Doctors' Words No Longer Gospel

If you're a pharmaceutical marketing professional today, you don't need special 3D glasses to see barriers and problems coming at you from all directions. REMS programs, accountable care organizations, Internet information (and misinformation) overload, aging populations, payer restrictions, tightening FDA restrictions, specialty product distribution, the relentless growth of generics...I'll pause here and let you continue the list for your brand. Every one of these issues adds another layer to the complexity of what was once a fairly straightforward transaction: Find the customer's unmet need and fill it.

Al Topin

Here's how it worked. Patients had illnesses, physicians diagnosed and treated those illnesses, and pharmaceutical manufacturers supported them by creating and marketing products to treat those illnesses better, with greater safety, or (insert unique brand benefit here). We as marketers helped to solve the core unmet needs of physicians and patients and to support the moment of truth in the physician's office—that moment when our brand was chosen because it solved the unmet needs better than any other option.

The job of the sales rep was to bring the brand story—data, mechanism of action, and brand benefits—into the physician's office. Probe for concerns, discuss the advantages, and ask for a trial.

And in the days of thousands-strong sales forces, it worked. Company to physician, physician to patient, a successful model of modern medicine. Life spans have grown longer, diseases have been eliminated or contained, and for many, the quality of life has improved.

Then the healthcare market began to change. More regulations, changes, and barriers coming soon to a market near you. Finding a customer's unmet need and filling it is just the starting point (in fact, exactly who the customer is now isn't always clear). To be successful, we have to look at the market differently, understand how multiple forces are creating a new dynamic at the point of care, and design our programs accordingly.

Back to the unmet need

Even with added influencers and barriers, we can safely say the key players in terms of core pharmaceutical marketing communication are the pharma manufacturer/marketer, the healthcare practitioner, and the patient. What we can't say is that they need the same things from a brand and a company that they used to or are impacted the same way.

Let's start with you, the pharma manufacturer and marketer. Frankly, your needs haven't changed all that much. You still need to deliver to your shareholders and stakeholders—revenue, profit share, innovation, and satisfied customers. And you still need to deliver on your mission to contribute to the health and well-being of patients (which is why you got into this business, anyway).

Physicians, however, are another story. They now practice in an environment that's radically different from just a few years ago. New discoveries have made the science of disease treatment more complicated and the drugs in the physician's armamentarium more complex. Regulations and payment issues have added more than paperwork to their practice, and keeping up with it takes more and more of their already limited time. Patients walk into their exam room with stacks of articles downloaded from the Internet—some helpful, some misleading, some downright wacky. And they might not be alone—their caregiver is often in the office as well, expecting their fair share of the physician's time. If you ask today's physician what they need, you may hear something like this: "I'm not as comfortable treating many of my patients. I can't always treat their condition the way I'd like to or the way I've been trained to. I don't have the time to sit with each patient, explain their condition and treatment over and over, and correct the misinformation they have found or heard. I need more time. I need more help."

Add to that the fact that the prescriber isn't always the physician anymore. Physician assistants and nurse practitioners continue to grow in influence and bring a whole new set of needs into the equation. Patients have changed as well. They no longer salute the doctor's white coat and do exactly what they are told. They have multiple sources of information, loads of questions, and help from family, friends, and caregivers, and they expect to play a major role in treating their health problems (in spite of their lack of medical training, experience, or credentials). Led by the large, diverse generation of Baby Boomers, today's patients expect more from their physician and healthcare practitioners. They now see themselves as partners in treating their disease. And what do they need?

"I expect to play a role in this process. I can think for myself and don't take everything my doctor says as gospel (because quite frankly, my doctor doesn't give me all that much time). I need to be in control of my body, my situation, my disease."

Doctors are getting more frustrated, patients more assertive, and marketers more challenged. Discomfort and disconnects are everywhere. But so is opportunity...for companies and brands that are willing to embrace and work within this new dynamic in this multidimensional marketplace.

A new set of needs

Our comfort zone is finding and filling the unmet medical needs of patients with new and innovative products—that, we get. But with a shape-shifting market, added influencers, empowered patients, and beleaguered prescribers, how much do we know about the new dynamic that influences the decision to use those new and innovative products?

At a minimum, we know that the relationship between prescribers and patients has changed forever. And addressing that change takes a new approach to your professional brand marketing program.

First, listen to patient conversations in depth. It's not news that patients are on the Internet talking to each other about their conditions, their physicians, and their treatments. They're forming opinions about your brand (based on both accurate and inaccurate influencers) long before they are even written a script. Unless you're listening to patients—using any one of the monitoring tools out there and in-depth research with patients, family members, and caregivers—you're missing out.

Stop thinking about just your brand, think about their practice. The bottom line is that doctors can find your brand's data at the click of a mouse. What they can't find as easily are information and resources to help them communicate about treatment decisions with the patients in their practice. Information to help them combat the misinformation they're often presented with during patient visits. Build that into your brand program and you'll build a renewed fan base.

Go through, not around, the physician to reach the patient. The web, smartphones, and tablets opened up opportunities for brands to talk directly to patients like never before. But we can't forget that the most critical conversation about your brand is the one that happens between the physician and the patient. So don't ignore the physician as a channel to the patient. Programs that go through the physician not only help patients, but contribute to the credibility of both your brand and your company.

Realize that adherence programs are no longer a nice-to-have. You know success doesn't come when the script is written. It's when it's filled, and refilled. Patient adherence can be affected by everything from drug performance to pricing issues to patient habit and behavior. Get programs in place that help patients stay on their medication, and you'll help both patients and the physicians who treat them.

Define the brand's role

Even with all the complexities in today's market, there's still a moment of truth for your brand. The moment at the point of care that happens between the prescriber and the patient. So take a close look at each of the dimensions and influences that impact that moment and decide what your brand can do to help that prescriber help his or her patient.

Al Topin is President of Topin & Associates, and a member of Pharm Exec's Editorial Advisory Board. He can be reached at atopin@topin.com.