December 2006
	Pharmaceutical Marketing Old Wives’ Tales As I have sat back over the course of the last month and examined the trends I am seeing in the pharmaceutical industry, I have been impressed by the extent to which, as described in Malcolm Gladwell’s seminal book, The Tipping Point, important initiatives start in the minds and hands of a few people and grow to the “tipping point” at which juncture they become general practice. Interestingly, by this point many key players have forgotten where the initiative started, what it was designed to accomplish, etc. Therefore, they are left to go through motions consistent with the initiative, without understanding how their actions could be improved upon, when the initiative has become irrelevant or changed to a point where it requires different action. For example, at some point in unrecorded history, the assumption was made that a Pharmaceutical Sales Representative (PSR) spending more time with a physician was better than her or him spending less time. Seems like it makes sense. And as a result, all sorts of machinations, including serving food to the physicians, using computers instead of paper visual aids to deliver the detail presentation and mirrored sales forces, i.e., more than one PSR calling on the same physician to represent a product, have been developed in an effort to lengthen the selling time with physicians. The only problem is that in 2006, as in the waves of the same project conducted in the previous two years, the syndicated GfK Market Measures' Sales Force Effectiveness Study, The Ideal Sales Rep: Identifying How Physicians and Sales Reps Prioritize Key Selling Attributes, found that physicians consistently report that one of the most important elements in their evaluation of a PSR is the extent to which he or she makes good, respectful use of the doctor’s time and presents new information as time-efficiently as possible. Interestingly, the hundreds of physicians across a number of different specialties surveyed understand this perspective, as do PSRs (added to the sample for the first time this year). District Managers (DMs), also added to the sample for the first time this year, and likely those above them in pharmaceutical management from whom a DM receives his or her direction and who are not out there in physicians’ offices every day, continue to cling to the longer-is-better belief. It is a pharmaceutical old wives’ tale that has crossed the tipping point, taken on a life of its own and is extremely hard to derail, even when clear evidence is presented to the contrary. A second example can be found in the notion that physicians can be neatly arrayed on a dimension ranging from early adopters to late adopters of new products. Not true. Some physicians, most typically those comfortable with their own scientific ability to evaluate a new product based on data and other information presented, will be early adopters of genuinely new products that offer significant advantages over former therapies, but will not ever employ a product if their evaluation concludes that it is a me-too agent, i.e., one that offers no advantages over the drugs they have been using. Other doctors, on the other hand, will quickly adopt a product that is similar to ones they are currently using, especially if it is introduced by a representative they like, is manufactured by a company they trust and is launched with a copious supply of samples. Such doctors, however, will often be extremely slow to adopt a genuinely new product, and often heard to say things like “Let other doctors evaluate new products on their patients.” Thus, pharmaceutical marketers should learn to rethink the age-old habit of routinely targeting commercially available lists of early adopters for especially intense promotion when launching a product, asking themselves instead the question, “Early adopters of what?” As a third and final example drawn from the hundreds or even thousands of old wives’ tales requiring reexamination, we can focus broadly on the purpose of pharmaceutical marketing itself. If asked, I believe that most pharmaceutical marketers would respond that the focus of the pharmaceutical marketer should be on getting the company’s product prescribed, preferably as the product of choice. Little attention has been paid by these marketers, at least historically, to the challenge of keeping patients on the medication once prescribed, especially if the drug is designed to treat chronic, asymptomatic and relatively common conditions such as hypertension, hyperlipidemia, etc. As a result, persistence rates with such medications are relatively low, with large numbers of patients spontaneously, i.e., without discussion with their doctors, discontinuing these medications after only a few months of therapy. Most physicians try, with the little time they have available, to encourage patient compliance. Many of them, however, believe that patients’ personalities are the major drivers of persistence or lack thereof, and are therefore somewhat doubtful about doctors’ ability to really make a difference through their interventions. In brief, the old wives’ tale of the pharmaceutical marketer’s job being successfully completed when the initial prescription is written needs to be reevaluated to include assisting the physician, in ways more meaningful than patient newsletters and other tactics currently being employed, in keeping the patient on the drug. In summary, many of the assumptions that currently serve as the foundation for pharmaceutical marketing, and thus of pharmaceutical marketing research, need to be reconsidered at their most fundamental levels by those of us in the industry responsible for these areas of endeavor. Many were never correct to begin with, while others have needed to be changed significantly over time. In fairness, we are starting to see clients become aware of this fact, and as a result they are beginning to conduct in-depth research that explores how things really work, rather than simply and myopically focusing on researching how promotion for Product A can demonstrate its superiority over Product B. Ethnography and similar exploratory research methodologies are proving invaluable here. The bottom line: Research and understand, rather than assume you understand, assumptions that matter in your pharmaceutical marketing and marketing research efforts. Have a great holiday season, and a happy, healthy and successful New Year. Richard B. Vanderveer, Ph.D. Group Chief Executive Officer GfK U.S. Healthcare Companies