING THE DISCONNECT
The fix to that disconnect is right in front of us. We need to make market access a fundamental part of every brand's strategy beyond just the last pillar on an already-crowded brand planning slide. We need to use technological tools and all those new media that our patients and HCPs consume so furiously to learn and communicate about market access issues, too. We need, in short, to close the space between the brand and the market access teams.
Take, for example, a complex biologic, perhaps an oncolytic or MS treatment. Most have what's called a “hub,” a patient-support program that's used to verify insurance coverage and deal with other access and reimbursement matters. These hubs process transactions every day — verifying benefits status, checking prior authorizations, connecting patients with nurses for clinical support. They are usually run by — you guessed it — the market access people and administered by companies many of us have never heard of.
These hubs represent a potential gold mine of business intelligence for the brand. Given the vast analytic firepower that brands have at their disposal, just think what might be possible with a trend analysis on all those coverage verifications and clinical interactions with nurses. We could find out — to a granular level while maintaining patient confidentiality — what sorts of access challenges patients face and what issues drive them to call on those nurses. Are their issues being resolved? How long does it take for them to be resolved? What day-to-day problems do they face? These are fundamental questions for brands — questions of how and why brands are succeeding or failing in the marketplace — answers to which should be in hand when strategic decisions about the brand are made. Yet the folks on the brand communications side of the fence rarely if ever see or even ask for data like this.
Most brands likely already have robust CRM systems in place to communicate with patients and physicians on an ongoing basis. These rails can as easily be used to anticipate and address potential market access issues as they are for any other subject. For example, prior authorizations for some biologics need to be renewed every six months. The CRM could alert the patient at month four, reminding him or her to speak with the doctor or office staff to get the appropriate paperwork filled out. They could even provide a sample copy of the exact paperwork that will be required in an easy-to-use format for the patient to provide to his or her extended care team.
The CRM could also check in with the patient in advance of open enrollment to educate the patient about how benefits changes or shifting out-of-packet caps may impact the ability to fill the prescription in the new year. In the present market access environment, patients can get lost in a sea of reimbursement and insurance red tape. A brand that provides a personalized helping hand with such things would truly be doing something all marketers claim as one of their primary goals: empowering the patient.
Here's another example, let's say for a brand for a highly prevalent chronic disease like diabetes. The diabetes market has a lot of competitors and a lot of drug classes, many of which have very little differentiation between them. The market has now become a race to the bottom — who can offer the biggest discounts to payers or the richest co-pay-offset program for patients?
But it does not need to be that way. Right down the hall, in the market access department, your brand very likely has a group of people who live and breathe health economics and outcomes research. Those people have the knowledge and external relationships to develop credible outcomes studies and may already be doing so without your knowledge. Somewhere on the brand team or at its agency partner, you also very likely have access to a few folks who have spent a night on a sidewalk to purchase a new Apple product. Put the two together and you have the potential to create technology-assisted patient studies with the power to differentiate your brand in even the most crowded marketplace.
Imagine it — 100 people with diabetes on your therapy and enrolled in your support program, 100 people not on your therapy, all of them wearing a passive data-collection device — a “wearable” in geek lingo — and enrolled in your study. All of the rules and endpoints of the study are set by the outcomes research team in partnership with a hospital system or large physician practice to ensure optimal design. While every diabetes drug has a patient-support program, with such a study you'd find out with a high degree of scientific rigor whether yours is the best and how your brand is able to provide true “value” beyond just the table-stakes lowering of A1C. The data generated from such a study would give you a powerful differentiating argument to the payers — or the insight into why the program isn't the best and the impetus to revisit previous assumptions and investments to help you improve it until it is.
I cannot emphasize enough how critical this sort of outcomes research is going to be for our industry in the next few years — or how surprised I am that so few brands are jumping in with both feet. The technological tools are already in hand, the expertise is very likely right down the hall, and the payers are growing more and more insistent on comparative effectiveness data every day. If technology-assisted outcomes studies aren't already in your budget for 2017 or your agency partners cannot make them a reality, then you may want to reconsider your priorities or the vendor partners you are engaging. In a crowded and highly competitive marketplace, the brands that can supply rigorous outcomes data to payers are the brands that will win.
Of course, there are rules that govern interactions between commercial and medical HEOR teams that need to be considered. But don't confuse rules with stop signs. Seek to understand what the rules actually are and which of your colleagues are empowered to reassess them to better reflect the needs of today's highly advanced organized customers. Then you will begin to reap the rewards of better collaboration. Outcomes studies take time to design and execute; the clock continues to tick toward your brand's loss of patent exclusivity.
All this may sound rather complicated, but the bottom line is simple: Digital technologies have become critical parts of the brand marketer's toolbox and of the lives of patients who use their treatments. Market access is something that patients and physicians have to consider more than ever when making choices regarding their health. And for whatever reason, we as an industry have allowed a gap to develop between brand and market access. We need to break down traditional silos and use the tools and technologies at hand to bridge that gap, in any and every way possible, starting today.