Direct to Consumer: Right to Win

It's the start of a new quarter, and you've just been named the new product manager for Brand X.

Here's where you stand: Your patent expires in 18 months, and you need to migrate as many of your current patients as possible to an improved formulation. Unfortunately, the patients you have today tend to leave your brand as quickly as they come in—adherence is a constant challenge. Meanwhile, you've just lost half your brand team, and your competition is backing their me-too product launch with marketing dollars you can't possibly match.

Congratulations.

Sound familiar? Most brand teams are being tasked to do more with less. And because the lifespan of a pharma brand is defined more by patent expiration than by consumer tastes or marketing prowess, your efforts must be even more focused to ramp up and sustain a high level of productivity over a relatively short period of time.

Brian Kaiser

Succeeding in this environment means aligning resources—dollars, brainpower, and operational capabilities—around strategies that produce the best return.

Jimmy Rhodes

Direct-to-patient (DTP) marketing programs represent a powerful way to drive patient compliance and adherence. They're most productive when they target the right patients—the problem is that many DTP programs don't. These programs treat all patients equally though, in fact, all patients are not equal—at least in terms of opportunity and potential return for your brand.

Lisa Carr

The benefit of direct marketing is the ability to communicate a targeted message directly to a desired consumer to drive a specific behavior. Targeting is what enables you to achieve greater ROI while spending the same or less. Given limited time and resources, then, your programs will be more productive if they focus specifically on patients you have a right to win.

The Right to Win

The right to win (RTW) refers to having an achievable, substantive opportunity to boost return with a specific, receptive target.

Accept up front that you probably don't have the right to win with every patient in your database. That's because not everyone will be equally receptive to your brand proposition, based on their perceived need for your brand or attitudinal affinity. At the same time, not all patients represent enough revenue to the brand to support investing in a DTP effort.

Defining the right to win for your brand requires segmenting your patient universe against two dimensions:

• the value of the patient to your brand (e.g., revenues, lifetime opportunity)

• the value of your brand to the patient (e.g., perceived state of need, attitudes, affinity)

Overlaying these two dimensions creates a RTW framework that enables you to objectively assess which patients represent a greater opportunity (see "Right to Win Worksheet,"). This is the sweet spot where the value to both parties is highest. Your RTW patients will fall in this upper-right hand quadrant of this framework. The goal is to design programs or optimize existing ones to primarily target this group. Because of their high affinity and value, they are the ones in which you should invest more of your time and attention.

Right To Win Worksheet: A do-it-yourself guide to help boost your DTP program

Frame Up the Strategy

Of the two dimensions, the value of a patient to your brand is often the more straightforward to determine. In practice, there are a number of ways to do this:

Longitudinal data Derive value and opportunity from longitudinal patient studies and assign values to specific segments of patients. For example, a new-to-therapy patient may be assigned a value based on average script usage for all new-to-therapy patients over time.

Condition-based factors Build the value component from the ground up through an understanding of condition-based factors such as current therapy usage and severity and frequency of suffering. For example, current users who suffer more frequently may be more valuable than those who suffer less frequently. This kind of information can be captured using survey questions at a consumer interaction point like Web site registration.

Modeling A more sophisticated approach may include developing statistical models from an anonymous patient sample using individual responses to screening questions as well as consumer engagement histories as independent variables that can later be applied to score a consumer base.

Using these approaches, you can determine patient value over time and begin to segment patients from least to most valuable. Certain components may then emerge that also drive or define patient value, such as length of time on therapy or since diagnosis.

Defining the affinity dimension—your brand's value to the patient—may be more challenging and is likely to be specific to your brand and patient universe. Factors to consider might include:

Demographics If the brand is indicated only for certain patients—for example, males ages 18 to 34—those patients become the baseline definition of affinity or fit.

Tolerability Patients reporting a higher incidence of side effects may be less compliant and receptive long-term.

Indication profile Is the therapy first line? Is it only for moderate or severe cases? Which of your patients fall into these categories?

Previous therapies Identifying previous therapies tried and rejected can provide insight into affinity for your brand, particularly if they're in the same class.

Attitudes towards the disease state How important is finding a solution? What is the perceived efficacy of available solutions?

In many cases, however, these factors aren't enough to define your RTW opportunity. Affinity can often be more attitudinal than behavioral in nature. That's when consumer research is invaluable.

Revisiting your past research—such as product positioning or market sizing—can provide clues as to the attitudinal factors at work. For example, it may be that overall attitudes about compliance are the best indicator of affinity. Patients who don't believe they need to take a medication every day for their symptoms may be less compatible for a daily medication than they are for an alternative weekly therapy regimen that already exists. Or, a patient who is inherently concerned about taking prescription medications may be less compatible for a prescription medication if an over-the-counter medication is also available.

Ultimately, you will identify particular components of brand value that become shorthand for right to win. Including these as screener questions at program registration will allow you to segment patients within your brand's particular RTW framework.

Power Patients

OK, let's revisit our scenario: Your challenge as product manager for Brand X is maximizing your DTP strategy. The pressure point from senior management is an impending patent expiration. Your competition outspends you by a wide margin in the fight for new patients. Cutbacks have taken their toll on your resources. And you've started the strategic planning process to implement a lifecycle strategy to launch your reformulation.

The RTW approach is ideally suited for this situation. Why? Because the dynamics require that only the most productive avenues are explored. Time, resources, and the margin for error are razor thin. The opportunity cost of applying resources against less productive marketing efforts likely means losing out on revenue that you have no time to recoup.

The framework in the chart "Right to Win Worksheet" demonstrates some hypothetical RTW dimensions for your brand. Looking at the value of a patient to Brand X, your team decides to calculate potential lifetime value according to projected compliance rates and time on therapy.

Equally important, however, is identifying characteristics that reflect brand affinity. In this case, an analysis of your most adherent patients reveals that most of them share at least two characteristics: They perceive a moderate-to-high symptom severity that makes staying on therapy important for them, and they already have solidly positive attitudes towards your brand.

You've identified your right-to-win patient. Now what?

The first strategy that emerges is maximizing adherence with as many current patients as possible to derive remaining value before your patent expires. That's a strategy that is ideally applied to all patients, not just your RTW group.

But your RTW analysis provides an additional, more potentially productive opportunity: It has identified the patients who are most likely to benefit from your brand and who possess attitudes that make them potentially more receptive to the improved Brand X. These patients represent your best prospects for migration to the next-generation product.

With your RTW target in hand, you can now pursue a marketing campaign with two distinct objectives: You reach out to all of your current patients to promote adherence. But among RTW patients, you focus your team's efforts on nurturing the brand loyalty that will support future migration.

Your analysis has provided you with attitudinal information that illuminates the profile of this patient segment and that will help you steer your messaging in the most meaningful ways.

This brand-building strategy also protects your valuable RTW patients from your big-spending competition. Me-too brands often seek out market share gains at all costs, taking whatever patients they can acquire.

By insulating your RTW patients, you force competitors to gain share outside the RTW segment, among less valuable patients. With a less productive patient mix, your competitors may experience higher churn and be forced to spend excessively to replace lost patients.

Your RTW analysis will also help you optimize your media plan for reaching RTW patients, who may differ from the average patient in important ways that drive the overall channel mix, day part, and even size of the buy. Buying media with RTW patients in mind will produce a greater return for the same or smaller investment.

The Right Results

Using the RTW strategy to make your direct-to-patient programs more productive means that when your line extension is approved, you can be confident you'll have secured the numbers needed to promote a successful launch of your lifecycle strategy, mitigated the impact of losing patent protection, and insulated your most valuable patients from competitors. All this with fewer resources than you initially thought possible.

Your team wasn't lured in by a one-size-fits-all strategy that would have diverted your team's attention and overtaxed the organization at a critical juncture. Instead, you were smart enough to find the patients with whom you had the right to win—and you won. And that is a cause for congratulations.

Brian Kaiser is vice president, healthcare strategy, at Targetbase. He can be reached at brian.kaiser@targetbase.com

Jimmy Rhodes is vice president, strategic business analysis at Targetbase. He can be reached at jimmy.rhodes@targetbase.com

Lisa Carr is director, healthcare strategy at Targetbase. She can be reached at lisa.carr@/targetbase.com